![]() ![]() Furthermore, FBT is not feasible or clinically indicated for all youth (e.g., caregiver(s) unavailable or not willing to participate, prior and/or current abuse in the home, co-occurring suicidality and emotion dysregulation that is better managed within a dialectical behavior therapy framework). Indeed, over half of adolescents who receive the treatment most supported by research evidence-family-based treatment (FBT) for anorexia nervosa (AN) -are still not recovered one year after completing treatment. Existing evidence-based treatments for youth with eating disorders produce modest effects at best. In adolescents, some of the medical complications resulting from malnutrition (e.g., osteoporosis, growth arrest) may be irreversible if weight restoration is not attained. Recommendations to advance research on CBT and DBT for adolescent eating disorders are provided, including a call for efficacy studies that clarify their performance compared to other leading approaches.Įating disorders are associated with high rates of co-occurring psychiatric disorders and serious medical risks including death. However, the field is lacking studies that systematically compare CBT and DBT to other evidence-based approaches. This review concludes that research supports the feasibility and acceptability of these approaches, as well as preliminary evidence of their effectiveness. ![]() This systematic review of CBT and DBT for adolescent eating disorders focuses on feasibility (i.e., how easy it was to implement the treatment), acceptability (i.e., how well the intervention was received by patients and therapists), effectiveness (i.e., how well the intervention performed under routine, real-world circumstances), and efficacy (i.e., how well the intervention performed in highly-controlled research settings). Potentially viable but less well-studied treatments for adolescents with eating disorders include cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). Plain English summaryĭespite high rates of relapse and likelihood for severe and enduring illness, there is a dearth of evidence-based treatment options for adolescents with eating disorders. Adequately powered trials to establish the effectiveness and efficacy of CBT and DBT are needed, particularly ones that compare these treatments against other leading approaches. ConclusionsĬBT and DBT demonstrate promise as alternatives to family-based approaches for adolescent eating disorders. ResultsĮligible studies ( N = 50 CBT: n = 40, DBT: n = 10) indicated that both treatments are reasonably feasible, acceptable, and possibly effective for adolescent eating disorders across diagnoses and levels of care, though efficacy trials are lacking. PsycINFO and PubMed were searched using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify studies examining the feasibility, acceptability, effectiveness and/or efficacy of CBT or DBT for adolescent eating disorders. This review aims to summarize and critically analyze the current literature on the feasibility, acceptability, effectiveness, and efficacy of CBT and DBT for adolescent eating disorders, and then proposes areas of future research. Cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT) have been proposed as alternative treatment options, with burgeoning research in this area. Current evidence-based treatments for adolescents with eating disorders have modest effects, underscoring the need to improve current treatment approaches. Identifying with a desire or fear tightens the knot that binds one to it, and, thereby, the sway it can have over one.Eating disorders have serious psychological and physical consequences. Mara's most effective weapon is sustaining a climate of fear, whether the fear be of drought or famine or cancer or terrorism. He uses deceptions, disguises, and threats, he possesses people, and he uses all kinds of horrible phenomena to terrify or cause confusion. ![]() First, Mara behaves like one of the demons of popular thought. The Pali Canon gives initial answers, not as alternatives, but as varying terms. ![]() Second, how does Mara operate? Herein lays the key to Mara's influence over all unenlightened beings. Only in Nirvana is his influence unknown. Mara saturates every nook and cranny of life. In other words, Mara's realm is the whole of samsaric existence. Mara symbolizes the entire existence of unenlightened humanity. "First, what is Mara's domain? Where does he operate? At one point the Buddha indicated that each of the five skandhas, or the five aggregates, as well as the mind, mental states and mental consciousness are all declared to be Mara. ![]()
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