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      Eclectic Therapy for Dual Diagnosis: A Case Study

      research-article
      * , a ,
      The European Journal of Counselling Psychology
      PsychOpen
      bulimia nervosa, BPD, dual diagnosis, counselling psychology

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          Abstract

          This paper discusses the case of Helektra, a 28 year old female who was diagnosed with bulimia nervosa and borderline personality disorder using DSM-IV diagnostic criteria. The patient had referred herself to a state-run service in Athens, Greece. Therapy lasted for two and a half years. The patient’s therapeutic schedule included an integrated therapy model which was based on Fairburn`s diary (Fairburn, 1995, 2008) and on psychodynamic psychotherapy for personality disorders (McWilliams, 1994; Roberts, 1997). The findings of this case study are supportive of the benefits that have been associated in the psychological literature with the integration and eclectism of psychotherapeutic models.

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          Most cited references34

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          Psychological treatment of eating disorders.

          Significant progress has been achieved in the development and evaluation of evidence-based psychological treatments for eating disorders over the past 25 years. Cognitive behavioral therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder, and existing evidence supports the use of a specific form of family therapy for adolescents with anorexia nervosa. Important challenges remain. Even the most effective interventions for bulimia nervosa and binge-eating disorder fail to help a substantial number of patients. A priority must be the extension and adaptation of these treatments to a broader range of eating disorders (eating disorder not otherwise specified), to adolescents, who have been largely overlooked in clinical research, and to chronic, treatment-resistant cases of anorexia nervosa. The article highlights current conceptual and clinical innovations designed to improve on existing therapeutic efficacy. The problems of increasing the dissemination of evidence-based treatments that are unavailable in most clinical service settings are discussed. ((c) 2007 APA, all rights reserved).
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            Cognitive Behavioral Therapy for Eating Disorders

            Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for bulimia nervosa. A new “enhanced” version of the treatment appears to be more potent and has the added advantage of being suitable for all eating disorders, including anorexia nervosa and eating disorder not otherwise specified. This article reviews the evidence supporting CBT in the treatment of eating disorders and provides an account of the “transdiagnostic” theory that underpins the enhanced form of the treatment. It ends with an outline of the treatment's main strategies and procedures.
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              The mechanisms of change in the treatment of borderline personality disorder with transference focused psychotherapy.

              We address how Transference Focused Psychotherapy (TFP) conceptualizes mechanisms in the cause and maintenance of borderline personality disorder (BPD) as well as change mechanisms both within the patient and in terms of specific therapists' interventions that engender patient change. Mechanisms of change at the level of the patient involve the integration of polarized representations of self and others; mechanisms of change at the level of the therapist's interventions include the structured treatment approach and the use of clarification, confrontation, and "transference" interpretations in the here and now of the therapeutic relationship. In addition, we briefly review evidence from our group regarding the following hypothesized mechanisms of change: contract setting, integration of representations, and changes in reflective functioning (RF) and affect regulation.
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                Author and article information

                Journal
                EJCoP
                Eur J Couns Psych
                The European Journal of Counselling Psychology
                Eur. J. Couns. Psych.
                PsychOpen
                2195-7614
                28 March 2014
                : 3
                : 1
                : 42-53
                Affiliations
                [a ]Department of Eating Disorders “18 Ano”, Attica Psychiatric Hospital, Bournazou, Athens, Greece
                Author notes
                [* ]Department of Eating Disorders “18 Ano”, Attica Psychiatric Hospital, Bournazou 37, 11 521, Athens, Greece. stamatia_2000@ 123456yahoo.com
                Article
                ejcop.v3i1.26
                10.5964/ejcop.v3i1.26
                5bfef45e-eb21-4e8e-b236-e1513b5ae66f
                Copyright @

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 August 2013
                : 13 November 2013
                Categories
                Articles

                Psychology
                BPD,bulimia nervosa,dual diagnosis,counselling psychology
                Psychology
                BPD, bulimia nervosa, dual diagnosis, counselling psychology

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