Abstract
Although group therapy is often recommended for the treatment of bulimia nervosa, relatively little is known about predictors of short-term outcome. This pilot study examined whether a standardized measure of readiness for change might be related to changes in binge frequency. Sixteen bulimic patients participated in short-term cognitive behavioral group therapy for twelve weeks. Each patient completed the Change Assessment Scale prior to treatment, along with a battery of symptom measures which were readministered at the conclusion of therapy. Bulimic patients with positive outcome in binge frequency were at a higher stage of readiness for change at pretreatment than were patients with negative outcome. Results indicated that there may be methods of determining who would be most likely to benefit from cognitive behavioral group therapy, and tentatively suggest that interventions may be more successful when readiness for change is taken into consideration.
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Abraham, S.F., Mira, M., Beumont, P.J., Sowerbutts, T.D., Llewellyn-Jones, D. (1982). Eating behaviours among young women.Medical Journal of Australia, 2, 225–228.
American Psychiatric Association (1987).Diagnostic and Statistical Manual of Mental Disorders (3rd ed. revised). Washington, D.C.: Author.
Blouin, J.H., Carter, J., Blouin, A.G., Tener, L., Schnare-Hayes, K., Zuro, C., Barlow, J., and Perez, E. (1994). Prognostic indicators in bulimia nervosa: Treatment with cognitive-behavioral group therapy.International Journal of Eating Disorders, 15, 113–123.
Connors, M.E., Johnson, C.L., and Stuckey, M.K. (1984). Treatment of bulimia with brief psychoeducational group therapy.American Journal of Psychiatry, 141, 1512–1516.
Davis, R., Olmsted, M.P., and Rockert, W. (1992). Brief group psychoeducation for bulimia nervosa II: Prediction of clinical outcome.International Journal of Eating Disorders, 11, 205–211.
Fairburn, C.G. (1985). Cognitive-behavioral treatment for bulimia. In D.M. Garner and P.E. Garfinkel (Eds.),Handbook of psychotherapy for anorexia nervosa and bulimia. (pp. 160–192). New York: Guilford Press.
Fairburn, C.G., Peveler, R.C., Jones, R., Hope, R.A., and Doll, H.A. (1993). Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight.Journal of Consulting and Clinical Psychology, 61, 696–698.
Ferguson, G.A. (1981).Statistical analysis in psychology and education. New York: McGraw-Hill.
Franko, D.L. (1993). The use of a group meal in the brief group therapy of bulimia.International Journal of Group Psychotherapy, 43, 237–242.
Franko, D.L. and Zuroff, D.C. (1992). The Bulimic Automatic Thoughts Test: Initial reliability and validity data.Journal of Clinical Psychology, 48, 505–509.
Garner, D.M., Fairburn, C.G., and Davis, R. (1987). Cognitive-behavioral treatment of bulimia nervosa: A critical appraisal.Behavior Modification, 11, 398–431.
Garner, D.M., Olmsted, M.P., Davis, R., Rockert, W. (1990). The association between bulimic symptoms and reported psychopathology.International Journal of Eating Disorders, 9, 1–15.
Halmi, K. (1985). Rating scales in the eating disorders.Psychopharmacology Bulletin, 21, 1001–1043.
Herzog, D.B., Keller, M.B., and Lavori, P.W. (1987). Outcome in anorexia nervosa and bulimia nervosa: A review of the literature.Journal of Nervous and Mental Disease, 176, 131–143.
Johnson, C.L., Tobin, D., and Enright, A. (1989). Prevalence and clinical characteristics of borderline patients in an eating disordered population.Journal of Clinical Psychiatry, 50, 9–15.
Kristeller, J.L., Rossi, J.S., Ockene, J.K., Goldberg, R., and Prochaska, J.O. (1992). Processes of change in smoking cessation: A cross-validation study in cardiac patients.Journal of Substance Abuse, 4, 263–276.
Lacey, J.H. (1983). Bulimia nervosa, binge eating, and psychogenic vomiting: A controlled treatment study and long term outcome.British Medical Journal, 286, 1609–1613.
Laube, J.J. (1990). Why group therapy for bulimia?International Journal of Group Psychotherapy, 40, 169–187.
McConnaughy, E.A., DiClemente, C.C., Prochaska, J.O., and Velicer, W.F. (1989). Stages of change in psychotherapy: A follow-up report.Psychotherapy, 26, 494–503.
McConnaughy, E.A., Prochaska, J.O., and Velicer, W.F. (1983). Stages of change in psychotherapy: Measurement and sample profile.Psychotherapy, 20, 368–375.
Mitchell, J.E., Pyle, R.L., Pomeroy, C., Zollman, M. (1993). Cognitive-behavioral group psychotherapy of bulimia nervosa: Importance of logistical variables.International Journal of Eating Disorders, 14, 277–287.
Olmsted, M.P., Davis, R., Rockert, W., Irvine, M.J., Eagle, M., and Garner, D.M. (1991). Efficacy of a brief group psychoeducational intervention for bulimia nervosa.Behaviour Research and Therapy, 29, 71–83.
Ordman, A.M. and Kirschenbaum, D.S. (1985). Cognitive behavior therapy for bulimia: An initial outcome study.Journal of Consulting and Clinical Psychology, 53, 305–313.
Prochaska, J.O., and DiClemente, C.C. (1983). Stages of process of self-change of smoking: Toward an integrative model of change.Journal of Consulting and Clinical Psychology, 51, 390–395.
Prochaska, J.O., Norcross, J.C., Fowler, J.L., Follick, M.J., and Abrams, D.B. (1992). Attendance and outcome in a worksite weight control program: Processes and stages of change as process and predictor variables.Addictive Behaviors, 17, 35–45.
Prochaska, J.O., Velicer, W.F., Rossi, J.S., Goldstein, M.G., Marcus, B.H., Rakowski, W., Fiore, C., Harlow, L. L., Redding, C.A., and Rosenbloom, D. (1994). Stages of change and decisional balance for 12 problem behaviors.Health Psychology, 13, 39–46.
Rybicki, D.J., Lepkowsky, C.M., and Arndt, S. (1989). An empirical assessment of bulimic patients using multiple measures.Addictive Behaviors, 14, 249–260.
Walsh, B.T., Hadigan, C.M., Devlin, M.J., Gladis, M., and Roose, S.P. (1991). Long-term outcome of antidepressant treatment for bulimia nervosa.American Journal of Psychiatry, 148, 1206–1212.
Wilson, G.T., Rossiter, E., Kleifeld, E.I., and Lindholm, L. (1986). Cognitive-behavioral therapy of bulimia nervosa: A controlled evaluation.Behaviour Research and Therapy, 24, 277–288.
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Franko, D.L. Ready or not? Stages of change as predictors of brief group therapy outcome in bulimia nervosa. Group 21, 39–45 (1997). https://doi.org/10.1007/BF02872753
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DOI: https://doi.org/10.1007/BF02872753