Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
We eat to live and eating is an important focus for our family and social
lives. In a country like the United States, food is readily available. But large
amounts of food put us at risk for the three major eating disorders: obesity,
bulimia, and anorexia nervosa. This fact sheet will discuss the role of behavior
therapy in the treatment of these disorders.
A recent report from the National Institutes of Health suggests that people
who are more than 20% over their ideal weight should seek treatment. Over
one quarter of all women, and nearly as many men, in the United States fall
into this category. Obesity is related to health risks, including high blood pressure,
diabetes, and gall bladder disease. At very high levels of obesity, life expectancy
is shortened. People should lose weight for health reasons and not for
We do not understand all the causes of obesity. Recent research suggests
that both family genetics and the environment are involved. Environmental
factors include easy access to large amounts of food, eating high-caloric and
high-fat foods, and having lower activity levels, including little or no excercise.
For people who have up to about 50 pounds to lose, behavior therapy has been
a successful approach to treatment. It is better than medicines that curb the
appetite and dietary treatments. Treatment is usually done in groups of 8 to 12
people. It consists of learning to look at and change key behaviors. Keeping
records of eating activity forms the basis of treatment. The records are used to
help change the way one eats, for example, eating in fewer places and eating
more slowly; to change to a heart-healthy diet by decreasing the amount of fat
one eats and increasing dietary fiber; and to increase activity levels.
Losing weight and keeping it off is hard work. People who manage to
change these key behaviors and continue to practice them over the years are
the ones who lose the most weight at first and who keep it off the longest.
Weight loss of about a pound a week can be expected with this treatment. In
addition, the lost weight is usually kept off for at least a year.
People who have more weight to lose should try a combination of behavior
therapy and a very-low-calorie diet (less than 800 calories). The diet should be
done under medical supervision. The combination has been shown to be more
successful than using the very-low-calorie diet alone. These treatment programs
are usually available in specialized centers, such as eating disorders
clinics. These clinics are usually found at major medical centers.
Should overweight children be treated?
Overweight children at any age have a greater risk of becoming obese adults
than normal-weight children. These children tend to have higher blood pressure
and cholesterol levels than normal weight children do. High blood pressure
and cholesterol are risk factors for heart disease in later life. This is
why overweight children should be treated. Behavior therapy programs tailored
to the child’s age have both short-term and long-term success in
helping children lose weight. These programs usually involve parents.
Social standards for body shape change over time. This is especially true
for women. In the United States, a thin body is expected for women. Most
women diet from time to time. However, a few restrict their diet in a major
way. These women tend lose control of their eating and begin to binge-eat.
Binge eating leads to the possibility of weight gain. As a result, individuals
begin to purge. Some ways people purge include vomiting or using laxatives
or diuretics. Less often, people purge by not eating for several days.
Over time, an extreme concern about body shape develops. This fosters
more severe dieting and increases the frequency of purging when diet rules
are broken. These behaviors are known as bulimia. Bulimia carries health
risks, including increased dental problems and a loss of potassium, which
may lead to problems such as abnormal heart rhythms. Psychological
problems, including irritability and depression, can also occur. The vast
majority of bulimics are women, although a few men do develop this problem.
Cognitive behavior therapy has been shown to be helpful in overcoming
bulimia. Treatment consists of careful record keeping. This can be used to
help the patient form new behaviors, including:
eating three or more balanced meals each day;
delaying and then stopping purging;
looking at and changing false beliefs about food, dieting, and body shape; and
learning that things other than body shape are important to developing a good self-image.
The length of treatment depends on the severity of the bulimia. The average
number of treatment sessions is between 15 and 20. Cognitive behavior
therapy has some benefits for people who are bulimic. Most people have
increased self-control of binge eating and purging. Also, about two-thirds
of patients are able to return to normal eating patterns. Weight gain after
treatment is the exception rather than the rule. When people do gain
weight, these gains are usually small. Behavior therapy for bulimia nervosa
is available at a number of eating disorders centers. When choosing a treatment
program, it is important to ask about the therapist’s experience in
treating patients with bulimia. Antidepressant medications have also been
shown to be useful. Such medication may be especially helpful for patients
who do not get better with behavior therapy.
Should bulimics be hospitalized?
Unless there are major medical problems, or a related severe mental health
problem, hospitalization is not usually necessary for the treatment of bulimia.
Hospitalization takes people out of the environment in which the
problem occurs. This may make recovery from the disorder harder because
bulimics must learn to eat normally in their own environment.
Anorexia is the rarest of the three eating disorders. Anorexia is characterized
by a large loss of body weight. People often fall 20% to 30% below
their ideal weight. Anorexia nervosa may become a chronic illness. It usually
begins in early adolescence. It can require frequent hospitalization for
the medical problems of starvation. About 5% of anorexic patients die because
of the disorder. About half of those die from the complications of the
disorder and about half from suicide. Most patients with this disorder need
to be hospitalized, preferably in a unit designed for the treatment of eating
disorders. Early cases, in which weight loss has not fallen to low levels, can
be treated on an outpatient basis.
Behavior therapy forms the basis of modern treatment of anorexia nervosa.
Most patients with this disorder are worried about gaining weight. They
know they need to gain weight to be healthy and to have normal social
functioning. However, weight gain and changes in body shape can be
frightening for the anorexic. These people feel “fat” even though they are
often very thin.
A rewarding environment that helps the anorexic want to gain weight is
set up to help them overcome their problems. Within such an environment,
weight gain leads to access to pleasant activities. This rewards weight gain.
As the patient gains weight, the family is usually involved in helping the patient
return to a normal social life. In addition, the anorexic is helped to
build up behaviors that will aid in the process.
Research has shown that about three quarters of anorexics treated with
behavior therapy will gain a reasonable amount of weight. In addition, they
will return to reasonably normal activities. Some anorexics will relapse and
will need to be rehospitalized. A few patients will not get better with this
Much progress has been made in understanding and treating the eating
disorders over the past 20 years. Because of strong research efforts, behavior
therapy has become either the treatment of choice or a major part of
treatment for these problems. If support for research continues, we should
expect to keep improving our ability to treat these disorders.
For more information or to find a therapist:
Please feel free to photocopy or reproduce this fact sheet, noting that this fact sheet was writen and produced by ABCT. You may also link directly to our site and/or to the
from which you took this fact sheet