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Bulimia: Cognitive-Behavioral TreatmentROBERT A. MINES and CHERYL A. M Bulimia: Cognitive-Behavioral TreatmentROBERT A. MINES and CHERYL A. M

Bulimia: Cognitive-Behavioral TreatmentROBERT A. MINES and CHERYL A. M - PDF document

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Bulimia: Cognitive-Behavioral TreatmentROBERT A. MINES and CHERYL A. M - PPT Presentation

CognitiveBehavioral TreatmentFood1 Eat a portion from each of the major food groups each day4 Buy small quantities and individually packed portionsEating1 Try the Japanese Tea Ceremonyits the ID: 242096

Cognitive-Behavioral TreatmentFood1. Eat portion

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Bulimia: Cognitive-Behavioral TreatmentROBERT A. MINES and CHERYL A. MERRILLThe authors review the assumptions about processes that maintainissues,suchas AxisII diagnosis, hospitalization, and psychopharmaceutics, are addressed.B ulimia is a complex syndrome consisting of cognitive,strained eating and abstinence violation have been used to de-scribe aspects of cognitive processing germane to the mainte-are related to the bulimic's belief that purging is a reliable meth-Phase 1: Behavioral Strategies .The primary objective in Phase 1 is to assist clients in gainingno anxiety [0] to extreme[100]), their anxiety relative to weight gain, beliefs aboutBelow are examples of behavioral strategies for clients whoSetting1. Eat only at planned mealtimes.562 JOURNAL OF COUNSELING AND DEVELOPMENT / JUNE 1987 / VOL. 65 Cognitive-Behavioral TreatmentFood1. Eat a portion from each of the major food groups each day.4. Buy small quantities and individually packed portions.Eating1. Try the Japanese Tea Ceremony-it's the first and seconddigestion, relieve mouth hunger, and allow your stomach to tellpeople (e.g., those who are anorexic or obese), it may be 50 to100 pounds higher or lower. Therefore, you need to add or cuta few (or many) weeks.Not Necessarily Random Suggestions1. Exercise moderately to burn excess calories and increase) assistin teaching alternative coping skills (e.g.,sessionsper week. The therapist first explains the rationalesession. The purpose of the food is tosessions. After improve-ment occurs on the moderate anxiety-related foods, she bringsfood with greater SUDS values and repeats the procedure.During thesessions, while the client is eating, the therapistdiscussesthe client's thoughts and feelings using cognitive tech-band as a meansof regulating weight. The therapist and clientPhase 2: Cognitive StrategiesAfter behavioral control of the eating and purging has beenapproach. The behavioral control is achieved relatively easilymaintenanceof regular eating patterns and reduction of dietarycope more effectively with such circumstances, and reduce thefrequency of the occurrences. In addition, therapeutic tasks in-ues perpetuating the eating problem and body image distortionsas a meansof identifying and learning al-:ternative coping skills. Extended training in coping skills mayI/lI IDkIAI (1C (' IAIOCI IAI(l- ANIF-) ME:%/CIDP ACAIT / II IAIC 10R7 / \/I PIZ, Mines and MerrillThe cognitive phase can typically vary from 5 to 18sessionsup to a couple of years. The cognitive factors associated withPhase 3:Relapse PreventionMarlatt (1985) definedrelapse prevention"as a self-managementa return to pretreatment base rate. The goals of relapse preven-as an over-learned, maladaptive habit pattern-a maladaptive copingaspect of the change process because the client is faced withrelapse(Marlatt, 1985).reactions so as to prevent the lapse from becoming a majorto assistthe client in identifying and coping with covert determinants ofrelated issues.RELATED TREATMENT CONCERNSual abuse (more than 80% in our clients). These clients will notclients will benefit from a course of antidepressant medication.564medication referral are those with a multigenerational historyof depression or those with symptoms of an "agitated depres-REFERENCESAbraham, S., & Beumont, P. (1982). How patients describe bulimia ofPsychological Medicine,12, 625-635.American Psychiatric Association. (1980).Diagnosticand statistical manualofmentaldisorders(3rd ed.). Washington, DC: Author.Bulimarexia: The binge-purgeNew York: Norton.Psychological Medicine,11, 707-711.A handbook of psychotherapy for anorexiaand bulimia (pp. 160-192). New York: Guilford Press.Behavior Therapy, 16,393-405.Journal of Behavioral Medicine, 5,135-141.Journal of Personality,43, 647-660.disorder by family history and response to dexamethasone suppres-sion test.American Journal of Psychiatry,139, 685-687.Binge eatingin obesity: Preliminaryfindings and guidelines for behavioral analysis and treatment.Addic-tive Behaviors, 6,155-166.view of the model.In G. Marlatt & J. Gordon(Eds.),Relapse prevention(pp. 3-70). New York: Guilford Press.Merrill, C.A. (1984, August).Cognitive techniques in the group treatmentof bulimia.Paper presented at the meeting of the American Psycho-Merrill, C.A. (1986).Group treatment of bulimia: The effectso modifyingassumptionsand teachinof problemsolving. Unpub 'shed doc-Mines,R.A. (1983,March).A comparison of three group modalities in thebulimia:Preliminary results.Paper presented at the nationalmeeting of the American College Personnel Association, Houston.Assumptions and recommendations.American Mental Health Counse-lors Association journal,8, 229-236.Pyle, R., Mitchell, J.,& Eckert, E. (1981). Bulimia: A report of 34 cases.Journal of Clinical Psychiatry, 42,60-64.treatment of bulimianervosa. In D. Garner & P. Garfinkle (Eds.), Ahandbookof psychotherapyfor anorexia nervosa and bulimia(pp. 193-209).Russell, G. (1979).Bulimia nervosa:An ominous variant of anorexianervosa.Psychological Medicine,9, 429-448.Winstead, M. (1984,August).Cognitive-behavioral factors of relapse amongbulimics.Paper presented at the National Convention of the AmericanRobert A. Mines is the director ofMines& Associates, P.C.,and hasconductedan ongoing research program on bulimia group treatment at the University ofDenver for thepast5 years. Cheryl A. Merrillisa psychotherapistwithMines& Associates, P.C.The authors share first authorship onthisarticle.JOURNAL OF COUNSELING AND DEVELOPMENT / JUNE 1987 / VOL. 65