Treating Bulimia Nervosa with Cognitive-Behavioral Therapy and Interpersonal Psychotherapy
Conclusion and Implications for Future Research
Research suggests that interpersonal psychotherapy achieves comparable effects to cognitive -behavioral therapy for the treatment of bulimia nervosa in young women. However, further investigation is needed to explore whether certain types of patients respond preferentially to IPT compared to CBT. The role of certain patient characteristics such as self esteem, motivation to change, and expectations for change in mediating treatment outcomes needs to be explored. This is significant in enhancing the efficacy and efficiency of each treatment by tailoring it to individual needs and characteristics.
Moreover, although CBT has been identified as the leading treatment for bulimia nervosa in young women and IPT has been shown to have comparable effects (albeit achieving improvements more slowly), both treatment modalities have significant limitations. In some cases, only about 50% of patients abstain from binge eating and purging. Therefore, additional research is necessary to enhance both treatments as well as to explore different treatment strategies for those patients who derive little or no benefit from CBT or IPT.Additionally, the finding that IPT is slower than CBT in achieving its therapeutic effects despite providing good long term maintenance of change necessitates further research on increasing its utility. For instance, it could be the case that IPT was slower than CBT in engendering its effects because of how the treatment was implemented. In particular, IPT for bulimia nervosa has been implemented in a manner that avoids any overlap with the application of CBT (for instance IPT disregards the interaction of interpersonal problems with the symptoms of bulimia nervosa).
This is a noticeable departure from the original application of IPT for the treatment of depression which placed significant emphasis on the interaction between the symptoms of the disorder and the interpersonal context (Klerman et al., 1984).Therefore, future research on IPT should focus on examining the interaction between interpersonal problems and the core characteristics of bulimia nervosa (such as eating patterns, and attitudes about weight and shape). These adaptations in the implementation and content of IPT may potentially enhance its efficacy and efficiency in treating bulimia nervosa in young women.
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