A comprehensive platform for training in CBT for EDs has been developed; findings indicate that the use of the platform may increase competence scores.14,15 Likewise, a comprehensive online training program in interpersonal psychotherapy has also been developed, including telephone-based simulation assessment for measurement of adherence and competence in the treatment, with testing currently underway.16
Best-buy interventions. When selecting an evidence-based treatment to disseminate, selection criteria should be based on best-buy interventions and include: efficacy, cost-effectiveness, clinical range, ease of training and learning, and mode of treatment delivery.17 Transdiagnostic treatments may be considered best buys because they have the advantage of offering greater clinical range and thus more practicality, which may enhance adoption of the method by therapists. In that sense, interpersonal psychotherapy might be considered a best-buy intervention given its ability to not only address EDs but also a variety of other problems, including depression, anxiety, and PTSD.18
Cost-effectiveness is also a key consideration in defining a best buy. Family-based treatment might be considered a best buy given that it is cost effective compared with weight restoration via inpatient hospitalization. Likewise, guided self-help CBT has the advantage of being very easy to learn and deliver, even by inexperienced practitioners, making it very cost-effective.
Electronic support tools. Electronic support tools for therapists have the potential to enhance quality of care. First, checklists can help therapists ensure important points are covered in session and can also aid in decision-making. For instance, an electronic measurement-feedback system for routine outcome monitoring can be used. Meta-analytic work suggests that routine outcome feedback improves patient outcomes, at least in the short-term.19 Such monitoring can provide therapists with alerts that clients are “off track” indicating the current course of treatment may be ineffective. Furthermore, the detection of symptom improvements can reassure clients they are making progress and enhance the therapeutic alliance.
Electronic support tools can also be used to enhance adherence to therapy and facilitate transmission of information to the therapist. Recovery Record is a mobile app that can be used by patients with EDs to self-monitor meals, thoughts, emotions, and behaviors and share this information with the therapist.
Dr Fitzsimmons-Craft is Assistant Professor of Psychiatry, and Dr Wilfley is the Scott Rudolph University Professor of Psychiatry, Medicine, Pediatrics, and Psychological and Brain Sciences, Washington University School of Medicine, St. Louis, MO. The authors report no conflicts of interest concerning the subject matter of this article.
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