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Jennifer Wilde, PhD & Liz McCabe, PhD November 11, 2011, 12:00 pm WPIC Auditorium

 

Department of Psychiatry Lecture Series
Clinical Grand Rounds: Behavioral Medicine

Development of an Outpatient Intervention for Older Adolescents and Adults with Anorexia Nervosa: Emotion Acceptance Behavior Therapy (EABT)

Presenting:  Jennifer Wilde, PhD and Liz McCabe, PhD

Anorexia nervosa (AN) is a serious psychiatric illness associated with significant morbidity and mortality, yet there are no evidence-based interventions for older adolescents and adults with AN. Although structured behavioral interventions provided in intensive settings (e.g., inpatient, day hospital) are effective at restoring weight and reducing aberrant eating behaviors in the short-term, few AN patients are fully weight-recovered upon completion of intensive treatment, and rates of relapse and re-hospitalization are as high as 50% during the year following discharge. Furthermore, many individuals with AN do not have access to structured treatment programs that provide nutrition rehabilitation or address eating disorder psychopathology. Thus, there is a critical need for the development of effective outpatient interventions for underweight individuals with AN. In this presentation, we will describe on-going work at the Center for Overcoming Problem Eating (COPE) to develop Emotion Acceptance Behavior Therapy (EABT), a novel outpatient intervention for individuals aged 17 years and older with AN. EABT is a manualized psychotherapeutic intervention based on an empirically-informed conceptualization of AN that emphasizes the role of anorexic symptoms in helping individuals to avoid aversive emotional states. EABT includes standard behavioral interventions that are central to the clinical management of AN (e.g., weight monitoring, nutrition counseling) coupled with techniques designed to increase emotion awareness, reduce emotion avoidance, and help patients tolerate distress or discomfort without resorting to maladaptive coping. We will review theoretical and empirical work in support of the EABT model, including results from studies conducted at COPE. Next, a patient who completed EABT will be interviewed to illustrate important concepts, and some of the challenges inherent in providing outpatient interventions for AN. Finally, we will close by presenting results from a recently-completed uncontrolled pilot study of EABT in 24 AN patients.

For more information regarding the Department of Psychiatry Lecture Series, please contact Jeanie Knox Houtsinger at knoxjv@upmc.edu.