Personalized Feedback Enhances CBT for Bulimia Nervosa

Feedback has long been a part of psychosocial and health behavior interventions. Now computerized assessment and treatment tools are making it even more effective, according to a group of London researchers.

Janet Treasure, MD and colleagues at the Institute of Psychiatry, London, have reported that adding repeated personalized feedback to guided self-help cognitive behavioral therapy (CBT) improves treatment outcome for patients with bulimia nervosa, or BN (Br J Clin Psychol 2006; 45:111). In this randomized control study, 61 patients with DSM-IV -defined BN were randomly chosen to receive 14 sessions of CBT guided self-care, with or without personalized feedback on current physical and psychological status, risk and problems, and other variables that might help or hinder change.

The patients received feedback in a number of ways: (1) with personalized letters sent after patients were first evaluated and at the end of treatment; (2) with a specially designed feedback form administered halfway through treatment; (3) with computerized feedback about bulimic and other symptoms, such as anxiety, depression, and interpersonal functioning, repeated at intervals throughout treatment and follow-up.

Adding feedback to CBT didn’t have any effect on patients signing up for or dropping out of treatment. However, it did improve outcome by reducing self-induced vomiting and dietary restriction. Thus, the authors suggest that repeated personalized feedback can improve outcome when paired with CBT self-help programs.