Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA.
Clin Psychol Rev. 2012 Jun;32(4):343-57. doi: 10.1016/j.cpr.2012.03.001. Epub 2012 Mar 9.
Given the well-documented shortage of cognitive-behavioral therapy (CBT) for eating disorders, there is a compelling need for advances in dissemination. Guided self-help based on cognitive-behavioral principles (CBTgsh) provides a robust means of improving implementation and scalability of evidence-based treatment for eating disorders. It is a brief, cost-effective treatment that can be implemented by a wide range of mental health providers, including non-specialists, via face-to-face contact and internet-based technology. Controlled studies have shown that CBTgsh can be an effective treatment for binge eating disorder and bulimia nervosa, although it is contraindicated for anorexia nervosa. Several studies have shown that CBTgsh can be as effective as more complex specialty therapies and that it is not necessarily contraindicated for patients with comorbid conditions. Mental health providers with relatively minimal professional credentials have in some studies obtained results comparable to specialized clinicians. Establishing the nature of optimal "guidance" in CBTgsh and the level of expertise and training required for effective implementation is a research priority. Existing manuals used in CBTgsh are outdated and can be improved by incorporating the principles of enhanced transdiagnostic CBT. Obstacles to wider adoption of CBTgsh are identified.
鉴于认知行为疗法（CBT）治疗饮食失调症的明显短缺，因此迫切需要在传播方面取得进展。基于认知行为原则的指导自助疗法（CBTgsh）为改善饮食失调症的循证治疗的实施和可扩展性提供了一种强大的手段。它是一种简短、具有成本效益的治疗方法，可以由广泛的心理健康提供者（包括非专业人员）通过面对面接触和互联网技术来实施。对照研究表明，CBTgsh 可以作为暴食症和神经性贪食症的有效治疗方法，尽管它不适合厌食症患者。几项研究表明，CBTgsh 可以与更复杂的专业治疗一样有效，并且对于合并症患者并非禁忌。在某些研究中，具有相对较少专业证书的心理健康提供者已经获得了与专业临床医生相当的结果。确定 CBTgsh 中最佳“指导”的性质以及有效实施所需的专业知识和培训水平是研究的重点。现有的 CBTgsh 使用手册已经过时，可以通过纳入增强型跨诊断 CBT 的原则来改进。确定了更广泛采用 CBTgsh 的障碍。
