This feature by Lucene Wisniewski is the first part in a two-part series about applying DBT to the treatment of eating disorders. In part 1, Lucene addresses some of the existing literature and basic concepts for the application of DBT to eating disorders.
Eating Disorders and DBT
As a field, we have been interested in applying DBT to the treatment of eating disorders (EDs) for about the past 20 years, with the first writings on the topic appearing in the literature in the late 90’s.
The rationale for applying DBT to the treatment of EDs centers around two basic concepts: 1. Current, evidence-based treatments for EDs (e.g., cognitive behavioral or interpersonal psychotherapy) are not wholly effective for all patients and 2. DBT’s treatment of EDs is based in an affect-regulation model, which addresses ED symptoms differently than the aforementioned approaches.
The field has been slowly accruing research and clinical papers on the application of DBT to EDs, and the interested reader should be aware of a special series that in early 2020 will be published in Eating Disorders, the Journal of Treatment and Prevention. This special series, co-edited by BTECH trainers Drs. Lucene Wisniewski & Leslie Anderson along with Dr.Tiffany Brown will include articles written by experts from all over the world! It will include papers summarizing the most up to date data on DBT’s effectiveness with adult and adolescent EDs as well as recommendations for which DBT for ED to use with which ED diagnosis.
This latter part is important given that as it is not likely a surprise to you that the treatment for Binge Eating might be different than the treatment for Anorexia Nervosa which also might be different from the treatment for individuals who suffer from EDs that cooccur with other psychiatric conditions.
The significant results from the reviewed studies are encouraging and support further research for the use of DBT with individuals who suffer from EDs. The findings suggest that DBT, if adapted correctly, could serve as a powerful treatment for clients with eating disorders, especially those who have traditionally been difficult-to-treat or who have been previously unresponsive to the more standard treatment approaches. Please, if you are treating eating disorder cases using DBT: collect data! we need to better understand and refine the treatment for this population.
Read here for part 2, in which Lucene shares advice for clinicians and insight on when it is appropriate to use DBT with clients diagnosed with an eating disorder.
Lucene Wisniewski, PhD, FAED, is the owner and founder of Lucene Wisniewski, PhD, LLC, and DBTOHIO, as well as an Adjunct Assistant Professor of Psychological Sciences at Case Western Reserve University. From 2006-2014, she served as Clinical Director and co-founder of the Cleveland Center for Eating Disorders, a comprehensive eating disorder treatment program offering evidenced based care. Read her full biography here.