How do we target the factors that maintain anorexia nervosa? A behaviour change taxonomical analysis

Abstract

All psychological treatments for anorexia nervosa appear to have equal (albeit modest) effects. This may be explained because they target similar processes. Although different psychological treatments have been developed for anorexia nervosa treatment, their taxonomical components have not been compared. This study undertook a taxonomical analysis of behaviour change techniques (BCTs), using the CALO-RE analysis tool, from the manuals of Enhanced Cognitive Behavioural Therapy (CBT-E), Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA), Family Based Therapy (FBT), Specialist Supportive Clinical Management (SSCM), and Focal Psychodynamic Psychotherapy (FPT). The highest number of BCTs were found in FPT (72,5%), and the lowest were in SSCM (30%). The other interventions had a similar range of BCTs which mainly focused on goal planning (FBT (50%), CBT-E (47.5%), MANTRA (42.5%)). Modelling, shaping, and training communication, self-monitoring, and fear arousal were the less commonly used BCTs across manuals. Manualized psychological interventions for people with anorexia nervosa share a substantial number of behaviour change techniques which might explain their similar levels of effectiveness. New strategies may be needed in order to improve outcomes.

Keywords:

• Taxonomical analysis
• behaviour change techniques
• eating disorders
• psychological interventions
• anorexia nervosa

Acknowledgements

Consultation was provided by Professor Janet Treasure, who is partially funded by Maudsley Biomedical Research Centre.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

To conduct this work, C.L. and M.A.S. were funded by São Paulo Research Foundation (FAPESP), process number 2015/15103-5.