This book uniquely combines CBT with the Department of Health stepped care model to provide the first comprehensive case study-approach textbook. A step-by-step guide to using CBT, the book is structured around case examples of clients who present with the most commonly encountered conditions; from mild depression and GAD to more complex, enduring symptoms and diagnosis like OCD, personality disorder and social phobia.

The distinctive practical format is ideal in showing how to put the principles of CBT and stepped care into effect. As well as echoing postgraduate level training, it provides an insight into the experiences the trainee will encounter in real-world practice. Each chapter addresses a specific client condition and covers initial referral, presentation and assessment, case formulation, treatment interventions, evaluation of CBT strategies and discharge planning.

The book also includes learning exercises and clinical hints, as well as extensive reference to further CBT research, resources and reading. It will be invaluable for trainees on Improving Access to Psychological Therapies (IAPT) programs, and anyone studying graduate CBT courses.

Client Presenting with Chronic Bulimia Nervosa

Client presenting with chronic bulimia nervosa

Learning Objectives

By the end of this chapter you should be able to:

  • Identify bulimia nervosa from the diagnostic criteria
  • Describe the development of the condition
  • Identify the range of assessment tools leading to case formulation and treatment
  • Understand the interventions at core belief level

Diagnostic Criteria

The diagnostic criteria for bulimia nervosa (BN) using DSM-IV-TR 307.51 (APA, 2000) states that the individual experiences recurrent bouts of binge eating that clearly includes larger amounts than normal and is eaten within a specific short timeframe. The bingeing episode itself may be described as uncontrollable by the individual, although if interrupted the bingeing will stop and this may explain the reason for bingeing to be viewed as a secret activity by the individual. ...

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