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Cognitive remediation therapy for patients with eating disorders: a qualitative study

Transdiagnostisk metakognitiv trening(TCRT) er en ny behandling for spiseforstyrrelser som retter seg mot kognitive vansker ifm. fleksibilitet, sentral koherens og impulsivitet. Denne studien evaluerte TCRT gjennom kvalitative intervjuer med 13 pasienter. Analysen resulterte i fire hovedtemaer: behandlingsrelevans, opplevelse, opplevde resultater og fremtidige anbefalinger.

Forfatter: Camilla Lindvall Dahlgren 
Medforfatter: Tora Thorsrud, Marit Aspelund Bang, Trond Nordfjærn & Siri Weider 
Navn på tidsskrift: Journal of Eating Disorders


De fleste pasientene vurderte behandlingen positivt og rapporterte at de lærte seg om forskjellige måter å tenke på. Syv pasienter beskrev det som et startpunkt for endringer. TCRT kan bidra til å engasjere pasienter, bygge terapeutiske allianser og tilby strategier for å håndtere kognitive utfordringer.

Abstract

Background
Transdiagnostic Cognitive Remediation Therapy (TCRT) is a new adaptation of cognitive remediation therapy for eating disorders (EDs) developed to address common cognitive difficulties across ED diagnoses (i.e., cognitive flexibility, central coherence, and impulsivity). This is the first evaluation of this novel treatment. The aim of this study was to explore acceptability and patients’ experience of TCRT.

Methods
Thirteen patients diagnosed with restrictive or binge/purge subtypes of EDs and concurrent cognitive difficulties completed semi-structured qualitative interviews after receiving TCRT. Interview transcripts were analyzed using reflexive thematic analysis.

Results
The analysis resulted in four main themes: (1) Treatment fit (2), Treatment experience (3), Perceived outcomes, and (4) Future recommendations. Eleven of the thirteen patients evaluated the treatment positively, found the focus relevant and expressed how it contributed to new insights related to thinking style. Seven of the patients also described it as a starting point for making changes and using new strategies. Importantly, experiencing some challenges related to the cognitive difficulties addressed in the treatment seemed essential for engagement.

Conclusion
Offering TCRT as an adjunctive treatment for patients with EDs and concurrent cognitive difficulties can be a way to engage patients in treatment, build therapeutic alliances and provide important awareness and strategies to handle challenges related to thinking style.

Trial registration
This study is part of a larger randomized controlled trial, ClinicalTrials.gov Id: NCT03808467.

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