This book presents CBT-AN-20, a newly developed briefer form of cognitive-behavioural therapy (CBT) for anorexia nervosa, designed to treat individuals in 20 sessions, helping clinicians to offer effective therapy to more patients and enabling patients to move more quickly towards recovery.
This manual addresses the key CBT skills needed to deliver effective CBT-AN-20. It uses a combination of psychoeducation, nutrition, exposure therapy, and behavioural experiments to overcome starvation and to support essential weight gain/stability. It then details the skills needed to work with emotional factors and with body image issues. Importantly, it also stresses the meta-competences needed to work with anorexia nervosa – such as early change, motivational work, engaging with the "anorexic voice", and maintaining a working alliance that stresses change. Accompanying the text is a range of useful web-based materials to support the clinician reading the manual. These include checklists, psychoeducation materials, measures, and videos of skills in action.
CBT-AN-20’s pragmatic structure supports its delivery by both experienced therapists and those newer to the field who are practising under expert supervision. This book is a "must read" for all levels of practitioners from all disciplines who work with eating disorders.
Table of Contents:
1. Introduction 2. Overview of anorexia nervosa 3. Meta-competences in CBT-AN-20 4. Introduction to the competences and skills needed for CBT-AN-20 5. Assessment of the patient and their needs 6. Outline of CBT-AN-20 7. Phase 1 (Sessions 1-19): Dietary change for weight regain and exposure therapy 8. Phase 2 (Sessions 10-19): Behavioural experiments to challenge cognitions about food and uncontrollability of weight gain 9. Phase 3 (Sessions 12-19): Emotional and interpersonal triggers and maintenance 10. Phase 4 (sessions 12-20): Body image 11. Phase 5 (sessions 18-20 and beyond): Ending and relapse prevention 12. Adaptations of CBT-AN-20 13. Final considerations for current and future therapists 14. Summary and Future Directions Appendices References
About the Author :
Glenn Waller is Professor of Clinical Psychology, University of Sheffield, UK.
Kamryn T. Eddy is Professor of Psychology, Harvard Medical School, USA.
Charlotte L. Rose is a Principal Psychological Therapist at STEPs Community Eating Disorder Service, Avon and Wiltshire Mental Health Partnership NHS Trust, UK.
Jennifer J. Thomas is Professor of Psychology, Department of Psychiatry, Harvard Medical School, USA.
Hannah M. Turner is a Consultant Clinical Psychologist at the Hampshire Adult Eating Disorder Service, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, UK.
Tracey D. Wade is Matthew Flinders Distinguished Professor, Flinders University, Australia and Director of the Flinders University Services for Eating Disorders, Australia.
Review :
“A powerful new resource in the battle to reduce suffering from anorexia nervosa. This book captures a wealth of clinical and research experience from some of the world’s leading scientist-practitioners in the treatment of anorexia nervosa. It offers a novel, shorter course of treatment that can help eating disorder clinics see more patients in less time without sacrificing efficacy; it also increases affordability of treatment. Numerous clinical tools are provided including downloadable resources and skills videos for clinicians. Highly recommended for all who treat anorexia nervosa!!”
Carolyn Black Becker, PhD, ABPP, FAED, FABCT, FAPS, Professor of Psychology, Trinity University, Licensed Psychologist, USA
“This much-needed treatment manual for anorexia nervosa, written by leading experts in the field, offers a unique blend of depth, detail, and clinical practicality. Its international perspective ensures relevance across diverse clinical contexts, while the clear, step-by-step guidance makes it an invaluable tool for both novice and experienced clinicians. Stand-out chapters on meta-competence, clinical skills, and adaptations for varied presentations support flexible application of the intervention. In summary, this book is an essential resource for any clinician seeking to enhance their expertise and confidence in treating patients with this challenging disorder”
Roz Shafran, PhD, FMedSci, Emeritus Professor of Translational Psychology, UCL Great Ormond Street Institute of Child Health, UK
“Written by clinicians with deep expertise, compassion, and dedication to sharing knowledge, this work reflects how far cognitive-behavioural therapy interventions for anorexia nervosa have come in real-world clinical practice. It challenges the assumption that longer treatment is always necessary and offers clear, practical guidance on open weighing, early nutritional change, working with the anorexic voice, and exposure – alongside compelling rationales for clients (“the why”) and strategies clinicians can implement immediately (“the how”). Whether new to the field or a seasoned clinician, this is what a treatment manual should be – and what we continue to refine as science evolves.”
Dr Bronwyn Raykos, MPsych (Clinical) / PhD, Morgan Psychology (Director), Western Australian Country Health Service, Centre for Clinical Interventions, Australia
“This innovative work by an international group of collaborators is an effort to develop a briefer and effective treatment for anorexia nervosa. The treatment model rests on various techniques rooted in functional analysis and designed to help patients approach their anxieties and behaviors in the context of a realistic and collaborative treatment relationship. At the same time, there is careful attention to the “anorexic voice” which needs to be heard, understood, and addressed. Overall, this comprehensive and innovative new work opens possibilities for patients and clinicians. The field should look forward to new studies of this potentially very useful intervention.”
Stephen Wonderlich Ph.D., Interim President, Sanford Research, Chester Fritz Distinguished Professor, University of North Dakota School of Medicine and Health Sciences, USA
“Written by world leading experts, this book offers a comprehensive, up-to-date, and engaging master class for clinicians delivering CBT to those affected by anorexia nervosa. Designed to help reduce waiting lists by completing treatment in 20 sessions, it features clearly written chapters that outline both the core competences and meta-competences required for effective therapy. The book also includes a detailed treatment protocol and practical resources. It is an essential guide for both novice clinicians and experienced practitioners looking to enhance the CBT treatment they provide."
Rachel Lawson, Clinical Head, South Island Eating Disorders Service, New Zealand
“CBT-AN-20 is the guide I wish I had years ago. Building on the strong foundations of CBT-E and CBT-T, it offers a compassionate, structured, and evidence-based approach tailored to the complex realities of anorexia nervosa. This manual addresses the most challenging aspects of anorexia nervosa - low weight, ambivalence, perfectionism, and the anorexic voice - with a scientific clarity and clinical wisdom. In a world where time is limited and patient suffering profound, CBT-AN-20 is a hopeful, accessible, and powerful tool that empowers both clinicians and those they serve.”
Eva Trujillo Chi Vacuán, MD, MET, FAED, CEDS, FAAP, Fiaedp, CEO and CoFounder, Comenzar de Nuevo, AC, México, Clinical Professor, Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico
