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Dialectical behavior therapy adapted for bulimia: a case report
D L Safer1, C F Telch, W S Agras
1Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California 94305-5722, USA.
Objective:
This case report describes the application of dialectical behavior therapy (DBT) to the treatment of bulimia nervosa in a 20-session manualized therapy.
Method:
The treatment, based on an affect regulation model of eating disorders, was developed to teach emotion regulation skills to replace eating-disordered behaviors. The patient, a 36-year-old woman, had a long history of binge eating and purging that had not responded to 2 years of counseling. In the 4 weeks before treatment began, she reported 13 objective binges and 21 purging episodes.
Results And Discussion:
Upon initiating DBT, her binge eating and purging rapidly declined. She achieved abstinence by the fifth week of treatment and maintained it through treatment. In the 6 months following treatment, she reported a total of two objective binge episodes and two purge episodes.