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Stepped care treatment for eating disorders.

2000; American Psychological Association; Volume: 68; Issue: 4 Linguagem: Inglês

10.1037/0022-006x.68.4.564

1939-2117

G. Terence Wilson, Kelly M. Vitousek, Katharine L. Loeb,

Body Image and Dysmorphia Studies

A stepped care approach would link different patient needs to therapeutic modalities that range from simple advice to intensive inpatient care. Brief methods, including self-help and psychoeducation, may be effective for a subset of patients with bulimia nervosa and binge eating disorder. Identifying this subset remains a challenge. It is unclear how patients who fail to respond to evidence-based, first-line treatments should be treated. Given the absence of data on effective treatment of anorexia nervosa (AN), discussion of a stepped care approach is speculative. Because AN typically demands expert and sustained treatment, the lower levels of stepped care models are inapplicable for these patients. A stepped care approach poses methodological challenges for clinical research and raises important clinical issues, such as when to switch from 1 level of treatment to another.