Feasibility, Acceptability and Outcomes of Group
CBT
‐T: A Naturalistic Mixed‐Methods Comparison With Individual
CBT
‐T
Laura Dixon, Anastasia Harris, Victoria Taylor, Lily Spoozak, Sara Bartel, Susan Gamberg, Nami Trappenberg, Colby Price, Navjot Sandila, Elena Koning, Sarrah I. Ali, Erin Piercy, Glenn Waller, Aaron Keshen ABSTRACT
Objective
This study aimed to evaluate the feasibility of implementing 10‐session group cognitive behavioural therapy (CBT‐Tg) in routine outpatient eating disorder care and to descriptively examine outcomes of CBT‐Tg and individual CBT‐T (CBT‐Ti).
Method
Using a naturalistic, non‐randomised, mixed‐methods design, this implementation study was conducted in a publicly funded outpatient eating disorder service. Adults eligible for outpatient eating disorder services selected CBT‐Tg or CBT‐Ti following intake. Feasibility outcomes included acceptability (treatment satisfaction, qualitative interviews, dropout), demand (uptake over time) and practicality (estimated clinician time). Effectiveness outcomes included eating‐disorder psychopathology, measured by the eating disorder examination questionnaire (EDE‐Q), and secondary outcomes assessing eating disorder symptoms, impairment and mood/anxiety during treatment and follow‐up.
Results
Of 157 referred patients, 116 consented and initiated treatment. Satisfaction was high in both formats. Premature termination from CBT‐Tg was 44.7%. Demand supported offering CBT‐Tg in 8 of 9 three‐month intervals. Estimated clinician time per enrolled patient was 4.3–5.7 h for CBT‐Tg versus 8.0 h for CBT‐Ti. EDE‐Q global scores improved with very large within‐group effects at end of therapy and were maintained through 6‐month follow‐up in both formats (CBT‐Tg: g = −1.57 at end of therapy; g = −1.63 at follow‐up; CBT‐Ti: g = −1.97; g = −2.14).
Discussion
CBT‐Tg appears feasible and acceptable in real‐world outpatient care, with large and sustained improvements in eating disorder psychopathology and potential efficiency advantages relative to individual delivery. Findings support further evaluation in comparative and cost‐effectiveness studies.