When someone is having emotional or behavioral problems, people often recommend getting “professional help”. But is all professional help created equal? Unfortunately when it comes to psychotherapy, the answer is no. Not all forms of therapy are equivalent — typically, it does matter which kind you get. Consider, for example, the case of bulimia. Bulimia’s hallmarks include: eating much more food than normal during a meal or snack; engaging in vomiting, excessive exercise, or other means to reduce weight; preoccupation with body image or shape; feeling that eating is not under your control; and excessive fear of weight gain. Bulimia and other eating disorders can be life threatening, and should be taken very seriously.
Research on Bulimia Treatment
Why is psychotherapy recommended to treat bulimia? Because research studies show that it helps. One recent well-done study conducted in Denmark compared psychoanalytic treatment vs. cognitive-behavioral therapy (CBT) for bulimia. This study was a comparable effectiveness study, an important type of research that is particularly relevant to mental health. The study compared two groups of people with bulimia. One group received 20 sessions of CBT, and the other received one hundred sessions of psychoanalytic therapy. One might ask, why did they make the two groups uneven in that way? The researchers chose to do this because it more closely reflected how these therapies are typically delivered “in the real world.” CBT is typically a short-term treatment, and psychoanalytic therapy is often a long-term treatment. That is why the CBT group was seen by CBT therapists for five months, and the psychoanalytic therapy group received two years’ worth of weekly treatment.
How did these patients do? The patients who received CBT for five months were 44% likely to be completely binge- and purge-free after two years. The patients who received psychoanalytic therapy were only 15% likely to be completely binge- and purge-free after two years. This is quite a stark difference between the groups; patients in the short-term CBT group were nearly three times as likely to be binge- and purge-free than those in the other group. Perhaps most significantly, the CBT group achieved these gains after only five months, and the gains were maintained for at least the two year period of the study.
It should be noted that on a broader measure of eating disorder symptoms, the two groups came out very similarly at the end of two years’ time. However, the CBT group made its gains in the first five months, whereas the psychoanalytic therapy group improved gradually over two years. If you had bulimia, which treatment would you choose? The moral of the story is that choosing the type of therapy you receive is an important decision that may affect how much improvement you make and how quickly you make it.