Inpatient Cognitive Behavior Therapy for Severe Eating Disorders

Enhanced cognitive behaviour therapy (CBT-E) for eating disorders has been developed and evaluated only in outpatient setting. Aim of the paper is to describe a novel model of inpatient treatment, termed inpatient CBT-E, indicated for patients with an eating disorder of clinical severity not manageable in an outpatient setting or that failed outpatient treatment. Inpatient CBT-E is derived by the outpatients CBT-E with some adaptations to rend the treatments suitable for an inpatient setting. The principal adaptations include: 1) multidisciplinary and noneclectic team composed of physicians, psychologists, dieticians and nurses all trained in CBT; 2) assisted eating; 3) group sessions; and a CBT family module for patients younger than 18 years. The treatment lasts 20 weeks (13 for inpatients followed by seven weeks of residential day treatment) and, as CBT-E, is divided in four stages and can be administered in a focused form (CBT-F) or in a broad form (CBT-B). A randomized control trial is evaluating the effectiveness of the treatment.