Dialectical Behavior Therapy Group for Eating Disorders
Every year, 30 million people in the United States of America suffer from an eating disorder (National Eating Disorder Association, 2014). Due to the complex nature of the disease, eating disorders are notoriously difficult to treat. New research suggests that DBT could provide qualities that other therapies lack. This paper will explore the diagnoses of various eating disorders, components of DBT, and the function of a DBT group in the treatment of eating disorders. Professionals in the field of eating disorders began exploring DBT, which was not previously used for eating disorders, and may have discovered an effective alternative.
Eating Disorders
Eating disorders are a nondiscriminatory disease that takes the lives of millions of people each year. As of 2014, the Diagnostic and Statistical Manual of Mental Disorders 5 (5th ed.; DSM–5; American Psychiatric Association, 2013) changed the criteria for eating disorders and included binge eating disorder as its own category instead of group it as an eating disorder not otherwise specified. The three main eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder and without intervention and proper treatment, individuals suffering from an eating disorder are faced with years of struggling, which may end in death.
Anorexia Nervosa
Popular culture glorifies anorexia as a fad diet or as an idealized body; however, anorexia does not equate to success, it is a deadly disease. In fact, anorexia has the highest mortality rate of any other psychiatric illness (Arcelus, Mitchell, Wales, & Nielsen, 2011). Individuals will go to any extreme in order to lose weight. According to the DSM-5, the foll...
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Palmer, R. L. (2002). Dialectical behaviour therapy for borderline personality disorder. Advances in Psychiatric Treatment, 8, 10-16. doi:10.1192/apt.8.1.10
Safer, D. L., Telch, C. F., & Agras, W. S. (2001). Dialectical behavior therapy for bulimia nervosa. The American Journal of Psychiatry, 158, 632-634. doi:10.1176/appi.ajp.158.4.632
Salbach-Andrae, H., Bohnekamp, I., Pfeiffer, E., Lehmkuhl, U., & Miller, A. L. (2008). Dialectical behavior therapy of anorexia and bulimia nervosa among adolescents: A case series. Cognitive and Behavioral Practice, 15(4), 415-425. doi:http://dx.doi.org.library3.webster.edu/10.1016/j.cbpra.2008.04.001
Telch, C. F., Agras, W. S., & Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 1061-1065. doi:10.1037//0022-006X.69.6.1061
Ever since 1979, the world became introduced to a different type of anorexia disorder called bulimia nervosa by Gerald Russell. In the similar attempt to lose weight like anorexia, bulimia nervosa is characterized by having episodes of binge eating, followed by intense efforts to avoid gaining weight. Some of the methods to avoid gaining the weight can be to induce self-vomiting, and consuming laxatives or diuretics. As a result of Russell studying theses eating disorders, he discovered that approximately 1/100 women in Western societies were affected in 1990 (Palmer, 2014). Ever since bulimia nervosa became a known eating disorder, more people have been able to effectively be diagnosed with it, and more useful information about the disorder
The National Institute of Mental Health: Eating Disorders: Facts About Eating Disorders and the Search for Solutions. Pub No. 01-4901. Accessed Feb. 2002.
In a fourth study, Argas, Linehan, and Telch (2001) adapted DBT skills for the treatment of binge eating disorders. The researchers proposed that the essential problem in binge eating is underdeveloped and insufficient emotional regulation system. The researchers found that the individuals receiving treatment had significantly lower scores than the individuals that were assigned to the wait-list control group. In addition, 89% of the participants stopped binge eating by the end of the treatment. However, six months later, the number of participants that remained abstinence dropped to 56%. One limitation in this study was the sample size. There was a high rate of attrition in both the treatment group and the wait-list group. The study begun with forty-four participates, but at the end of the study only ten participants completed the study.
Bulimia nervosa is an eating disorder with psychological, physiological, developmental, and cultural components. The disorder is commonly characterized by binge eating followed by inappropriate compensatory behaviors, such as self-induced vomiting, excessive exercise, fasting, and the misuse of diuretics, laxatives or enemas. Patients properly diagnosed with bulimia nervosa endure many psychological and physiological problems. In order to alleviate these problems for the patient, usually some type of intervention is required. Considering the financial costs to the patient who seeks treatment, it is important to identify effective and efficient treatment programs. Due to the wide variety of individual patient differences, it would be unwise to proclaim one treatment method as the universal cure for bulimia nervosa. However, identifying what methods work under particular conditions may help therapists tailor an individualized treatment program after a careful assessment of the client. Having this knowledge would potentially save both the client and the therapist a lot of time and frustration; not to mention, the patient would be on the path to recovery sooner. Kaye et al (1999) stress the importance of making progress towards the understanding and treatment of anorexia and bulimia nervosa, in order to generate more specific and effective psychotherapies and pharmacologic interventions.
Each year millions of people in the United States develop serious and often fatal eating disorders. More than ninety percent of those are adolescent and young women. The consequences of eating disorders are often severe--one in ten end in death from either starvation, cardiac arrest, or suicide. Due to the recent awareness of this topic, much time and money has been attributed to eating disorders. Many measures have been taken to discover leading causes and eventual treatment for those suffering from anorexia. (http://www.kidsource.com/kidsource ...er.html#Causes of Eating Disorders) )
Two psychological approaches/perspectives with reference to the critical issues of eating disorders to be discussed are the cognitive and psychodynamic approaches. There are several eating disorders and the most common two of them are Anorexia Nervosa involving the irrational fear of being extensively overweight and Bulimia Nervosa involving periods of binge eating when food is excessively eaten within a two hour period than would normally be eaten in that time. This paper will seek to understand and describe cognitive and psychodynamic approaches whilst also comparing and contrasting the differences between the two.
