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HOW TO MAKE A MESS OF COGNITIVE-BEHAVIOURAL THERAPY FOR THE EATING DISORDERS: IMPROVING DELIVERY AND OUTCOMES BY STICKING TO OUR PRINCIPLES Princess Hotel Room: Princess 1/2 Although the eating disorders are difficult to treat, individual cognitive behaviour therapy (CBT) has the best outcome among adults. However, the results are mixed. While we are used to considering how patients fail to engage in CBT effectively, it is also important to understand that clinicians also act in ways that impair the effectiveness of this approach. Each of these behaviours on the part of the clinician is understandable, but they reflect safety behaviours on our part and can be counter-therapeutic. If we want to maintain our ability to help the patient to change, then we need constantly to remind ourselves of the common traps that can inhibit such change, and the need to avoid therapist ‘drift’. Glenn Waller, DPhil, is a consultant clinical psychologist with the Central and North West London Eating Disorders Service, and is a Professor of Psychology at the Institute of Psychiatry, King’s College London. His research and clinical work focus on the psychopathology and treatment of the eating disorders. Key References:
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