An exploration of women’s experiences of cognitive-behaviour therapy for the treatment of bulimia nervosa

Hallikainen, Kati (2018) An exploration of women’s experiences of cognitive-behaviour therapy for the treatment of bulimia nervosa. Doctoral thesis, London Metropolitan University.


Background: The previous and current NICE guidelines consider cognitive-behaviour therapy (CBT) to be the best psychological intervention for the treatment of bulimia nervosa (BN). This is despite various issues with the studies contributing to this evidence-base. Overall, research has suggested that CBT is associated with the highest levels of symptom reduction, but little is known about what makes the therapy effective. Clients’ views regarding the topic have been especially neglected thus far.

Aims: The study aimed to gain a detailed understanding of women’s experiences of CBT and its impact on their post-therapy lives. It also sought to provide clinicians and other professionals with helpful insights into how best support individuals with bulimic difficulties.

Methodology: Semi-structured interviews were completed with four women who met the inclusion criteria for the study. The verbatim transcripts were analysed by using Interpretative Phenomenological Analysis (IPA).

Findings: Three master themes and nine subthemes were revealed through the analytical process. The master themes were: Loss of control; Staying on the surface; and Holding onto power.

Conclusions: The findings indicated that the concept of ‘control’ and concerns regarding its loss and maintenance were central to all four women taking part in the study; these concerns were present in each master theme. Although all participants reported CBT to have helped them to address their disordered eating behaviours, parts of the women’s identities associated with these difficulties were left untouched. The implications of the findings to clinical practice, and suggestions for future research will be discussed.

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