CBT is a psychosocial intervention that can be applied in the treatment of anorexia nervosa among the adolescent females in Singapore. As Costa and Melnik (2016), noted female adolescent suffering from anorexia usually indicate binge eating and compensatory behaviour (bulimic symptoms). Byrne et al. (2015) add to that by asserting that, most female adolescents are dissatisfied with their body shape and weight. Consequently, they adopt abnormal eating disorders, abuse of diet pills, diuretics, laxatives, severe restriction of eating and depending on a given type of food with beliefs that it would help them lose weight. Others engage in an unhealthy form of exercises hoping to acquire specific body shape and weight. Eventually, they become underweight due to semi-starvation.
This problem of body shape and weight among female adolescents cuts across is not restricted to Singapore and other European nations. Indeed, it is more common in other countries as compared to Singapore. Therefore, using CBT as the treatment measure, therefore, would aid in the regulation of feeding as well as the cognitive restructuring among the adolescents. Due to its multidimensional nature of intervening with the anorexia nervosa, CBT becomes more appropriate especially when treating female adolescents in Singapore. Besides, the CBT treatment approach also incorporates cognitive and behavioural intervention, nutritional counselling, self-monitoring and psychoeducation (Murphy, Straebler, Cooper & Fairburn, 2010). Thus, it is the more effective as compared to other approaches that solely relies on medication and nutritional counselling. It also requires individual, family and societal input to aid in weight loss and again as well as acknowledging their body shapes. The inclusivity nature of the CBT model makes it efficient and most efficient in treating female adolescents who are having anorexia nervosa.
Conjoint Family-based Treatment (CFT)
The CFT treatment model for anorexia nervosa focuses on weight restoration where by the parents, guardians and the entire family help in regulation of meals so that female adolescent can avoid compulsory behaviours (Hughes, Le Grange, Court, Yeo, Campbell, Allan, Sawyer, 2014). In the process, the clinical therapist intervenes in the family interactions to help make the recovery process efficient and quicker.
Although the CFT model successful in the treatment of anorexia nervosa, it is faced with many challenges. At times, the intervention of the clinical therapist becomes difficult especially when the content to be shared ought to be for the patient only. The therapist may find it difficult to separate the adolescents from their family and relatives. As such, the therapist might opt not to share crucial information with the patient. Secondly, parents and other caregivers might become excessively sympathetic with their adolescents. In other times, the caregivers may become a distress to the patient, thus impeding the recovery process. Another challenge that faces the CFT treatment model is inadequate therapists who have knowledge and experience in both anorexia nervosa and general family therapy (Herpertz-Dahlmann, van Elburg, Castro-Fornieles & Schmidt, 2015). The therapist, therefore, might become reluctant to address the family and focus only on the adolescent.
The CFT treatment model can be applicable in Singapore female adolescents since it is more effective in the reduction of eating-disorders related traits due to the inclusion of the caregivers. Among the female adolescents, the CFT helps in improving the eating behaviours through emotional expression when the therapy is conducted in groups and subgroups regarding the percentage average weight gain and functioning return (Bulik, Brownley, Shapiro & Berkman, 2012).
Bulik, C., Brownley, K., Shapiro, J., & Berkman, N. (2012). Anorexia Nervosa. Handbook of Evidence-Based Practice in Clinical Psychology. http://dx.doi.org/10.1002/9781118156391.ebcp001025
Byrne, C., Kass, A., Accurso, E., Fischer, S., OBrien, S., & Goodyear, A. et al. (2015). Overvaluation of shape and weight in adolescents with anorexia nervosa: does shape concern or weight concern matter more for treatment outcome? Journal of Eating Disorders, 3(1). http://dx.doi.org/10.1186/s40337-015-0086-7
Costa, M., & Melnik, T. (2016). Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews. Einstein (Sao Paulo), 14(2), 235-277. http://dx.doi.org/10.1590/s1679-45082016rw3120
Herpertz-Dahlmann, B., van Elburg, A., Castro-Fornieles, J., & Schmidt, U. (2015). ESCAP Expert Paper: New developments in the diagnosis and treatment of adolescent anorexia nervosaa European perspective. European Child & Adolescent Psychiatry, 24(10), 1153-1167. http://dx.doi.org/10.1007/s00787-015-0748-7
Hughes, E. K., Le Grange, D., Court, A., Yeo, M. S., Campbell, S., Allan, E., Sawyer, S. M. (2014). Parent-focused treatment for adolescent anorexia nervosa: a study protocol of a randomised controlled trial. BMC Psychiatry, 14, 105. http://doi.org/10.1186/1471-244X-14-105
Murphy, R., Straebler, S., Cooper, Z., & Fairburn, C. G. (2010). Cognitive Behavioural Therapy for Eating Disorders. The Psychiatric Clinics of North America, 33(3), 611627. http://doi.org/10.1016/j.psc.2010.04.004
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