Cognitive therapy for bulimia nervosa: An A-B replication series

Objective: To investigate whether a new treatment for bulimia nervosa (BN) works, and to examine its effects on key cognitions and behaviours hypothesized to be important in the underlying model. Method: An A-B single-case series with follow-up was conducted. Treatment was based on a specific model of BN. It consisted of individualized formulation, enhancing motivation for change, cognitive restructuring of specific cognitions, behavioural experiments and targeting particular underlying assumptions and negative self-beliefs. Relapse prevention was also addressed. Results: All treatment completers did extremely well and no longer met Diagnostic and Statistical Manual of Mental Disorders, 4th edition revised (DSM-IV) criteria for bulimia nervosa. Two were entirely symptom-free at the end of treatment and at follow-up. The third experienced only very occasional binge eating and vomiting. Individual scores on self-report symptom measures and on all measures of cognition indicated a return to normative levels. Discussion: Treatment focusing on specific cognitive change is a promising intervention for BN. Further work might usefully evaluate this treatment in a larger study. Copyright © 2007 John Wiley & Sons, Ltd.