RICCARDO DALLE GRAVE, M. D.

·  To engage patients in treatment and change

·  To increase understanding of the eating problem

·  To reduce concerns about weight

·  To establish a pattern of regular eating

Form

·  Twice-weekly sessions for four weeks

Content

·  Engaging patients

·  Creating a personalized formulation

·  Establishing self-monitoring and ccollaborative weighing

·  Providing personalized education

·  Introducing a pattern of regular eating

·  Involving significant others

·  To review progress and barriers to change

·  To plan Stage Three

Form

·  One or two session once a week

Content

·  Assessing jointly progress and compliance

·  Identifying any additional barriers to change

·  Deciding whether to continue with the focused version of CBT-E or move over to the broad version

·  Planning Stage Three accordingly

·  To address the mechanisms that have been maintaining the eating disorder psychopathology

·  To address the remaining eating disorder features

·  To develop the ability to tackle setbacks

Form

·  Weekly sessions

Content

·  Continuing to implement the strategies and procedures introduced in Stage One

·  Implementing one or more of the following modules*

Body Image

Dietary Restraint

Events, Moods and Eating

Setbacks and Mindsets

·  To maintain the changes achieved during treatment

·  To minimize the risk of relapse

Form

·  Three sessions every two weeks

Content

·  Identifying remaining problems

·  Jointly devising a specific (realistic) plan for addressing them

·  Ensuring patient have realistic expectations

·  Discussing future possible ‘at risk’ times

·  Devising a plan for dealing with setbacks

To review progress and revise the long-term maintenance plan

·  To engage patients and help them arrive at the decision to regain weight, as well as address the eating disorder psychopathology.

Form

·   Twice-weekly sessions: up to 8 weeks

Content

·  Engaging patients

·  Establishing self-monitoring and collaborative weighing

·  Educating about the psychobiological effects of being underweight and considering the implications

·  Creating a personalized formulation with the inclusion of malnutrition symptoms

·  Discussing the pros and cons of change (regaining weight)

·  Involving significant others

·  To review progress and barriers to change

·  To plan the following four weeks

Form

·  One session every four weeks until there is a regular rate of weight gain in Step One and Two

Content

·  Assessing jointly progress and compliance

·  Identifying any additional barrier to change

·  Deciding whether to continue with the focused version of CBT-E or move over to the broad version

·  Planning the following four weeks accordingly

·  To help patients achieve weight regain at the same time as addressing the key maintenance mechanisms.

Form

·  Twice-weekly sessions until there is a regular rate of weight regain, then once a week

Content

·  Continuing to implement the strategies and procedures introduced in Step One

·  Introducing measures to encourage weight regain until a low–normal weight is reached (e.g., BMI between 19.0 and 20.0 kg/m²)

·  Implementing one or more of the following modules*

Body Image

Dietary Restraint

Events, Moods and Eating

Setbacks and Mindsets

·  To maintain the changes achieved during treatment

·  To minimize the risk of relapse

Form

·  Three sessions every two weeks

Content

·  Identifying remaining problems

·  Jointly devising a specific (realistic) plan for addressing them

·  Ensuring patient have realistic expectations

·  Discussing future possible ‘at risk’ times

·  Devising a plan for dealing with setbacks

·  Drawing up specific plan for weight monitoring (weight must remain over 19.0, and any drop below 19.0 requires action).

NB: In the longer term some patients may need to regain further weight

To review progress and revise the long-term maintenance plan