Coping Strategies Therapy for Bulimia Nervosa

by David L., Ed. Tobin and David L. Tobin

Bulimia nervosa can evidence itself in a vast array of comorbid symptoms, often overwhelming both the patient's ability to cope and managed care's willingness to pay. This manual provides an effective, integrated treatment approach for working with clients struggling with bulimia nervosa in today's managed care environment.

• Format: Hardcover
• Language: English
• ISBN: 155798638X
• ISBN13: 9781557986382
• Release Date: January 2000
• Publisher: American Psychological Association (APA)
• Length: 249 Pages
• Weight: 1.72 lbs.
• Dimensions: 0.9" x 7.4" x 10.3"

Customer Reviews

An integrative approach for the treatment of BN

In coping strategies therapy (CST) for bulimia nervosa, the author brings together a range of models and theoretical assumptions (transtheoretical model, dose-effect theory and coping theory) that result in an interesting framework with the ambition of integrating these different strategies and approaches into a broad and effective treatment. The empirical evidence for these models and theories, as well as their application to BN is described in chapter one. The book is organized into two parts. In part one (comprising 3 chapters), the framework for CST is presented. Part two is devoted to the description of four doses of treatment (chapter 4-7) and some conclusions (chapter 8). By using the transtheoretical model, the intervention might be matched to an individual's readiness to change. This would reduce resistance, stress and time to implement a change by accelerating movement toward the action stage. As described in chapter 2, CST involves a range of therapeutic activities including education, self-management, problem solving, cognitive restructuring, or brief interpersonally and affectively charged interventions. Dose-effect theory where dosage reflects both the concentration and duration of treatment has been used to create a theoretical structure for organizing diverse approaches to treatment. There are four doses of therapy in CST: A 2-session dose, an 8-session dose, a 20-session dose and a dose of 50-100 or more sessions. The author suggests that the coping theory links dimensions of coping in a cohesive framework that is consistent with current models of psychotherapy for BN. Problem solving and cognitive restructuring reflects cognitive behavior therapy (CBT), social support and expressing emotions reflects Interpersonal psychotherapy (IPT) and brief psychodynamic therapy and the disengagement factors reflect dialectic behavior therapy (DBT), trauma therapy and expressive psychotherapy. In chapter 3, a multifactorial model for assessing individual differences among patients with BN is presented by using a combination of factor analytically derived constructs and transtheoretical model with an interpersonal model of development and trauma, based on object relation theory. The author provides very helpful guidelines from his clinical practice, and the result is an unusual mix of empirical findings and clinical theory. The four doses of therapy are described in chapter 4-7. The initial evaluation for all doses is described in chapter 4. Dose 1 is the smallest dose of the CST lasting 1-2 visits. The instillation of hope is the core clinical intervention in dose 1. The core strategies are the most basic of the active behavioral processes and the problem engagement dimension of coping. They include self-monitoring of eating pattern and symptoms and meal stabilization. Patients who are in preparation phase (according to transtheoretical model) with sufficient motivation for behavior change are candidates for dose 2 of CST. Dose 2 (3