title: Assessing the distinctiveness of psychotherapies and examining change over treatment for anorexia nervosa with cognitive-behavior therapy, interpersonal psychotherapy, and specialist supportive clinical management.
abstract: Therapist adherence to cognitive-behavior therapy (CBT), interpersonal psychotherapy (IPT), and specialist supportive clinical management (SSCM) for anorexia nervosa (AN), was examined across three phases of therapy in a randomized clinical trial.
  
  
  
  Adherence in early, middle, and late phase therapy sessions from 53 of 56 participants in the trial was assessed using the CSPRS-AN by independent raters after listening to complete therapy sessions.
  
  
  
  The three forms of psychotherapy were distinguishable by blind raters. Subscale scores were higher for the corresponding therapy than the other therapy modalities. In CBT and SSCM, a phase-by-therapy effect was found, with the CBT subscale highest for CBT, intermediate for SSCM, lowest for IPT, and elevated in the middle phase of CBT and SSCM. The SSCM subscale was highest for SSCM, intermediate for CBT, lowest for IPT, and elevated in the middle phase of SSCM. Adherence to activities around normalizing eating, weight gain, and education about anorexia nervosa was higher in SSCM than in either CBT or IPT.
  
  
  
  Ensuring the distinctiveness of therapies in existing clinical trials with differential treatment outcome is essential. Research on adherence to therapy modalities has the potential to help understanding of the effective components of new and existing treatments for AN. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:958-962).
authors: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. virginia.mcintosh@otago.ac.nz.|Specialist Mental Health, Canterbury District Health Board, Christchurch, New Zealand. virginia.mcintosh@otago.ac.nz.
authors: Virginia V W
authors: VV
authors: McIntosh
authors: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.|Specialist Mental Health, Canterbury District Health Board, Christchurch, New Zealand.
authors: Jennifer
authors: J
authors: Jordan
authors: Department of Psychology, University of Canterbury, Christchurch, New Zealand.
authors: Janet D
authors: JD
authors: Carter
authors: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors: Suzanne E
authors: SE
authors: Luty
authors: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.|Specialist Mental Health, Canterbury District Health Board, Christchurch, New Zealand.
authors: Frances A
authors: FA
authors: Carter
authors: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors: Janice M
authors: JM
authors: McKenzie
authors: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors: Christopher M A
authors: CM
authors: Frampton
authors: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors: Peter R
authors: PR
authors: Joyce
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000628:therapy*; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D010349:Patient Compliance; D011613:Psychotherapy / Q000379:methods*; D013038:Specialization; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult
keywords: anorexia nervosa; cognitive-behavioral therapy; eating disorders; interpersonal psychotherapy; randomized controlled trial; specialist supportive clinical management