(PS5-45) Brief Strategic Therapy for the Treatment of Bulimia Nervosa: Effectiveness of Problem-solving and Action-oriented Strategies

Brief Strategic Therapy (BST) has been in development in Italy and preliminary research supports its effectiveness in treating bulimia nervosa (BN) and binge eating disorder (BED) (Pietrabissa et al., 2109). BST has particularly emerged to fill in the gap in outpatient treatment when CBT fails to help clients achieve success (Cuijpers, 2024; Schnicker, 2013). While CBT for BN focuses on stabilizing eating behaviors and changing distorted body image thoughts and beliefs (Fairburn et al., 1993), BST focuses on action-oriented strategies and problem-solving of current maladaptive thinking and behavioral cycles through analogical language (Nardone and Portelli, 2005). This study aimed to evaluate the long-term effectiveness of BST for BN through one-year post-treatment in a naturalistic setting. Data was collected at two different community clinics that accepted public funded clients in Ireland. Participants included 35 clients seeking treatment for BN (80% female and 20% male), 6 of whom prematurely discontinued therapy and the study (67% female and 33% male). The Eating Disorder Examination Questionnaire (Fairburn & Beglin, 1994) and the Clinical Impairment Assessment questionnaire (Bohn & Fairburn, 2008) were completed at pretreatment, posttreatment, 6 months, and 12 months follow-up. Results demonstrated statistically significant findings at the p ≤ .001 level for all standardized mean difference point estimate effects (Hedges' g). The difference between pretreatment assessment and 12-month posttreatment assessment for BN was as follows: restraint = -3.24, eating concerns = -4.34, shape concerns = -3.50, weight concerns = -3.78, and psychosocial impairment = -3.84. Findings with such extremely high negative effect sizes indicate decreases in BN symptomology and psychosocial impairment, supporting BST as a new alternative treatment for BN in outpatient settings. Further research is warranted, focusing on clinical trials to better establish BST.