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Assertion skills

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PSYC 205
Elaine Power

 Altering this all or nothing thinking can help ppl begin to eat more moderately. They are also taught assertion skills to help them cope with unreasonable demands placed on them by others an they learn more satisfying ways of relating to ppl as well  The overall goal of treatment of BN is to develop normal eating patterns. Ppl need to learn to eat three meals a day and even to eat some snacks between meals without sliding back into binging and purging. Regular meals control hunger and thereby its hoped, control the urge to eat enormous amounts of food, the effect of which –being overweight- is counteracted by purging. To help patients develop less extreme belief about themselves the cognitive beh therapist gently but firmly challenges such irrational belief as no one will love me if im fatter  A generalized assumption underlying such cognitions for female patients might be that a woman has value to a man only if she is a few pounds underweight-a belief that is put forth in the media and ads  This cbt approach has the patient bring small amounts of forbidden food to eat in the session. Relaxation is employed to control the urge to induce vomiting. Unrealistic demands and other cognitive distortions are continually challenged. The therapist and patient work together to determine the events thoughts and feelings that trigger an urge to binge and then to learn more adaptive ways to cope with these situations  The outcomes of cbt are promising at least in the short term. A meta analysis showed that cbt yielded better results than antidepressant drug treatments.  Cbt often results in less frequent binging and purging with reductions ranging from 70% to more than 90%; extreme dietary restraint is also reduced significantly and there is improvement in attitudes toward body shape and weight  Another recent review concluded that cbt is the most commonly used and empirically supported treatment for body image disturbance in the normal population.  To conclude that no other treatment has greater efficacy than cbt  If we focus on the patients we find that at least half of those treated with ct improve very little  Predictors of relapse include less initial motivation for change and higher initial levels of food and eating preoccupation  Argued that if cbt is extended and takes the form of a schema focused cognitive behaviour bulimia. The goal of this approach is to identify and modify deeply ingrained and painful core belied systems that reflect the indiv cognitive schemas.  Waller argues that a negative core belief system involving negative aspects of the self must be replaced by positive core beliefs in order for improvement to occur  Component analyses of the cbt—imp aspect is the response p
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