Enhanced Cognitive-Behavior Therapy (CBT-E) is one of the most effective treatments for eating disorders, tailored to address a wide range of eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder. Known as a "transdiagnostic" approach, CBT-E focuses on the underlying psychological issues common to all eating disorders.

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CBT-E for Adolescents Core Principles

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CBT-E centres on the individual, encouraging adolescents to take control of their recovery journey. Parents are involved in a supportive role, helping to create a positive environment for the patient’s recovery, though the primary responsibility remains with the adolescent. This collaborative treatment actively involves patients in decision-making, aiming to promote self-management and personal responsibility. A major goal of CBT-E is to address the core psychological factors of eating disorders—concerns about shape, weight, dietary restraint, and restrictive behaviours.​

 

Why CBT-E Works for Adolescents

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CBT-E’s flexible, individualized approach makes it especially well-suited for adolescent patients. Recognizing that every patient has unique needs, the therapist tailors CBT-E to the individual, ensuring treatment aligns with the patient’s developmental stage and specific challenges. With an emphasis on autonomy, CBT-E supports adolescents in making changes they feel invested in. By actively involving patients, CBT-E empowers them to feel a sense of control over their recovery, a factor that resonates particularly well with younger patients.

 

The CBT-E Process for Adolescents

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CBT-E for adolescents begins with two assessment sessions, followed by three structured steps:

 

1. Step One – Starting Well and Deciding to Change: Building a strong therapeutic foundation and motivating change.

2. Step Two – Addressing the Change: Implementing strategies to support weight regain or manage binge eating and purging behaviours.

3. Step Three – Ending Well: Focusing on maintaining progress and preparing for the future.

 

Treatment is delivered by a single therapist, with session frequency and format adapted based on the patient's needs. Patients not underweight typically undergo 20 sessions, while underweight patients may need up to 30 sessions, either in a “focused” or “broad” format.

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Family Involvement in Treatment

 

Parents participate in a 90-minute initial interview during the first week of treatment, followed by joint sessions alongside the patient. These sessions keep parents informed about progress and help them understand how best to support the patient’s changes, while respecting the adolescent’s primary responsibility for their recovery.

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CBT-E’s collaborative and flexible design makes it a highly effective and accessible treatment, helping adolescents overcome eating disorders in a way that promotes long-lasting change and personal empowerment.

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