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Investigating the Use of CD-Rom CBT for Bulimia Nervosa and Binge Eating Disorder in an NHS Adult Outpatient Eating Disorders Service

Published online by Cambridge University Press:  05 January 2011

Lisa Graham*
Affiliation:
Lancashire Care NHS Foundation Trust, Chorley, UK
Mark Walton
Affiliation:
Lancashire Care NHS Foundation Trust, Chorley, UK
*
Reprint requests to Lisa Graham, East Lancashire Eating Disorders Service, Eating Disorders Managed Clinical Network, Lancashire Care NHS Foundation Trust, NHS Eating Disorders Service, 18 Euxton Lane, Chorley PR71PS, UK. E-mail: lisa.graham@lancashirecare.nhs.uk

Abstract

Background: Many patients who experience bulimia nervosa (BN) and binge eating disorder (BED) find it hard to access evidence-based treatments. Rates of failure to enter outpatient services following initial assessment are high, as are dropout rates from specialist outpatient eating disorders services. Aims: To offer CD-Rom CBT, a cognitive-behavioural multi-media supported self-help treatment, in a locality-based outpatient NHS Eating Disorders Service to patients who have binge eating disorder and bulimia nervosa. Method: Patients referred to a catchment-based NHS outpatient eating disorders service who were assessed and had an eating disorder with a binge-eating component were offered CD-Rom based CBT (Overcoming Bulimia) whilst on the waiting list for individual CBT. Results: Forty patients completed the 8 sessions and attended the evaluation appointment (13 had BN, 27 had BED). For both groups, there were significant improvements in well-being and functioning, as well as significant reductions in problems and risk. There was also a significant reduction on the “Bulimic Subscale” of the EDI. These results were comparable with the original study findings (Schmidt, Treasure and Williams, 2001). Dropouts from the CD-Rom reflected rates common to other EDS treatments suggesting that CD-Rom did not directly impact upon service dropout rates. Conclusions: Computer assisted CBT for Eating Disorders offers a promising, feasible and acceptable first step for patients who have bulimia nervosa or binge eating disorder and access treatment from specialist eating disorders services.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

