CBT4BN: a randomized controlled trial of online chat and face-to-face group therapy for bulimia nervosa
<b><i>Objective:</i></b> Although cognitive-behavioral therapy (CBT) represents the first-line evidence-based psychotherapy for bulimia nervosa (BN), most individuals seeking treatment do not have access to this specialized intervention. We compared an Internet-based manualiz...
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| Main Authors: | , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2017
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| In: |
Psychotherapy and psychosomatics
Year: 2017, Volume: 86, Issue: 1, Pages: 47-53 |
| ISSN: | 1423-0348 |
| DOI: | 10.1159/000449025 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1159/000449025 Verlag, Volltext: https://www.karger.com/Article/FullText/449025 
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| Author Notes: | Stephanie C. Zerwas, Hunna J. Watson, Sara M. Hofmeier, Michele D. Levine, Robert M. Hamer, Ross D. Crosby, Cristin D. Runfola, Christine M. Peat, Jennifer R. Shapiro, Benjamin Zimmer, Markus Moessner, Hans Kordy, Marsha D. Marcus, Cynthia M. Bulik |
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| 520 | |a <b><i>Objective:</i></b> Although cognitive-behavioral therapy (CBT) represents the first-line evidence-based psychotherapy for bulimia nervosa (BN), most individuals seeking treatment do not have access to this specialized intervention. We compared an Internet-based manualized version of CBT group therapy for BN conducted via a therapeutic chat group (CBT4BN) to the same treatment conducted via a traditional face-to-face group therapy (CBTF2F). <b><i>Method:</i></b> In a two-site, randomized, controlled noninferiority trial, we tested the hypothesis that CBT4BN would not be inferior to CBTF2F. A total of 179 adult patients with BN (2.6% males) received up to 16 sessions of group CBT over 20 weeks in either CBT4BN or CBTF2F, and outcomes were compared at the end of treatment and at the 12-month follow-up. <b><i>Results:</i></b> At the end of treatment, CBT4BN was inferior to CBTF2F in producing abstinence from binge eating and purging. However, by the 12-month follow-up, CBT4BN was mostly not inferior to CBTF2F. Participants in the CBT4BN condition, but not CBTF2F, continued to reduce their binge-eating and purging frequency from the end of treatment to the 12-month follow-up. <b><i>Conclusions:</i></b> CBT delivered online in a group chat format appears to be an efficacious treatment for BN, although the trajectory of recovery may be slower than face-to-face group therapy. Online chat groups may increase accessibility of treatment and represent a cost-effective approach to service delivery. However, barriers in service delivery such as state-specific license and ethical guidelines for online therapists need to be addressed. | ||
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