title: Clinicians' concerns about delivering cognitive-behavioural therapy for eating disorders.
abstract: Despite research supporting the effectiveness of evidence-based interventions in the treatment of eating disorders, those interventions are under-utilised in routine clinical practice, possibly due to clinicians' concerns about delivering the relevant techniques. This study examined what elements of therapy clinicians worry about when delivering cognitive-behavioural therapy (CBT) for the eating disorders, and what clinician variables are associated with such concerns. The participants were 113 clinicians who used individual CBT with eating disorder patients. They completed a novel measure of concerns about delivering elements of CBT, as well as demographic characteristics and a standardised measure of intolerance of uncertainty. Clinicians worried most about body image work and ending treatment, but least about delivering psychoeducation. Their concerns fell into four distinct factors. Older, more experienced clinicians worried less about delivering the CBT techniques, but those with greater levels of prospective and inhibitory anxiety worried more about specific factors in the CBT techniques. Clinicians' capacity to tolerate uncertainty might impair their delivery of evidence-based CBT, and merits consideration as a target in training and supervision of CBT clinicians.
authors.affiliation: Southern Health Eating Disorders Service, Southern Health NHS Foundation Trust, Southampton, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Turner
authors.affiliation: Norfolk Community Eating Disorders Service, Norwich, UK.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Tatham
authors.affiliation: Barnsley Specialist Adult Learning Disability Health Service, South West Yorkshire Partnership NHS Foundation Trust, UK.
authors.forename: Marie
authors.initials: M
authors.lastname: Lant
authors.affiliation: South London and Maudsley Eating Disorder Service, South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry, King's College London, London, UK.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Mountford
authors.affiliation: Clinical Psychology Unit, Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2NT, UK. Electronic address: g.waller@sheffield.ac.uk.
authors.forename: Glenn
authors.initials: G
authors.lastname: Waller
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy; D001068:Feeding and Eating Disorders / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D035501:Uncertainty; D055815:Young Adult
keywords: Anxiety; Clinician; Cognitive-behavioural therapy; Eating disorders; Effectiveness