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Introduction

Cognitive behavioral therapy is a treatment used for patients with eating disorder cases. Bulimia being an eating disorder, I considered CBT as an excellent treatment for the disorder. In this article I will briefly explain why CBT is an excellent choice for the treatment. The arguments are supported by findings from peer reviewed articles which show results of how effectively CBT works.

Cognitive Behavioral Therapy (CBT)

As pointed above, cognitive behavioral therapy (CBT) is a treatment meant for disorder cases. The method makes use of a variety of methods to bring about a change in the patient. CBT can be viewed as group of therapies for it constitutes of the following therapies "Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy" (Pucci 2007, p. 1). By the fact that CBT constitutes groups of therapies is an advantage in that the best therapy that fits an individual case can be applied. Evidence has shown that CBT is an efficacious treatment for bulimic patients and that CBT is an evidence-based treatment although many issues still remain elusive. One such issue is whether CBT's action is well understood by researchers (Garner D. M. and Garfinkel P. E. 1997).

CBT for bulimia works by concentrating on both the cognitive distortions and the behavioral abnormalities of bulimic patients. That is to say CBT's main aim is to reduce the symptoms associated with binging and purging and then restructure the patient for his/her abnormal attitudes on both the weight and shape (Wilson and Fairburn, 1993).  From this perspective, bulimia nervosa is maintained by the inability to cope with negative thoughts about one's weight and shape. This in turn results into binging and purging behaviors which are the symptoms of this mental disease (Trumpeter J. 2006).

The treatment of this BN has involves three stages with 19-20 therapy sessions.

Stage one focuses 8 sessions of CBT treatment which consists of psycho-education, self-monitoring, thought restructuring, relapse prevention. Stage two involves highlighting of cognitive distortions that the patients usually have towards their body weight and shape and behaviors resulting from dysfunctional schemas. These are the individualized assessment of cues for binging and purging. Treatment involves therapist-assisted exposure and prevention of the targeted response. Stage three especially concentrates on maintenance of change and also relapse prevention strategies. Progress is usually exemplified by meaningful discussions in therapy sessions and through assessments like testing on the eating disorder examinations. 

Research has been done comparing the efficacy of CBT on bulimia nervosa and other forms of therapy. Suggestions that CBT is superior to others in decreasing symptoms of bulimic patients have been made severally, by Thackwray et al., 1993. The authors argue that pure behavioral interventions cannot fully lead to abstinence of binging and purging but proposes that CBT's focus on the patients' belief system is essential to treatment of CBT. The research by these authors compared CBT and BT with both behavioral and psychological outcomes. The authors show that the findings suggested that CBT reduced behavioral and psychological symptoms than BT (Trumpeter J. 2006).

Findings which show results of how effectively CBT works. The following are the outcome of a CBT and exposure with response prevention for bulimia nervosa. Bulimia nervosa can be treated for a short-term. Few data exists which examines long-term outcome for bulimia nervosa following CBT and exposure with response intervention (Mcintosh V. V. W. et al., 2011).

Method

The method used was random sampling where a group of 135 women with the disorder (purging bulimia nervosa) were randomly assigned to either RELAX (relaxation training) or one of the two ERP treatments which included the pre-Binge or the pre-Purge. Participants were then assessed yearly after treatments and follow-up data was then taken. The first assessment was after 6 months, then on a yearly basis for 5 years (Mcintosh V. V. W. et al., 2011).

Results

Out of the 135 women who took part in the treatment, 81 percent of them attended long-term follow-ups. After the elapse of 5-years, abstinence rates from binging were higher as compared to the two exposure treatments at 43 percent and 54 percent relatively than that of relaxation at 27 percent. As can be seen the difference between the two forms of exposure was small. After the 5 years, purging frequency was lower for the exposure treatments than for the relaxation training, while the rates of recovery varied widely depending on the definition of recovery. When recovery continued after 5 years, 83 percent of the patients no longer met DSM-III-R criteria for bulimia nervosa. A further 65 percent of the patients received no eating disorder diagnosis while a small percent of 36 were abstinent from bulimic behaviors in that last year after the 5 years (Mcintosh V. V. W. et al., 2011).  

Conclusions

Cognitive behavioral therapy is a treatment used for patients with eating disorder cases. The method makes use of a variety of methods to bring about a change in the patient. Evidence has shown that CBT is an efficacious treatment for bulimic patients This study above provides the arguments and possible evidence that a conditioned inoculation from exposure treatment as when compared with relaxation training.

This is especially effective in long-term binge eating at 5 years and a purging frequency over the same time and not for the other features of bulimia nervosa. Within a period of 5 years, differences among the group were not found. CBT is thus effective for bulimia treatment although a substantial group of patients remain not treated fully in the long-term. The recovery definition also impacted markedly on the recovery rates.

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