VINCENT SQUARE EATING DISORDER SERVICE
Cognitive Behavioural Therapy (CBT): Information for Clients
Here is a basic introduction to Cognitive Behavioural Therapy (CBT). It outlines key elements of CBT,
why CBT is the chosen therapy for you, and what CBT involves.
What is CBT?
CBT focuses on forming a shared understanding of what is
keeping your eating disorder going. It explores the links
between how you think, what you feel, your physical state and
what you do (see diagram). Highlighting these links helps to
identify what thoughts and behaviours might need to change
to help you feel better. CBT is time-limited. The number of
sessions will be decided with your clinician but each session
will last 50 minutes. CBT is generally a ‘here’ and ‘now’
approach, focusing on reducing your current eating disorder
symptoms. Sometimes, you and your therapist may look in
more detail at earlier experiences that might have laid
foundations for your current difficulties, but this would only be
if there is a good rationale and would be decided together.
Thoughts
(e.g., "I am going to keep
gaining weight"; “I have
broken my rules”)
Physical state
Feelings
(e.g., starvation)
(e.g., anxiety)
Behaviour
(e.g., avoid food; overeat;
over-exercise)
Why choose CBT in your case?
The National Institute for Clinical Excellence (NICE - a government body that reviews research
evidence and consults with experts in the field) recommends CBT as the current treatment of choice
for bulimia nervosa and other related eating disorders. It also suggests that CBT can be considered
as a treatment option for anorexia nervosa. (See the NICE leaflet for more information – available
from the service.)
What does CBT involve?
The aim is for your working relationship with your therapist to be a collaborative one. The therapist is
an active participant, but you are ultimately responsible for change. Initially, the therapist is likely to
guide you in developing the necessary skills and strategies. However, the ultimate goal is for you to
become your own therapist.
There are some aspects of CBT that are essential parts of the treatment of your eating disorder.
These are:
 Commitment to regular attendance and being punctual
 Being weighed weekly in each session
 Medical investigations if recommended (e.g. blood tests)
 Homework (including food diaries)
 Behavioural experiments – trying out changes to see what happens, but in a structured way
What can I expect of my therapist?
Your therapist works as part of a team, and will discuss your case with members of the team from
time to time in a confidential and respectful manner. Your therapist will respect your position as a
patient. This means that they will try to be punctual, not cancel at short notice, and give you as much
information as possible. In addition, they will not meet with you outside agreed times or outside the
clinic, and any physical contact will be limited to that which is courteous (such a handshake). Your
therapist will put your interests first. If you are uncertain or uncomfortable, it is important to discuss
this with your therapist. If you are still experiencing difficulty, you are very welcome to approach
Tanya Paxton (Service Director), Dr Frances Connan (Consultant Psychiatrist), or Dr Sue Harris
(Clinical Psychologist).
An advocacy service is available if you feel that you are not being listened too, or would like help to
get your views across. You can also access help through the Patient Advice and Liaison Service
(PALS). Your PALS representative at Vincent Square is Pam Taft, our receptionist.
Updated April 2013