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Complexity in eating disorders: a case for simple or complex formulation and treatment?

Published online by Cambridge University Press:  01 December 2017

Victoria A. Mountford ,
Madeleine Tatham ,
Hannah Turner  and
Glenn Waller Open the ORCID record for Glenn Waller [Opens in a new window]
Victoria A. Mountford
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK Eating Disorders Service, South London and Maudsley NHS Foundation Trust, UK
Madeleine Tatham
Affiliation:
Norfolk Community Eating Disorders Service, Cambridgeshire and Peterborough NHS Foundation Trust, UK
Hannah Turner
Affiliation:
Eating Disorders Service, Southern Health NHS Foundation Trust, UK
Glenn Waller*
Affiliation:
Department of Psychology, University of Sheffield, UK
*
*Author for correspondence: Glenn Waller, Department of Psychology, University of Sheffield, 1 Vicar Lane, Sheffield S1 2LT, UK (email: g.waller@sheffield.ac.uk).
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Abstract

Eating disorders are commonly regarded as complex psychiatric conditions, although this perception might be a product of the high levels of physical and psychological co-morbidity that are present in many such cases, rather than being about complexity in the eating disorder per se. This paper will consider the reasons that eating disorders are seen as complex, and whether or not that perceived complexity should be seen as a genuine reason to deviate from existing evidence-based cognitive behavioural therapy (CBT) protocols. Case examples will be used to illustrate how complex presentations can require clinicians to work skilfully with relatively simple formulations to achieve the best outcome, rather than using unnecessarily complex formulations and treatments. The importance of clear supervision is also stressed, as it can play a role in clinicians’ perception of the need for a complex or simple formulation, it can support the clinician in developing a collaborative, focused and efficient formulation, and it can keep the clinician on track with an evidence-based CBT approach.

Keywords

eating disorderscomplexityco-morbiditysupervisionevidence-based CBT

Information

Type
Special Issue: Complexity within Cognitive Behaviour Therapy
Information
the Cognitive Behaviour Therapist , Volume 10 , 2017 , e14
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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