CBT-E: Addressing Eating Disorder Psychopathology with Cognitive Behavioral Strategies and Procedures

Enhanced cognitive behavior therapy (CBT-E) is a highly personalized and flexible psychological treatment designed to address eating disorder psychopathology operating in the patient rather than their eating disorder diagnosis. The treatment was initially intended for adult outpatients but was also adapted for adolescents and intensive care settings (i.e., intensive outpatient, day-hospital, residential, and inpatient treatments). The most distinctive and unique feature of this approach, also termed “multistep CBT-E,” is that the same theory and procedures are applied at each level of care and by a CBT-E non-eclectic multidisciplinary team. This chapter describes the core principles of CBT-E for eating disorders, the transdiagnostic theory on which it is based, and the adaptations for clinical groups and settings. It also reviews the data from the studies that established the efficacy and effectiveness of CBT-E in adolescents, adults, and those with severe and enduring eating disorders treated in outpatient, day-hospital, and inpatient settings. Finally, it discusses the future challenges and directions of CBT-E to enhance its effectiveness, efficiency, and accessibility.