Treatments

What is CBT-E?

CBT-E (Enhanced Cognitive Behavioural Therapy) is a therapy for eating disorders. It helps you understand your eating disorder and learn new ways to manage unhelpful behaviours and thoughts.

Who is CBT-E for?

CBT-E is for anyone with an eating disorder, including:

• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
• OSFED (Other Specified Feeding or Eating Disorders)

What happens in CBT-E?

CBT-E has four stages:

1. Understanding your eating disorder: You’ll learn what keeps it going and start making small changes, like eating more regularly
2. Building progress: You’ll challenge unhelpful thoughts and beliefs about eating, weight, and your body
3. Tackling other issues: You might work on perfectionism, low self-esteem, or managing emotions
4. Staying well: You’ll learn how to prevent relapse and keep your progress going

Your therapist will also help you face fears, like certain foods, and take on challenges that are important for recovery.

What are the goals of CBT-E?

CBT-E aims to:

• Reduce behaviours and thoughts linked to your eating disorder
• Stay on track with recovery and manage setbacks

How many sessions will I need?

CBT-E usually involves 20 to 40 sessions. Your therapist may also offer follow-up sessions to help you stay on track.

What do I need to do?

To get the best results from CBT-E, you’ll need to:

• Do tasks between sessions, like tracking your eating and practising new skills
• Agree to be weighed weekly

Does CBT-E work?

Yes! Research shows that CBT-E can help many people fully recover from their eating disorder if they actively take part in therapy. It has been found to be as effective as other therapies for anorexia nervosa, such as MANTRA.

Will it affect my eating or weight?

CBT-E helps you build healthier eating habits and, if needed, supports weight restoration.

Can my family be involved?

Yes, if you’d like. You can bring a family member or close friend in some sessions to support your recovery.

What do people say about CBT-E?

People who have done CBT-E say it helped them:

• Understand their eating disorder better
• Learn what keeps it going
• Try new skills and ideas to recover

Some found it challenging to change behaviours and thoughts at first, but they said it got easier over time.

What is CBT?

CBT (Cognitive Behavioural Therapy) is a talking therapy that helps people feel better by changing unhelpful thoughts and behaviours.

What is CBT-T?

CBT-T stands for "Cognitive Behavioural Therapy - Ten." It is a program with 10 sessions to help adults with Binge Eating Disorder or Bulimia Nervosa. It focuses on:

• Helping you eat regularly and healthily
• Changing thoughts about food and your body
• Lowering anxiety and dealing with emotions

Who is CBT-T for?

CBT-T works well for adults with Binge Eating Disorder or Bulimia Nervosa.

What happens in CBT-T sessions?

You will meet with your therapist every week for about an hour. The therapy is divided into phases that you’ll work through together.

What are the goals of CBT-T?

CBT-T  aims to help you:

• Get into a regular eating routine
• Reduce anxiety
• Change unhelpful thoughts about food
• Handle emotions that affect your eating
• Feel better about your body
• Learn how to stay well in the future

How many sessions will I need?

You will be offered:

• 1 assessment session
• 4 or 10 therapy sessions
• Up to 2 follow-up sessions

What do I need to do?

To get the best results, you should:

• Complete activities between sessions, like keeping food diaries or practicing new skills
• Agree to be weighed weekly

CBT-T works best if you are open and motivated to change.

Does CBT-T work?

Yes! Research shows CBT-T helps people reduce symptoms of eating disorders.

What do people say about CBT-T?

“She was an incredible therapist for me, I was always made to feel safe and comfortable and the service provided changed my life.”

“CBT-T helped me think about the future, and now I feel much more positive."

"It was tough at times, but it really reduced my behaviours."

"It gave me the tools to live without an eating disorder."

What is CBT?

CBT (Cognitive Behavioural Therapy) is a talking therapy that helps people feel better by changing unhelpful thoughts and behaviours.

What is CBT-T?

CBT-T stands for "Cognitive Behavioural Therapy - Ten." It is a program with 10 sessions to help adults with Binge Eating Disorder or Bulimia Nervosa. It focuses on:

• Helping you eat regularly and healthily
• Changing thoughts about food and your body
• Lowering anxiety and dealing with emotions

Who is CBT-T group for?

CBT-T works well for adults with Binge Eating Disorder or Bulimia Nervosa.

What happens in CBT-T group sessions?

• Sessions are once a week, lasting 90 minutes.
• They are in-person or online.
• You work through different stages with your therapists and group members.

What are the goals of CBT-T?

CBT-T  aims to help you:

• Get into a regular eating routine
• Reduce anxiety
• Change unhelpful thoughts about food
• Handle emotions that affect your eating
• Feel better about your body
• Learn how to stay well in the future

How many sessions will I need?

You will be offered:

• 1 individual assessment session
• Weekly individual check-in sessions prior to the group
• 10 group therapy sessions, which will be reviewed at session 4
• Up to 2 follow-up sessions.

What do I need to do?

To get the best results, you should:

• Complete activities between sessions, like keeping food diaries or practicing new skills
• Agree to be weighed weekly

CBT-T works best if you are open and motivated to change.

Does CBT-T work?

Yes! Research shows CBT-T helps people reduce symptoms of eating disorders.

What do people say about CBT-T?