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References

Bara-Carril, N., Williams, C. J., Pombo-Carril, M. G., Reid, Y., Murray, K., Aubin, S., Harkin, P. J. R., Treasure, J. and Schmidt, U. (2004). A preliminary investigation into the feasibility and efficacy of a CD-ROM-based cognitive-behavioural self-help intervention for bulimia nervosa. International Journal of Eating Disorders, 35, 538548.CrossRefGoogle Scholar
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology, Qualitative Research in Psychology, 3, 77101.Google Scholar
Burney, J. and Irwin, H. J. (2000). Shame and guilt in women with eating disorder symptomatology. Journal of Clinical Psychology, 56, 5161.Google Scholar
Carrard, I., Rouget, P., Fernandes-Aranda, F., Volkart, A. C., Damoiseau, M. and Lam, T. (2006). Evaluation and deployment of evidence based patient self-management support program for Bulimia Nervosa. International Journal of Medical Informatics, 75, 101109.CrossRefGoogle ScholarPubMed
Carter, J. (2002). Self help books in the treatment of eating disorders. In Fairburn, C. G. and Brownell, K. (Eds.), Eating Disorders and Obesity. a comprehensive handbook (2nd ed., pp. 358361). New York: Guilford Press.Google Scholar
Coker, S., Vise, C., Wade, T. and Cooper, P. J. (1993). Patients with bulimia nervosa who fail to engage in cognitive behaviour therapy. International Journal of Eating Disorders, 13, 3540.3.0.CO;2-N>CrossRefGoogle Scholar
Core System Group (1998). CORE System. Leeds: Core System Group.Google Scholar
Fairburn, C. G., Marcus, M. D. and Wilson, G. T. (1993). Cognitive behavioural therapy for binge eating and bulimia nervosa: a comprehensive treatment manual. In Fairburn, C. G. and Wilson, G. T. (Eds.), Binge Eating: nature, assessment, and treatment (pp. 361404). New York: Guilford Press.Google Scholar
Fairburn, C. G., Cooper, Z. and Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a transdiagnostic theory and treatment. Behaviour Research and Therapy, 41, 509528.Google Scholar
Fairburn, C. G., Cooper, Z., Doll, H. A., Hawker, D. M., Wales, J. A. and Palmer, R. L. (2009). Transdiagnostic cognitive behavioural therapy for patients with eating disorders: a two site trial with 60-week follow-up. American Journal of Psychiatry, 166, 311319.CrossRefGoogle ScholarPubMed
Garner, D. M. (2004). The Eating Disorder Inventory – 3. Florida, USA: Psychological Assessment Resources, Inc.Google Scholar
Hoek, H. W. and van Hoeken, D. (2003). Review of the prevalence and incidence of eating disorders. International Journal of Eating Disorders, 34, 383396.CrossRefGoogle ScholarPubMed
Jacobs-Pilipski, C., Wilfley, D. E., Crow, S. J., Walsh, B. T., Lilenfeld, L. R., West, D. S., Berkowitz, R. I., Hudson, J. I. and Fairburn, C. G. (2007). Placebo response in binge-eating disorder. International Journal of Eating Disorders, 40, 204211.Google Scholar
Kordy, H., Richard, M., Herrmann, A., Murphy, F., Treasure, J. and Charpentier, P. (1999). A computer assisted eating disorder specific quality management system: EQUAL-TREAT. European Eating Disorders Review, 7, 239258.3.0.CO;2-N>CrossRefGoogle Scholar
Lewis, G., Anderson, L., Araya, R., Elgie, R., Harrison, G., Proudfoot, J., Schmidt, U., Sharp, D. and Williams, C. (2003). Self-Help Interventions for Mental Health Problems. Expert Paper for Department of Health.Google Scholar
Larsen, D. L., Attkinson, C. C., Hargreaves, W. A. and Nguyen, T. D. (1979). Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning, 2, 197207.CrossRefGoogle ScholarPubMed
Munro, C., Sanchez-Ortis, V. C., Stahl, D., House, J., Startup, H., Treasure, J., Williams, C. and Schmidt, U. (2008). A Randomised Controlled Trial of Internet-based CBT for Bulimia Nervosa in a Student Population: identifying and treating the “iceberg” of unmet need. Academy of Eating Disorders Annual Conference, Seattle, USA.Google Scholar
Murray, K., Schmidt, U., Pombo-Carril, M. G., Grover, M., Treasure, J. and Williams, C. (2007). Does therapist guidance improve uptake, adherence and outcome from a CD-Rom based cognitive behavioural intervention for the treatment of bulimia nervosa? Computers in Human Behaviour, 23, 850859.CrossRefGoogle Scholar
National Institute of Clinical Excellence (2004). Eating Disorders: core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. Clinical Guideline 9. London: The British Psychological Society and Gaskell.Google Scholar
Oliver, M. I., Pearson, N., Coe, N. and Gunnell, D. (2005). Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. British Journal of Psychiatry, 186, 297301.CrossRefGoogle ScholarPubMed
Pretorius, N., Arcelus, J., Beecham, J., Dawson, H., Doherty, F., Eisler, I., Gallagher, C. and Schmidt, U. (2009). Cognitive-behavioural therapy for adolescents with bulimic symptomatology: the acceptability and effectiveness of internet-based delivery. Behaviour Research and Therapy, 47, 729736.Google Scholar
Reas, D. L., Williamson, D. A., Martin, C. K. and Zucker, N. L. (2000). Duration of illness predicts outcome for bulimia nervosa: a long-term follow-up study. International Journal of Eating Disorders, 27, 428434.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists (2003). The Mental Health of Students in Higher Education. CR112.Google Scholar
Sanchez-Ortis, V. C., Munro, C., Stahl, D., House, J., Startup, H., Treasure, J., Williams, C., and Schmidt, U. (2010). A randomised controlled trial of internet-based Cognitive Behavioural Therapy for Bulimia Nervosa or related disorders in a student populations. Psychological Medicine. doi:10.1017/S0033291710000711.Google Scholar
Schmidt, U. and Treasure, J. (1993). Getting Better Bit(e) by Bit(e): a survival guide for sufferers of bulimia nervosa and binge eating disorders. Hove, UK: Psychology Press.Google Scholar
Schmidt, U., Treasure, J. and Williams, C. (2001). CD-Rom Based Treatment for Bulimia Nervosa Reduced Binge Eating and Use of Laxatives. Available at the Royal College of Psychiatrists: Press and Parliament at: http://www.rcpsych.ac.uk/pressparliament/pressreleasearchive/pr224.aspxGoogle Scholar
Schmidt, U., Andiappan, M., Grover, M., Robinson, S., Perkins, S. and Dugmore, O. (2008). A randomised controlled trial of the effectiveness of CD-Rom based cognitive behavioural self-care intervention for bulimia nervosa. British Journal of Psychiatry, 193, 493500.CrossRefGoogle ScholarPubMed
Shapiro, J. R., Reba-Harrelson, L., Dymek-Valentine, M., Woolson, S. L., Hamer, R. M. and Bulik, C. M. (2007). Bulimia nervosa treatment: a systematic review of randomised controlled trials. International Journal of Eating Disorders, 40, 321336.CrossRefGoogle Scholar
Simon, J., Schmidt, U. and Pilling, S. (2005). The health service use and cost of eating disorders. Psychological Medicine, 35, 15431551.Google Scholar
SPSS-10 for Windows. SPSS: San Diego, CA.Google Scholar
Turnbull, S., Ward, A., Treasure, J., Jick, H. and Derby, L. (1996). The demand for eating disorder care: a study using the general practice research data base. British Journal of Psychiatry, 169, 705712.Google Scholar
Waller, G., Schmidt, U., Treasure, J., Murray, K., Aleyna, J., Emanuelli, F., Crockett, J. and Yeomans, M. (2009). Problems across care pathways in specialist adult eating disorders services. Psychiatric Bulletin, 33, 2629.CrossRefGoogle Scholar
Waller, R. and Gilbody, S. (2009). Barriers to the uptake of computerised cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence. Psychological Medicine, 39, 705712.Google Scholar
Williams, C. J., Aubin, S. D., Cottrell, D. and Harkin, P. J. R. (1998). Overcoming Bulimia: a self-help package. Leeds, UK: University of Leeds Press.Google Scholar
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