title: What cognitive behavioral techniques do therapists report using when delivering cognitive behavioral therapy for the eating disorders?
abstract: OBJECTIVE
  Clinicians commonly "drift" away from using proven therapeutic techniques. This study examined the degree to which such drift occurs among cognitive behavioral therapy (CBT) clinicians working with a specific clinical population-adults with eating disorders.
  
  
  METHODS
  The study used a correlational design. The participants were 80 qualified clinicians (69 women, 11 men; mean age = 39.2 years, range = 23-62 years) who routinely offered what they described as CBT to adults with eating disorders. Each clinician detailed whether and how often he or she used different cognitive behavioral techniques when delivering CBT to such patients, and each completed the anxiety scale of the Brief Symptom Inventory (Derogatis, 1983).
  
  
  RESULTS
  Implementation of specific CBT techniques was far lower than protocols would suggest, particularly for clinicians who were anxious, older, or more experienced in working with the eating disorders (p < .05, in all cases). The use of treatment manuals was associated with greater use of recommended CBT techniques (p < .05, in all cases). Cluster analysis showed that clinicians fell into three types-behavior, motivation, and mindfulness oriented.
  
  
  CONCLUSIONS
  These findings need to be extended to other therapies and other disorders, but they indicate the need for stronger training and closer supervision if clinicians are to give patients the best chance of recovery. They demonstrate that clinicians' use of the label CBT is not a reliable indicator of the therapy that is being offered.
authors.affiliation: Eating Disorders Section, Institute of Psychiatry, King's College London, England. glenn.waller@kcl.ac.uk
authors.forename: Glenn
authors.initials: G
authors.lastname: Waller
authors.forename: Hannah
authors.initials: H
authors.lastname: Stringer
authors.forename: Caroline
authors.initials: C
authors.lastname: Meyer
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D016000:Cluster Analysis; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult