Cognitive emotional behavioural therapy

Domain II · Behavioural & cognitive · Emma Corstorphine · 2006 · United Kingdom

What it is

Cognitive-emotional-behavioural therapy for the eating disorders (CEBT-ED) extends cognitive-behavioural therapy (CBT). It was developed in the UK around 2006 for people with eating disorders whose difficulties with emotions block or undermine standard CBT. It targets the person's beliefs about…

Format

• Format and dose.
• Delivered individually or in groups; often used as a pre-treatment.

Who practises it, and how they are trained or regulated

• Whether this is a fixed protocol. In the 2007 book, CEBT-ED is one of three add-on approaches in chapter 25 ("Comorbidity with Axis II pathology"), in the part of the book for when the standard approach to CBT is not enough. It sits between DBT methods for emotion regulation (§25.1) and schema-focused CBT for core beliefs (§25.3), and runs to about four pages. It is an adaptation within CBT-ED, not a free-standing…
• A different four-phase account. A treatment-provider website describes four stages: assessing background (including how society stigmatises eating disorders); developing self-awareness; recognising emotions and how they link to eating, body image and self-esteem; and starting change by learning to regulate those emotions. It says sessions can be individual or in a group, follow a set number of sessions with fixed…
• Version followed: CEBT-ED as described by Emma Corstorphine (now Gray) in European Eating Disorders Review (2006) and in §25.2 of Waller, Cordery, Corstorphine et al., Cognitive Behavioral Therapy for Eating Disorders (Cambridge University Press, 2007), pp. 269–273. Sources: neither full text is drawn on. Sources include the book's contents list, which shows that §25.2, "Working with beliefs about emotions", has…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Homework not done (see section 5).
• Ending stirring up feelings of abandonment. Name it as an emotion to practise with.
• The client realising that expressing emotion at a moderate level is possible and acceptable.
• Rejecting every label, or being thrown by being observed. Check consent before naming what you notice.
• Discounting the evidence (“that doesn't count”). Name the discounting gently and include it in the review.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.