Stepped care treatment for eating disorders

Author: Wilson, G.T.; Vitousek, K.M.; Loeb, K.L.

Description: A stepped care approach would link different patient needs to therapeutic modalities that range from simple advice to intensive inpatient care. Brief methods, including self-help and psychoeducation, may be effective for a subset of patients with bulimia nervosa and binge eating disorder. Identifying this subset remains a challenge. It is unclear how patients who fail to respond to evidence-based, first-line treatments should be treated. Given the absence of data on effective treatment of anorexia nervosa (AN), discussion of a stepped care approach is speculative. Because AN typically demands expert and sustained treatment, the lower levels of stepped care models are inapplicable for these patients. A stepped care approach poses methodological challenges for clinical research and raises important clinical issues, such as when to switch from 1 level of treatment to another.

Subject headings: Anorexia Nervosa/therapy; Bulimia/therapy; Cognitive Therapy/methods; Eating Disorders/psychology/therapy; Hospitalization; Humans; Patient Care Planning; Patient Education as Topic; Patient Selection; Psychotherapy, Group/methods; Self-Help Groups; Treatment Failure; United States

Publication year: 2000

Journal or book title: Journal of Consulting and Clinical Psychology

Volume: 68

Issue: 4

Pages: 564-572

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Type: Journal Article

Serial number: 360