Interpersonal Psychotherapy for Bulimia Nervosa
Status: Strong Research Support
Interpersonal Psychotherapy (IPT) for bulimia nervosa is based on an intervention originally developed for the treatment of depression. In IPT, the focus is on interpersonal difficulties in the patient’s life. The connection between these problems and the development and maintenance of the eating disorder is identified at the beginning of treatment, but only implied thereafter; for the majority of the therapy, the symptoms of bulimia nervosa are never explicitly addressed. IPT for bulimia nervosa is conducted in approximately twenty weekly sessions, which encompass three phases. The first phase of IPT is devoted to identifying specific interpersonal problems areas currently affecting the patient, and choosing which of these areas to focus on for the remainder of treatment. The four typical interpersonal problem domains are role disputes, role transitions, interpersonal deficits, and unresolved grief. Interpersonal precipitants of current binge eating episodes are highlighted during this phase. In the second phase of IPT for bulimia nervosa, the therapist encourages the patient to take the lead in facilitating change in the interpersonal realm. The therapist’s role involves keeping the patient aware of the time frame of treatment and focused on the problem areas, clarifying issues raised by the patient, and encouraging change. The third phase covers maintenance of interpersonal gains and relapse prevention. This treatment is typically administered individually, but it can be delivered in group format. In clinical trials, IPT for bulimia nervosa has been shown to have a slower effect than CBT in achieving symptom improvement and resolution.
Key References (in reverse chronological order)
- Nevonen, L., & Broberg, A.G. (2006). A comparison of sequenced individual and group psychotherapy for patients with bulimia nervosa. International Journal of Eating Disorders, 39(2), 117-127.
- Mitchell, J.E., Halmi, K., Wilson, G.T., Agras, W.S., Kraemer, H., & Crow, S. (2002). A randomized secondary treatment study of women with bulimia nervosa who fail to respond to CBT. International Journal of Eating Disorders, 32(3), 271-281.
- Agras, W.S., Walsh, T., Fairburn, C.G., Wilson, GT, & Kraemer, H.C. (2000). A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa. Archives of General Psychiatry, 57(5), 459-466.
- Fairburn, C.G., Norman, P.A., Welch, S.L., O’Connor, M.E., Doll, H.A., & Peveler, R.C. (1995). A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Archives of General Psychiatry, 52, 304-312.
- Fairburn, C. G., Jones, R., Peveler, R. C., Hope, R. A., & O’Connor, M. (1993). Psychotherapy and bulimia nervosa: The longer-term effects of interpersonal psychotherapy, behaviour therapy and cognitive behaviour therapy. Arch Gen Psychiatry, 50, 419-428.
- Fairburn, C. G., Jones, R., Peveler, R. C., Carr, S. J., Solomon, R. A., O’Connor, M. E., Burton, J., & Hope, R. A. (1991). Three psychological treatments for bulimia nervosa: A comparative trial. Arch Gen Psychiatry, 48, 463-469.
- Fairburn, C. G., Kirk, J., O’Connor, M., & Cooper, P. J. (1986). A comparison of two psychological treatments for bulimia nervosa. Behav Res Ther, 24, 629-643.
- Fairburn, C.G. (1997). Interpersonal psychotherapy for bulimia nervosa. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of treatment for eating disorders (2nd ed.). (pp. 278-294). New York: The Guilford Press.
- Fairburn, C. G. (1992). Interpersonal psychotherapy for bulimia nervosa. In G. L. Klerman & M. W. Weissman (Eds.), New applications of interpersonal Psychotherapy (pp.353-378). Washington, D. C.: American Psychiatric Press.
- Klerman, G. L., Weissman, M. M., Rounsaville, B. J., & Chevron, E. S. (1984). Interpersonal psychotherapy of depression. New York: Basic Books.
- Contact Christopher G. Fairburn, DM, FRCPsych (Oxford University) at email@example.com