Most cognitive-behavioural therapy (CBT) protocols for treatment of patients with non-underweight eating disorders suggest that CBT should take about 20 sessions. However, patients report that their CBT for most such disorders lasts for a mean of about 40 sessions. So should we be extending our CBT protocols, or should clinicians be aiming to deliver them more efficiently? Indeed, do we even need 20 sessions?

In keeping with recent service provision issues in different countries and with evidence regarding the effectiveness of briefer versions of CBT for other disorders, the presenter and colleagues have developed and tested a 10-session version of CBT (CBT-T) for non-underweight eating disorders. Three case series have now shown CBT-T to be as effective as 20-session CBT, and patient acceptability is high. The therapeutic alliance in this therapy is strong, and comorbidity is reduced. Thus, CBT-T has the potential to ensure that more patients can be treated effectively.

CBT-T is focused on key elements of CBT for eating disorders, and is therefore more behaviourally focused and boundaried than some longer versions. However, it is a flexible protocol that is shaped to the individual patient’s eating pathology. CBT-T stresses early behavioural change (with lots of exposure and behavioural experiments) and ends with intensive body image work and relapse prevention.