This chapter outlines the essential transition phase following intensive CBT-E, emphasizing strategies to support patients as they return home and continue treatment in standard outpatient settings. Traditional intensive programs for eating disorders are associated with high relapse rates due to abrupt shifts in care and exposure to environmental triggers. Intensive CBT-E aims to minimize this risk through a gradual step-down approach, which includes open-ward treatment, day-hospital phases, weekend home visits, and the involvement of significant others to strengthen the home environment. Key goals during this stage include maintaining treatment gains, addressing residual eating disorder features, and preventing relapse. Patients are actively involved in monitoring early warning signs, applying strategies from core CBT-E modules, and preparing for common challenges such as dietary rules, body checking, body avoidance, and spikes in body image concerns. A structured post-discharge plan is collaboratively developed, focusing on life after intensive CBT-E, outpatient treatment continuity, priority problems for the first 3 months, and strategies to minimize relapse. Post-intensive outpatient CBT-E is delivered when it is possible with the same therapeutic framework to ensure consistency, gradually reducing session frequency while maintaining focus on regular eating, weight stability, and residual psychopathology. Relapse-prevention planning emphasizes distinguishing between lapses and relapses, identifying triggers, and employing proactive problem-solving strategies.

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Preparing for the Return Home Module

  • Riccardo Dalle Grave

摘要

This chapter outlines the essential transition phase following intensive CBT-E, emphasizing strategies to support patients as they return home and continue treatment in standard outpatient settings. Traditional intensive programs for eating disorders are associated with high relapse rates due to abrupt shifts in care and exposure to environmental triggers. Intensive CBT-E aims to minimize this risk through a gradual step-down approach, which includes open-ward treatment, day-hospital phases, weekend home visits, and the involvement of significant others to strengthen the home environment. Key goals during this stage include maintaining treatment gains, addressing residual eating disorder features, and preventing relapse. Patients are actively involved in monitoring early warning signs, applying strategies from core CBT-E modules, and preparing for common challenges such as dietary rules, body checking, body avoidance, and spikes in body image concerns. A structured post-discharge plan is collaboratively developed, focusing on life after intensive CBT-E, outpatient treatment continuity, priority problems for the first 3 months, and strategies to minimize relapse. Post-intensive outpatient CBT-E is delivered when it is possible with the same therapeutic framework to ensure consistency, gradually reducing session frequency while maintaining focus on regular eating, weight stability, and residual psychopathology. Relapse-prevention planning emphasizes distinguishing between lapses and relapses, identifying triggers, and employing proactive problem-solving strategies.