Dialectical behavioral therapy skills group as an adjunct to family-based therapy in adolescents with restrictive eating disorders

ABSTRACT

Dialectical behavior therapy (DBT) is commonly used in the treatment of eating disorders (ED), yet few studies have examined the utility of DBT skills groups as an adjunct to evidence-based therapy for ED. Thus, we sought to examine the preliminary efficacy of a DBT skills group as an adjunct to Family-Based Treatment (FBT) for adolescent restrictive ED. Our preliminary pilot study included 18 adolescent girls ages 13–18 (M= 15.3, SD = 1.64) with restrictive ED, including Anorexia Nervosa (AN; N = 10), Atypical Anorexia Nervosa (AAN, N = 5), and Other Specific Feeding or Eating Disorder (OSFED; N = 3). All participants were enrolled in a 6-month, weekly DBT skills group and were concurrently receiving family-based treatment (FBT). Participants who completed the intervention experienced large effect sizes for increases in adaptive skills (Cohen’s d = .71) and decreases in general dysfunctional coping strategies (Cohen’s d = .85); and small to medium effect sizes for decreases in binge eating (Cohen’s d = .40) and increases in percent expected body weight (% EBW; Cohen’s d = .32). Finally, small effect sizes were evidenced in decreases in Global EDE-Q scores (Cohen’s d = .26), EDE-Q restraint (Cohen’s d = .29) and CDI scores (Cohen’s d = .28). Our study presents promising preliminary data suggesting that adolescents with restrictive EDs receiving FBT could benefit from an adjunctive DBT skills group. Feasibility of and considerations for tailoring a DBT skills group to an outpatient ED treatment program are discussed.