The research-practice gap: bridging the schism between eating disorder researchers and practitioners (original) (raw)
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BMC medicine, 2016
Evidence-based practice in eating disorders incorporates three essential components: research evidence, clinical expertise, and patient values, preferences, and characteristics. Conceptualized as a 'three-legged stool' by Sackett et al. in 1996 (BMJ), all of these components of evidence-based practice are considered essential for providing optimal care in the treatment of eating disorders. However, the extent to which these individual aspects of evidence-based practice are valued among clinicians and researchers is variable, with each of these stool 'legs' being neglected at times. As a result, empirical support and patient preferences for treatment are not consistently considered in the selection and implementation of eating disorder treatment. In addition, clinicians may not have access to training to provide treatments supported by research and preferred by patients. Despite these challenges, integrating these three components of evidence-based practice is critica...
Disseminating Evidence-Based Psychological Treatments for Eating Disorders
Current Psychiatry Reports, 2015
The research-practice gap is of concern in the treatment of eating disorders. Despite the existence of empirically supported treatments, few receive them. The barriers to wider dissemination and implementation of evidence-based treatment include clinician attitudes towards such treatments and the lack of sufficient numbers of suitably trained therapists to provide treatment. In this review we discuss these barriers in the context of the wider issue of the dissemination and implementation of psychological treatments and review the research with regard to the treatment of eating disorders. Particular emphasis is placed on examining recent efforts to expand the availability and reach of treatments by making treatment delivery and training more scalable. We highlight promising developments and areas where further research is needed.
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International Journal of Behavioral Consultation and Therapy, 2010
This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified. Results indicated that the program was effective in significantly reducing eating disordered symptoms, anxiety symptoms, and depressive symptoms. The author discusses implications of the research and potential directions for future research.
Perceptions and use of empirically-supported psychotherapies among eating disorder professionals
Behaviour Research and Therapy, 2012
Despite growing support for the dissemination of empirically-supported treatments (ESTs), treatment providers have been slow to take up using ESTs. This study explored eating disorders (ED) professionals' views of empirical support for psychotherapies for EDs and the role of empirical evidence in ED treatment selection. We distributed a web-based survey to members of two international organizations of ED practitioners and researchers; 402 members (32.7%) were eligible and participated. Most providers reported they used ESTs in treating EDs, but these ESTs were often folded into eclectic approaches rather than used in forms that had been evaluated in research trials. Use of ESTs and perceptions of empirical support for psychotherapies differed between participants who were and were not recently involved in research. We conclude that perceptions of available research evidence may be important to target in efforts to increase the uptake of ESTs in clinical practice and to help close the research-practice gap.
Psychotherapy Research, 2013
This study describes the psychological interventions used for eating disorders (EDs) by community practitioners. Of 573 clinicians we screened across Alberta, 130 (22.7%) had treated EDs; 118 (90.8%) were interviewed. Clinicians reported varied reasons for psychotherapy choice and diverse training experiences; the primary approaches used varied by education and field. The most common primary approach was eclectic (43.2%), followed by cognitive-behavior therapy (CBT; 22.9%). However, self-reported CBT clinicians used specific CBT techniques infrequently. Half of clinicians incorporated addictions-based techniques. These results indicate that ED treatment provided by community clinicians is varied and generally does not align with evidence-based practice guidelines. PSYCHOTHERAPIES FOR EATING DISORDERS 3 Psychotherapies Provided for Eating Disorders by Community Clinicians: Infrequent Use of Evidence-Based Treatment Awareness of current trends in the use of psychological interventions is vital to those interested in promoting evidence-based practice in mental health. This information may help to bridge the gap between researchers who promote empirically-supported treatments (ESTs; i.e., treatments that have been demonstrated to be efficacious through controlled research trials) and front-line clinicians who provide treatment; evaluate the need for improved dissemination into clinical settings of ESTs; and ultimately increase the effectiveness of treatments provided to individuals in need. For example, some of the better-established ESTs for eating disorders (EDs) include cognitive-behavior therapy (CBT) and interpersonal psychotherapy (IPT) for bulimia nervosa (BN) and binge eating disorder (BED), and family-based therapy for anorexia nervosa (AN) (Wallace & von Ranson, 2012). Although recovery rates remain far from perfect and there
Therapeutic interventions in the treatment of eating disorders: A naturalistic study
Psychotherapy, 2016
This study used naturalistic data from psychodynamic (PD) and cognitive-behavioral (CB) clinicians in the community to offer a portrait of treatments for eating disorder (ED) patients as provided in everyday clinical practice. The research aims were (1) to examine the therapeutic interventions reported by PD and CB clinicians working with ED patients; and (2) to assess the impact of different variables (such as patient personality styles, ED symptomatology, and therapists' theoretical orientation and experience) on the technique use reported by clinicians. A national sample of PD and CB clinicians (N = 105) completed the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) to assess personality disorders of a female patient with EDs in their care, as well as the Comparative Psychotherapy Process Scale-Bulimia Nervosa (CPPS-BN; Thompson-Brenner & Westen, 2005) to describe the characteristic interventions used in their treatments. Results showed that PD clinicians tended to use primarily PD interventions, while CB clinicians employed CB techniques supplementing them with a wider range of PD strategies. However, clinicians from both theoretical orientations used adjunctive treatment techniques for EDs at a similar level. In addition, use of PD interventions was strongly associated with the personality styles of ED patients regardless of therapists' orientation, primarily being used more often when patients exhibited dysregulated and impulsive styles. Conversely, use of CB interventions was primarily related to a clinicians' CB orientation, patients with more explicit symptoms of anorexia nervosa, and negatively related to clinicians' years of experience. The clinical implications of these findings were discussed. (PsycINFO Database Record