How to Handle Slip-Ups During CBT-E
HOW TO HANDLE SLIP-UPS DURING CBT-E
Slip-ups, or relapses, are common during treatment for eating disorders, and should be treated as a normal part of the process of recovery.
What is CBT-E? How is CBT-E used for Eating Disorders?
CBT-E is a form of cognitive behavioral therapy that addresses the pathology of eating disorders. Some of the identifiable treatment processes of CBT-E include:
20 sessions over 20 weeks for those who have a BMI of over 17.5.
40 sessions over 40 weeks for those who have a BMI under 17.5. (17.5 is a commonly used threshold for anorexia nervosa).
Uses specific therapeutic interventions to address behavioral and cognitive changes.
Finds the key points of eating disorders to diminish the pathology
Focuses on behaviors driving cognitive processes vs the other way around
Often starts with an evaluation interview
Utilizes stages to help the patient ease into treatment
Stages of CBT-E
Stage 1: Stage one of treatment is meant to ease the client into the therapy. The focus of stage one is on collaborative understanding of the client’s case, psycho-education, and introducing and beginning to implement methods (like self-monitoring) that help the client as the treatment progresses. The importance of this stage is creating motivation in the client to continue with treatment.
Stage 2: Stage two is a brief stage lasting about two weeks that focuses on reviewing progress, celebrating wins, and reviewing areas of improvement. This is the time in which the treatment plan is discussed and changed if need be.
Stage 3: The main part of treatment, which focuses on the client’s self-image, distorted thoughts, feelings of rigidity and control, and implements behavioral and cognitive changes. This stage often lasts around eight weeks.
Stage 4: Composed of transitioning the client to home, or outpatient care, where they can continue to practice the skills learned during treatment. A check back occurs around week 20.
Minimizing Relapse in Eating Disorder Therapy:
It’s important to recognize that relapses are natural, as we said before. It’s not about “if” they occur. They will occur. Catching them early and applying intervention and methods learned in therapy to them will keep them from becoming more permanent. When you have a lapse, address it using the interventions and skills you learned during treatment.
Hope and Relapsing:
It’s important to maintain hope during a relapse. Remember that a relapse is normal, and that it will occur, and that you can treat it with diminished energy, choosing instead to focus on recovering from the relapse as quickly as possible. A relapse is not failure. It’s a normal step in the recovery process that occurs for almost everyone. A relapse is simply a small data point, nothing more, nothing less. It does not say anything about you as a person, except that you are having a normal experience as part of your recovery. Quick intervention on your part, performed with self-love and hope, can keep it from spiraling into something greater. Stay calm, and use the methods you have learned or are learning in treatment.