Experiences of enhanced cognitive behaviour therapy for Bulimia Nervosa

Background: Recent quantitative studies provide support for an “enhanced” transdiagnostic approach of Cognitive Behaviour Therapy (CBT-E) for eating disorders; however it is not yet known how recipients of CBT-E experience therapy. Aims: The current study used a qualitative approach to explore service users’ experiences of CBT-E. Method: Individuals with a diagnosis of bulimia nervosa and who had completed CBT-E from one service in Wales were invited to participate. Semi-structured interviews were completed with eight individuals and analysed using Interpretative Phenomenological Analysis (IPA). Results: Participants valued both specific and non-specific elements of CBT-E. Therapist specialism in eating disorders was considered to enhance therapist empathy. The most helpful aspects specific to CBT-E were gaining insight into maintenance cycles and experiential learning. The most challenging aspects of CBT-E were changing behaviours and cognitions “in the moment” and in the longer-term. Conclusions: The implication of therapist specialism and empathy is further discussed, as well as the difficulty for CBT-E in changing service users’ long-standing core beliefs