Successfully treating an eating disorder may be enough, without special treatment modules.
Reprinted from Eating Disorders Review
July/August Volume 25, Number 4
It has been suggested that perfectionism is a critical component that helps maintain an eating disorder (Thornton et al. 2009). Since perfectionism is viewed both as a maintaining factor and a risk factor for eating disorders, Drs. Mandy Goldstein and Stephen W. Touyz and colleagues in Sydney, Australia, had an interesting idea. Could adding a special treatment segment of direct treatment of perfectionism to treatment of persons with eating disorders have an effect on patients in a day treatment program?
Drs. Goldstein and Touyz designed a controlled study of participants enrolled in a step-down treatment phase from inpatient treatment to a day treatment program. Participants were randomized to treatment as usual or to treatment as usual plus the perfectionism treatment module. The patients completed self-report measures before treatment began, and after 7 sessions of treatment as usual or treatment plus the perfectionism module. In addition to the 7 sessions, all patients had 8 hours of treatment, 5 days a week, for 3.5 weeks. Three months after the end of treatment participants completed follow-up questionnaires.
Although there has been increasing interest in the potential role of treating perfectionism in eating disorders treatment, in this study it made no difference. The authors examined several possible reasons for this. They assessed a possible “ceiling effect” caused by the already-efficacious treatment, masking any effectiveness of the perfectionism treatment. Or, perhaps the dosage of perfectionism treatment (7 hours out of the 137 hours of treatment) was too low. Drs. Goldstein and colleagues noted that their pilot program was the first of its kind to investigate the impact of clinician-led treatment exclusively for perfectionism on the outcome of both eating disorder and perfectionism in a clinical cohort incorporating mixed eating disorder presentations.
The authors suggest possible future studies that could evaluate the effects of increasing treatment intensity, focusing on treatment of perfectionism in patients who have particularly large difficulty with unattainable standards, or delaying perfectionism treatment until after a patient fully recovers from his or her eating disorder. And, finally, the authors noted that “It may be that the best way to address perfectionism is in fact to treat the eating disorder.“