Courageous Conversations in Evidence Based Treatment

It may be clear from our name that our practice prioritizes engaging in evidence-based treatment for psychological concerns. What might be less clear is what evidence-based treatment actually consists of.

In 2006, the American Psychological Association defined evidence-based practice as the integration of three components of care:

1. “The best available research” with
2. “clinical expertise” in the context of
3. “patient characteristics, culture and preferences”

What does all that mean? Since eating disorders are one of the psychological concerns that we specialize in treating, let’s unpack it by reviewing a recent article, “Developments in the Psychological Treatment of Anorexia Nervosa and Their Implications for Daily Practice,” published in the journal Current Opinion in Psychiatry.

This article, comparing the effectiveness of various treatments for adults with anorexia nervosa (AN), represents the kind of literature we use at CEBT-Ohio to guide our work, and provides a helpful overview of the components of evidence-based treatment that we consider when developing treatment plans across all presenting concerns.

Research

Based on available research, the authors of the article conclude that, compared with no treatment at all, there are three kinds of treatment that help adults with AN to improve their weight, eating-disordered thoughts/behaviors and quality of life. These are:

• Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
• Cognitive Behavior Therapy-Enhanced (CBT-E)
• Specialist Supportive Clinical Management (SSCM)

At CEBT-Ohio, our clinicians have specialized training in the latter two approaches.

Importantly, the authors find that research failed to indicate any significant differences among the treatments in how much they help people improve; all three seem to be equally as effective.

Therefore, if you came to CEBT-Ohio for treatment of AN, we would first help you confirm with your medical provider that you are safe to pursue treatment at an outpatient level of care. Then we would begin the treatment planning process specifically with these three approaches in mind – because research shows that they have the highest chance of helping you recover.

Clinical expertise

The authors of the article also find that, even among groups of people who underwent the same therapy, some saw more improvement than others.

What explains this difference? People who saw therapists that were expertly trained, or closely followed the therapy protocol, generally had better outcomes. Therefore, if you came to CEBT-Ohio for help with AN, we would strive to provide one of the three evidence-based therapies as closely as possible to how it was delivered in the research that demonstrated its effectiveness.

Because new research is always being conducted and treatments can improve over time, clinical expertise is also an ongoing process. As such, we meet regularly as a staff to train on evidence-based therapies, and consult with one another to build upon our collective clinical expertise.

Patient characteristics / culture / preferences

The authors also find that actively involving people in their treatment planning – referred to as “shared decision making” (SDM) – can lead to better therapy outcomes for eating disorders and other psychological concerns.

This kind of involvement can understandably help people feel more engaged, heard and ultimately motivated in treatment. Therefore, we strive to view our services as a meeting of experts – you are the expert on your lived experience and we are the experts on treatments that will alleviate your psychological distress.

Figuring out the best treatment for your concerns will involve getting to know you as an individual, including your values, preferences, life experiences and various personal identities. If you were coming to CEBT-Ohio for treatment for AN, we would seek to understand the following information:

• What are the largest sources of distress currently in your life?
• What are your goals for therapy? How do you define wellness?
• What kind of treatment approach resonates the most with you?

Through this process, we hope to come to a collaborative decision regarding your ultimate evidence-based treatment plan. Even if this conversation leads to an evidence-based treatment that we do not specialize in, we will help you find expert clinicians in that discipline.

If you would like to know more about the evidence-based treatments that we offer or are interested in learning more about our services, please call us at (216) 544-1321.