Feasibility, Acceptability and Outcomes of Group CBT-T: A Naturalistic Mixed-Methods Comparison With Individual CBT-T

Area of Science:

• Psychiatry
• Clinical Psychology
• Healthcare Management

Background:

• Eating disorders require effective outpatient interventions.
• Cognitive Behavioural Therapy (CBT) is a leading treatment modality.
• Group-based delivery (CBT-Tg) may offer advantages in accessibility and efficiency compared to individual therapy (CBT-Ti).

Purpose of the Study:

• To assess the feasibility and acceptability of implementing 10-session group CBT (CBT-Tg) in routine outpatient eating disorder services.
• To descriptively evaluate the outcomes of both CBT-Tg and individual CBT (CBT-Ti).

Main Methods:

• A naturalistic, non-randomised, mixed-methods design was employed in a public outpatient eating disorder service.
• Adult patients chose between CBT-Tg or CBT-Ti.
• Feasibility was measured by acceptability, demand, and practicality (clinician time).
• Effectiveness was assessed using the Eating Disorder Examination Questionnaire (EDE-Q) and secondary outcome measures.

Main Results:

• Of 116 patients who started treatment, satisfaction was high for both CBT-Tg and CBT-Ti.
• CBT-Tg showed a 44.7% premature termination rate but high demand.
• Estimated clinician time per patient was lower for CBT-Tg (4.3-5.7 hours) than CBT-Ti (8.0 hours).
• Both formats yielded large, sustained improvements in EDE-Q scores from therapy end through 6-month follow-up.

Conclusions:

• Group CBT (CBT-Tg) is feasible and acceptable within routine outpatient eating disorder care.
• CBT-Tg demonstrates significant and sustained reductions in eating disorder psychopathology.
• Findings suggest potential efficiency gains with CBT-Tg, supporting further comparative and cost-effectiveness research.