I know what you did last summer (and it was not CBT): a factor analytic model of international psychotherapeutic practice in the eating disorders

Abstract

Objective: Although several studies have shown that eating disorders clinicians do not generally use treatment manuals, findings regarding what they do use have typically been vague, or closely linked to a particular theoretical approach. Our goal was to identify what eating disorder clinicians do with their patients in a more theoretically neutral context. We also sought to describe an empirically defined approach to psychotherapeutic practice as defined by clinicians via factor analysis.

Method: A survey developed for this study was administered to 265 clinicians recruited online and at regional and international meetings for eating disorders professionals.

Results: Only 6% of respondents reported they adhered closely to treatment manuals and 98% of the respondents indicated they used both behavioral and dynamically informed interventions. Factor analysis of clinicians' use of 32 therapeutic strategies suggested seven dimensions: Psychodynamic Interventions, Coping Skills Training, Family History, CBT, Contracts, Therapist Disclosure, and Patient Feelings.

Conclusion: The findings of this study suggest that most clinicians use a wide array of eating disorder treatment interventions drawn from empirically supported treatments, such as CBT-BN, and from treatments that have no randomized controlled trial support. Factor analysis suggested theoretically linked dimensions of treatment, but also dimensions that are common across models.