"Enhanced" Cognitive Behavioural Therapy (CBT-E)

What is CBT-E?

CBT-E is an "enhanced" form of cognitive behavioural therapy, developed specifically for treating eating disorders.

CBT-E is based on the theory that most eating disorders stem from overvalued beliefs about shape, weight and eating. In other words, eating disorders tend to develop because an individual invests much of their self-worth in controlling their eating and weight. CBT-E is also based on the idea that eating disorders are maintained by similar issues including low self-esteem, body image problems, perfectionism or difficulties managing intense emotions.

CBT-E is divided into four stages. Stage one of treatment is focused on improving the symptoms of an eating disorder as quickly as possible. Stage two involves an in-depth review of treatment and deciding a focus for the remainder of therapy (for example, improving body image and/or low self-esteem). These issues are addressed in stage three. The final stage of treatment focuses on ensuring that eating difficulties do not return in the future ("relapse prevention").

CBT-E is usually provided over 20 sessions. For clients who are significantly underweight, therapy is likely to be longer (around 40 sessions).

What does CBT-E help with, and does it work?

CBT-E is used to treat eating disorders including anorexia nervosa, bulimia nervosa, and binge-eating disorder. Research indicates that it is a highly effective treatment which has long-lasting benefits.

How does CBT-E differ from traditional CBT?

Although CBT-E is very similar to CBT, there are some important differences, including:

  • Therapy sessions are usually provided twice per week at the start of treatment. This helps ensure that the problematic symptoms of an eating disorder (for example, episodes of binge-eating) improve as quickly as possible.
  • Treatment progresses through a series of specific stages which are described above.
  • Each stage of therapy has a specific focus which is decided upon by you and your therapist. These may include (but are not limited to) building motivation to change, improving patterns of eating, developing new ways to manage emotions, improving self-esteem, and developing a more accepting relationship with your body.