In conclusion, I believe that this study is very important to the medical and mental health fields because it shows that the standard treatment used currently isn’t the most effective way of treating such disorders. Society and medical professionals should know and no longer assume if someone has an eating disorder it doesn’t mean it was caused by a psychiatric disorder. According to the findings of this study, the treatment should be changed to dealing with the physical signs of an eating disorder. It has high remission rate and a 0% mortality rate, which proves that it is very effective and more studies could be carried out to further prove this hypotheses.
In light of what is going on in the world today, eating disorders seem farfetched and frivolous. Anorexia Nervosa could be considered a classic example of a serious eating disorder as it is defined as having a fatal a...
Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by Marsha M. Linehan for the treatment of complex, difficult-to-treat mental disorders. Originally, DBT was developed to treat individuals diagnosed with borderline personality disorder (BPD; Carson-Wong, Rizvi, & Steffel, 2013; Scheel, 2000). However, DBT has evolved into a treatment for multi-disordered individuals with BPD. In addition, DBT has been adapted for the treatment of other behavioral disorders involving emotional dysregulation, for example, substance abuse, binge eating, and for settings, such as inpatient and partial hospitalization. Dimeff and Linehan (2001) described five functions involved in comprehensive DBT treatment. The first function DBT serves is enhancing behavioral capabilities. Secondly, it improves motivation to change by modifying inhibitions and reinforcement. Third, it assures that new capabilities can be generalize to the natural environment. Fourth, DBT structures the treatment environment in the ways essential to support client and therapist capabilities. Finally, DBT enhances therapist capabilities and motivation to treat clients effectively. In standard DBT, these functions are divided into modes for treatment (Dimeff & Linehan, Dialectical behavior therapy in a nutshell, 2001).
Upon completing this group project it was discovered that both approaches to therapy are valid when it comes to treating and stabilizing individuals with eating disorders. Each approach has its strengths to offer to the therapeutic process, such as, identifying individual needs and equipping the client with the tools to change one 's thought process. For treatment to be effective with eating disorders, it has to address the cognitions or the dysfunctional assumption that has led to the maladaptive self-defeating harmful behaviors. Often individuals with eating disorders use their dysfunctional assumption with the intent to harm others as a form of control or power over others. Using ‘CBT or a person centered approach will help to identify these
The three most commonly known eating disorders of today are anorexia nervosa, bulimia nervosa, and binge eating. Anorexia nervosa is a disease connected with abnormal eating; it is not brought on by excitement, delusions, overactivity or a bad habit, it is a mental illness. Development of anorexia usually starts in the early teenage years, however it can go undiagnosed for thirty to even forty plus years. Another eating disorder is bulimia, people who are bulimic have no time to think about daily life; all that is on there mind is their next meal. Someone who has bulimia often l...
In 1978, Brunch called anorexia nervosa a 'new disease' and noted that the condition seemed to overtake ?the daughters of the well-to-do, educated and successful families.? Today it is acknowledged and accepted that anorexia affects more than just one gender or socio-economic class; however, much of the current research is focused on the female gender. ?Anorexia nervosa is characterized by extreme dieting, intense fear of gaining weight, and obsessive exercising. The weight loss eventually produces a variety of physical symptoms associated with starvation: sleep disturbance, cessation of menstruation, insensitivity to pain, loss of hair on the head, low blood pressure, a variety of cardiovascular problems and reduced body temperature. Between 10% and 15% of anorexics literally starve themselves to death; others die because of some type of cardiovascular dysfunction (Bee and Boyd, 2001).?
Anorexic: this word is an adjective, a label, and to some, a lifestyle. Medically speaking, it is someone who suffers from the deadly and heartbreaking disease, Anorexia Nervosa. This term translates to “nervous loss of appetite”, but anyone who has battled through this sickness is aware how that is anything but true. Eating disorder patients do not, in fact, lose their appetite; there is more to it than that. Many perceive eating disorders as a choice to be thin, a diet, or a cry for attention; they do not see the mental destruction going on inside of the mind. Eating disorders have the highest mortality rate of any mental illness, yet only 30% of people fully recover (ANAD). The general mindset that society has about eating disorders walks hand in hand with these statistics, slowing down any advances patients may be able to make. Eating disorder patients are not getting proper treatment because of ignorant misconceptions about the illness.
Shapiro, C. M. (2012). Eating disorders: Causes, diagnosis, and treatments [Ebrary version]. Retrieved from http://libproxy.utdallas.edu/login?url=http://site.ebrary.com/lib/utdallas/Doc?id=10683384&ppg=3
Anorexia nervosa and Bulimia nervosa are described as psychological eating disorders (Keel and Levitt, 1). They are both characterized by an over evaluation of weight. Despite being primarily eating disorders, the manifestations of bulimia and anorexia are different. They both present a very conspicuous example of dangerous psychological disorders, as according to the South Carolina Department of Health, “Eating disorders have the highest mortality rate of any mental illness” (Eating Order Statistics, 1). While Bulimia and anorexia both psychological disorders primarily prevalent in women, anorexia tend to have different diagnostic complexities, symptoms and physiological effects as compared to bulimia.