Behaviour therapy in the management of patients with anorexia nervosa. A lenient, flexible approach

Many different treatment approaches have been advocated for anorexia nervosa, and most clinicians now incorporate some aspects of behaviour modification in refeeding an emaciated patient. Traditional operant programmes have required the patient to spend prolonged periods of time confined to a solitary existence in a bedroom devoid of her normal possessions. The present paper evaluated the rate of weight gain in 68 patients with anorexia nervosa (100 consecutive admissions to a specialised eating disorders unit) using a lenient, flexible approach to refeeding. Despite this more humane approach, similar results were achieved when compared to other more rigid behavioural programmes in that they gained 0.16 kg/day. This finding is discussed in the context of the rigid application of behavioural programmes which can be seen as punitive, undermine the patient's co-operation and destroy any therapeutic relationship which may develop.