Dialectical Behavior Therapy for Eating Disorders

Abstract

This chapter focuses on how dialectical behavior therapy (DBT) has been adapted to treat clients with primary eating disorder (ED) diagnoses as well as clients with comorbid borderline personality disorder (BPD) and EDs. The aim of this chapter is to describe to the reader how three independent treatment sites adapted standard DBT for use with clients with EDs. The three models are comprehensive DBT for individuals with BPD and ED; DBT for serious, complex, and treatment-resistant EDs; and DBT for binge eating disorder and bulimia nervosa. Each model meets the functions of a comprehensive DBT treatment in terms of enhancing the capabilities of clients, improving motivational factors, assuring generalization to the natural environment, and enhancing therapist capabilities and motivation to treat effectively and to structure the environment. Through focusing on how each program's adaptations were tailored to specific treatment settings and client populations, this chapter intends not only to present the models but to illustrate the principles behind their design. We first review the rationale for applying DBT to clients with EDs, then compare and contrast the three different adaptations of DBT, and finally provide an overview of the biosocial model as well as the stages and target hierarchy for clients with EDs. Each individual section describes how the model was adapted for particular treatment settings and client populations followed by specific descriptions of (1) stages and target hierarchy, (2) the DBT program structure, (3) therapist strategies, and (4) core strategies. (PsycINFO Database Record (c) 2015 APA, all rights reserved)(chapter)