To deliver or not to deliver cognitive behavioral therapy for eating disorders: Replication and extension of our understanding of why therapists fail to do what they should do

DOI

Objective: This study investigated the extent to which therapists fail to apply empirically supported treatments in a sample of clinicians in The Netherlands, delivering cognitive behavioral therapy for eating disorders (CBT-ED). It aimed to replicate previous findings, and to extend them by examining other potential intra-individual factors associated with the level of (non-)use of core CBT-ED techniques. Method: Participants were 139 clinicians (127 women; mean age 41.4 years, range=24–64) who completed an online survey about the level of use of specific techniques, their beliefs (e.g., about the importance of the alliance and use of pretreatment motivational techniques), anxiety (Intolerance of Uncertainty Scale), and personality (Ten Item Personality Inventory). Results: Despite some differences with Waller’s (2012) findings, the present results continue to indicate that therapists are not reliably delivering the CBT-ED techniques that would be expected to provide the best treatment to their patients. This ‘non-delivery’ appears to be related to clinician anxiety, temporal factors, and clinicians' beliefs about the power of the therapeutic alliance in driving therapy outcomes. Discussion: Improving treatment delivery will involve working with clinicians’ levels of anxiety, clarifying the lack of benefit of pre-therapy motivational enhancement work, and reminding clinicians that the therapeutic alliance is enhanced by behavioral change in CBT-ED, rather than the other way around.

Identifier
DOI https://doi.org/10.34894/3SPCPE
Related Identifier https://doi.org/10.1016/j.brat.2018.05.004
Metadata Access https://dataverse.nl/oai?verb=GetRecord&metadataPrefix=oai_datacite&identifier=doi:10.34894/3SPCPE
Provenance
Creator Mulkens, Sandra ORCID logo; Vos, Chloé de; Graaff, Anastacia de; Waller, Glenn ORCID logo
Publisher DataverseNL
Contributor Mulkens, Sandra; faculty data manager FPN
Publication Year 2018
Rights info:eu-repo/semantics/restrictedAccess
OpenAccess false
Contact Mulkens, Sandra (Maastricht University); faculty data manager FPN (Maastricht University)
Representation
Resource Type Dataset
Format application/x-spss-sav
Size 407513
Version 1.0
Discipline Agriculture, Forestry, Horticulture, Aquaculture; Agriculture, Forestry, Horticulture, Aquaculture and Veterinary Medicine; Life Sciences; Social Sciences; Social and Behavioural Sciences; Soil Sciences