4.3 Article

A Randomized Controlled Two-Stage Trial in the Treatment of Bulimia Nervosa, Comparing CBT Versus Motivational Enhancement in Phase 1 Followed by Group Versus Individual CBT in Phase 2

Journal

PSYCHOSOMATIC MEDICINE
Volume 72, Issue 7, Pages 656-663

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PSY.0b013e3181ec5373

Keywords

bulimia nervosa; group cognitive-behavioral therapy; motivational enhancement therapy; randomized controlled trial

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Objective: To conduct a randomized, controlled, two-stage trial in the treatment of bulimia nervosa, comparing cognitive-behavioral therapy (CBT) versus motivational enhancement in Phase 1 followed by group versus individual CBT in Phase 2. Methods: A total of 225 patients with bulimia nervosa or eating disorder not otherwise specified (EDNOS) were recruited into a randomized controlled trial lasting 12 weeks with follow-ups at 1 year and 2.5 years. Results: Patients improved significantly across all of the interventions with no differences in outcome or treatment adherence. Including motivational enhancement therapy rather than a CBT first phase of treatment did not affect outcome. Conclusions: Outcome differences between individual and group CBT were minor, suggesting that group treatment prefaced by a short individual intervention may be a cost-effective alternative to purely individual treatment.

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