I know what you did last summer (and it was not CBT): A factor analytic model of international psychotherapeutic practice in the eating disorders


  • This paper was presented at the Annual Meeting of the Eating Disorders Research Society, Toronto, Canada, October 2005 and at the Annual Meeting for Academy for Eating Disorders, International Conference, Barcelona, Spain, June 2006.



Although several studies have shown that eating disorders clinicians do not generally use treatment manuals, findings regarding what they do use have typically been vague, or closely linked to a particular theoretical approach. Our goal was to identify what eating disorder clinicians do with their patients in a more theoretically neutral context. We also sought to describe an empirically defined approach to psychotherapeutic practice as defined by clinicians via factor analysis.


A survey developed for this study was administered to 265 clinicians recruited online and at regional and international meetings for eating disorders professionals.


Only 6% of respondents reported they adhered closely to treatment manuals and 98% of the respondents indicated they used both behavioral and dynamically informed interventions. Factor analysis of clinicians' use of 32 therapeutic strategies suggested seven dimensions: Psychodynamic Interventions, Coping Skills Training, Family History, CBT, Contracts, Therapist Disclosure, and Patient Feelings.


The findings of this study suggest that most clinicians use a wide array of eating disorder treatment interventions drawn from empirically supported treatments, such as CBT-BN, and from treatments that have no randomized controlled trial support. Factor analysis suggested theoretically linked dimensions of treatment, but also dimensions that are common across models. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007