Enhanced Cognitive Behavioral Therapy (CBT-E)

What is CBT-E?

Enhanced Cognitive Behavioral Therapy or CBT-E is the leading evidence-based practice for those who experience eating disorders.

Since CBT-E’s foundation is rooted in Cognitive Behavioral Therapy (CBT), the approach within CBT-E is equally as “problem-oriented” and very present / future-focused.

CBT-E asks clients to take a step back and “de-center” from their eating disorder, to understand how the eating disorder operates and what behaviors are sustaining it.

CBT-E incorporates effective practices like understanding cognitive biases and acknowledging the connection of thoughts, feelings, and behaviors.

The treatment is a structured approach with four stages:

1. Engaging the client in treatment
2. Identifying emerging barriers to treatment
3. Addressing maintaining factors of the eating disorder
4. Ensuring changes are maintained and minimizing the risk of relapse

The majority of treatment is spent in stage 3, where the main goal is to identify and address the “maintaining factors and mechanisms” of the eating disorder.  This can include mood intolerances, interpersonal problems, perfectionism, and low self-esteem. These factors are commonly present across the various eating disorder diagnoses.