Did they just take the F out of FBT

A recent, and important article has just been published in the Journal of the American Academy of Child and Adolescent Psychiatry by Le Grange et al. The paper is the results of a Randomised Controlled Trial of Family Based Treatment (FBT) and Parent Focused Treatment (PFT) done at Royal Childrens’ Hospital in Melbourne. FBT is probably well known to most in the field. PFT is a variant of FBT which is very interesting. There is a manual available and an outline in the book Family Therapy for Adolescent Eating and Weight Disorders edited by Loeb, le Grange & Lock.  In PFT the adolescent only has a brief session with [...]

Self Compassion in Eating Disorders: Science or Fluffy Bunnies?

Self compassion is one of the pretty trendy topics in eating disorders.  It is becoming part of many therapist treatment packages despite it not being in any of the evidenced based treatment programs.  In fact,  strident evidence based practitioners, such as Glenn Waller warn against the incorporation of self compassion as an indication of therapist drift.  It is seen as somewhat the realm of fluffy bunnies rather than having a scientific base. I wonder if that is fair. Self-compassion is a multi-dimensional construct based on the recognition that suffering, failure, and inadequacy are part of the human condition, and that all people—oneself included—are worthy of compassion. It [...]

The Eating Disorder Voice

Almost all my patients talk to me of the “voice” that they hear. The (usually) harsh and critical voice that talk, shouts and cajoles all the time.  Sometimes it is reported as a friend, sometimes more like a dictator. Patients often feel scared and trapped by this voice, compelled to do what it says in an effort to silence it.  Often the voice feels more powerful than the person. What is the relationship between the anorexic voice and anorexic symptoms. In a paper that I was involved with we (Scott, Haystack & Thornton, 2014) found that the voice played a role as an “abuser” and also an “ascetic voice” [...]

What to do when the ‘evidence based treatments’ are not successful?

What to do when the ‘evidence based treatments’ are not successful? One of the big questions in the field is what should you do if an evidence based treatment is not successful. If we look at binge eating as a behaviour, and thus covering the diagnosis of bulimia nervosa (BN) and binge eating disorder (BED), then the “treatment of choice” would be Cognitive Behavioural Therapy (CBT). Yet we know that not all people recover using CBT and some relapse after treatment ends. It has been suggested that an ‘additive’ design, where other therapy protocols are added onto the treatment of choice, may be useful to examine. McIntosh [...]

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