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At the Eating Disorders Clinical and Research Program, our mission is to provide the highest quality patient care, clinical research, professional training, and public education.
At the Eating Disorders Clinical and Research Program, we offer a variety of outpatient treatment modalities to children, adolescents, and adults with feeding and eating disorders, ages 7 and up. To provide you with the best chance of symptom improvement, we offer the treatments that have been shown to be most effective in large-scale research studies. After a comprehensive assessment, we will recommend the treatment best matched to your individual needs. The descriptions below provide further information about each treatment so that you can become an active partner in designing your care.
Cognitive Behavioral TherapyCognitive behavioral therapy (CBT) is based on the premise that many of the psychological features of eating disorders are actually caused by under-eating—regardless of whether you are underweight, overweight, or anywhere in between. CBT is designed to help you understand how all of your eating disorder symptoms fit together, and then identify strategies for targeting each one. By recording your food intake in real-time (either on paper, or using a smartphone “app”), you can identify your own unique triggers for engaging in eating disorder behaviors such as restricting, binge eating, or purging. If the scale or mirror dictates how you feel about yourself most of the time, CBT can also help you improve your body image and identify alternate sources of self-esteem. Later sessions focus relapse prevention so that you feel properly equipped to handle any setbacks.
CBT is a time-limited treatment designed to last 20 sessions over six months. For most patients, this is sufficient to provide much-needed symptom relief. After completing CBT, some individuals seek additional psychotherapy outside of the EDCRP for ongoing support.
To learn more about CBT, you can read the book Overcoming Binge Eating (2nd edition) by Christopher Fairburn.
Cognitive Behavioral Therapy for Avoidant/Restrictive Food Intake DisorderWe also offer a new cognitive-behavioral therapy for individuals with Avoidant/Restrictive Food Intake Disorder (CBT-AR) ages seven and up. CBT-AR, which was developed here at Mass General , focuses on normalizing eating, increasing macronutrient intake via food intake rather than dietary supplements and (if needed) restoring weight and growth. CBT-AR also targets the maintaining mechanisms of avoidant/restrictive eating, including sensory sensitivities, lack of interest in eating and/or fear of aversive consequences of eating (e.g., vomiting or choking) using exposure-based techniques.
CBT-AR can be delivered in an individual or family-supported format depending on patient age and treatment goals. CBT-AR is a time-limited treatment designed to last 20-40 sessions over 6-12 months.
Cognitive Behavioral Therapy for Rumination DisorderWe also offer a brief cognitive-behavioral therapy for rumination disorder (CBT-RD) for both children and adults. CBT-RD is designed to last five to eight sessions and involves general CBT techniques tailored specifically for RD. Primary interventions include psychoeducation and self-monitoring to enhance patient awareness of regurgitation timing and triggers, diaphragmatic breathing as a habit reversal strategy, patient-specific strategies for reducing residual regurgitation episodes and relapse prevention.
Family-Based TreatmentFor underweight children, adolescents, and young adults, family-based treatment (FBT) empowers parents to take charge of normalizing their child’s eating. Rather than focusing solely on the patient, the therapist meets with the entire family (including both parents and siblings) to mobilize them to fight back against the eating disorder. FBT features specialized coaching deigned to absolve parents of blame, separate the child from the illness, and help parents re-nourish their child at home. Later sessions gradually transition eating opportunities back to the adolescent, and help the adolescent return to the developmentally appropriate task of growing up—from which he or she has typically been derailed by the eating disorder.
FBT is a time-limited treatment designed to last 20 sessions over the course of six to twelve months. For most individuals, this is sufficient to provide much-needed symptom relief. After completing FBT, some children and adolescents seek additional psychotherapy outside of the EDCRP for ongoing support.
To learn more about FBT, you can read the book Help Your Teen Beat an Eating Disorder by James Lock and Daniel Le Grange.
Guided Self-HelpGuided self-help based on cognitive-behavioral therapy (GSH) is an excellent option for adults who struggle with recurrent binge eating. In GSH, you will access tools to break the binge-eating cycle by collaboratively working through the workbook Overcoming Binge Eating (2nd edition) by Christopher Fairburn with an EDCRP clinician. Key components include self-monitoring, identifying binge triggers, eliminating harmful dieting, enhancing body image, and preventing relapse.
GSH is designed to last ten 25-minute sessions over the course of four months. For most patients, this is sufficient to provide much-needed symptom relief. After completing GSH, some individuals seek additional psychotherapy outside of the EDCRP for ongoing support.
Group TreatmentSome individuals find it helpful to make use of group therapy, either instead of or in addition to individual or family-based treatment. We currently offer a cognitive-behavioral therapy group for binge eating and purging. This 10-week skills-based group is appropriate for adults (ages 18 and up) seeking therapist and peer support to reduce bingeing and/or purging behaviors.
The group runs three to four times per year.
See schedules for the Fall 2016 CBT group and Winter 2017 DBT group.
PharmacotherapyIf needed, we also offer medication treatment in combination with therapy. Although medications are not a standalone cure against eating disorders, they can improve treatment response as well as potentially prevent future relapses. Additionally, eating disorders are often diagnosed along with other psychiatric conditions, which can be effectively treated and managed with psychopharmacologic approaches. In collaboration with the patient, we approach each case as unique and offer a personalized approach based on the individual’s needs, backed by expertise in psychopharmacology, which is at the cutting-edge of research.
Higher levels of careSome individuals find that they are not able to beat their eating disorder through outpatient support alone. To consider whether this might be the case for you, please click here.
While the EDCRP is an outpatient program, we often collaborate with our Harvard Medical School affiliates that offer high levels of care for eating disorders including:
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