The Need for Change: A Pluralistic Psychotherapeutic Approach to Adult Outpatient Treatment for Anorexia Nervosa - A Critical Literature Review.

Eating disorder anorexia nervosa has the highest mortality rate of any mental health condition and is historically viewed as one of the most challenging to treat. Recommended psychotherapeutic treatment offered to adult outpatients with a moderate form of the condition via the National Health Service in Wales is exclusively based on an enhanced form of cognitive behavioural therapy (CBT-ED). This research is presented as a standalone critical review of post-2015 literature concerning CBT-ED and its variant CBT-E as an outpatient treatment for adults with anorexia nervosa in order to answer the research question: Could a pluralistic psychotherapeutic approach fulfil a need for an alternative NHS adult outpatient treatment for moderate anorexia nervosa? It critically explores: (a) A need for alternative forms of therapy to be offered to the above patient demographic; and (b) Whether a pluralistic approach could fulfil that need. Findings in relation to (a) include: (i) CBT effectiveness can be interpreted as moderate at best in routine outpatient practice, with high levels of drop-out at around 50%; (ii) Many patients find CBT unsatisfactory or unsuitable, however, their experience and preferences are neglected by researchers and healthcare policy makers despite being key to improving or developing treatments; and (iii) Tentative links may therefore be implied between high levels of outpatient drop-out and treatment dissatisfaction. Findings in relation to (b) suggest: (i) a pluralistic approach may fulfil a need for an alternative intervention which could contribute to reducing drop-out due to its focus on tailored, individualised treatment and client-therapist collaboration strongly support patient preferences; and (ii) The approach also allows for a variety of different therapeutic modalities to be practiced which may better suit patients’ needs than the ‘one-size-fits-all’ model currently offered. Being a relatively new approach, recommendations are strongly made for further research in relation to working pluralistically with AN, with a particular focus on patient preferences.

Name dc:type.qualificationname

mphil

Level dc:type.qualificationlevel

masters

Grantor dc:publisher.institution

University of Wales Trinity Saint David

Year dc:date.issued

2023

Author dc:creator

• Sullivan, Melina

• BF Seicoleg

Dc Identifier Grantnumber

UWTSD

OAI identifier oai:identifier

oai:repository.uwtsd.ac.uk:2645