"CBT-T was life-changing. The therapists were kind and supportive."

"The sessions helped me understand my emotions and build healthy habits."

"I now have tools to stay on track if I ever struggle again."

One participant shared this letter:
“I really can’t thank you all enough. The help, advice and general support has been greatly appreciated. I now look at food in a whole new light having learnt so much from therapy. I am determined more than ever to keep up the good work. I have kept all work sheets, emails and notes in case I need to refer back to the tools which you have taught me. I would highly recommend this to anyone who is suffering...I am in a better place with food today than I have been in the last thirty years!!”

What is MANTRA?

MANTRA (The Maudsley Model of Anorexia Nervosa Treatment in Adults) is a talking therapy designed to help people with anorexia nervosa. It focuses on the reasons why people get stuck in anorexia, like rigid thinking, avoiding emotions, or struggling in relationships, which can make anorexia worse and harder to move away from. MANTRA helps by exploring these patterns and finding new, healthier ways to cope. It’s tailored to your individual needs, so it focuses on what matters most for you.

Who is MANTRA for?

MANTRA is for people with anorexia nervosa. It might suit you if you:

• Think in very rigid or detail focused ways
• Feel your anorexia helps you in some way
• Find yourself getting stuck in unhelpful relationship patterns
• Struggle to manage your emotions

What happens in MANTRA?

MANTRA has different sections that you’ll work through with your therapist. You’ll get a workbook to guide you.

Therapy starts with building motivation to change. Together, you and your therapist will:

• Explore what might have caused your anorexia
• Understand what keeps it going, like avoiding emotions or patterns in your relationships

Based on this, you’ll decide what to focus on in therapy to break free from the cycles that keep you stuck.

What are the goals of MANTRA?

MANTRA helps you:

• Learn new ways to handle emotions, relationships, and unhelpful thoughts
• Build a healthier sense of who you are

How many sessions will I need?

You’ll usually have between 20 and 30 sessions of one-to-one therapy.

What do I need to do?

To get the most out of MANTRA, you’ll need to:

• Do exercises between sessions, like tasks from the workbook or practising new skills
• Agree to be weighed every week

Therapy works best if you’re open to change and willing to put in time and effort in between sessions.

Does MANTRA work?

Yes! Research shows MANTRA helps reduce eating disorder symptoms, improve distress levels, and support weight recovery. MANTRA has been found to be as effective as other recommended therapies for anorexia nervosa, such as CBT-E.

Will it affect my eating or weight?

MANTRA focuses on the psychological reasons behind anorexia. However, recovery also requires changes to eating and weight. Your therapist will support you with this during treatment.

Can my family be involved?

Yes, this is encouraged in MANTRA. Family or loved ones can join some sessions to support you, but this is your choice.

What do people say about MANTRA?

“Looking back at myself one year ago, I feel like a completely different person. I’m certain that my family and friends are eternally grateful after watching the life return to me over the past year or so.”

“It has helped me to make sense of things and connect dots that I never would’ve thought of myself.”

What is Guided Self Help (GSH)?

Guided Self Help is a low-intensity intervention based on CBT (Cognitive Behavioural Therapy). The practitioner acts as a coach or guide to help people build skills to become their own therapist.

Who is GSH for?

GSH works well for people aged 16+ with Binge Eating Disorder or Bulimia Nervosa.

What happens in GSH sessions?

You will meet with the practitioner every week for about 45 minutes. The intervention is divided into 6 stages that you’ll work through together.

What are the goals of GSH?

You and your therapist will work on:

• Get into a regular eating routine
• Reduce anxiety about weighing
• Handle emotions that affect your eating
• Feel better about your body
• Learn how to stay well in the future

How many sessions will I need?

You will be offered:

• 1 assessment session
• 9 intervention sessions
• 1 follow-up session

What do I need to do?

To get the best results, you should:

• Attend all your sessions
• Complete activities between sessions, like keeping food diaries or practising new skills.
• Agree to be weighed weekly

GSH works best if you are open and motivated to change.

Does GSH work?

Yes! Research shows GSH helps people reduce symptoms of Binge Eating Disorder and Bulimia Nervosa.

What is Family Therapy for Anorexia Nervosa (FT-AN)?

FT-AN is a type of family therapy that helps young people under 19 who have anorexia nervosa. It is a treatment recommended by NICE (National Institute for Health and Care Excellence). FT-AN works by bringing the whole family together, helping them to rediscover their strengths and resources. Parents are encouraged to take an active role in finding ways to overcome their child’s illness.

FT-AN has 4 stages:

• Getting to know each other and making things feel safe
• Managing eating and other symptoms
• Supporting with family and teenage life challenges
• Getting ready to finish therapy and preventing problems from coming back

Who comes to the sessions?

The young person and parents or carers are usually asked to come to every session. We are aware that eating disorders can affect all family members, so brothers, sisters, and other loved ones may also join the appointments.

What happens in an FT-AN session?

Every family is different, so the sessions can be flexible to meet their needs.

In the early sessions, we focus on:

• Managing symptoms
• Helping the young person to eat more and restore weight
• Giving support to the whole family
• Building skills to help with change

Later on, the focus moves to:

• Helping the young person become more independent
• Strengthening relationships
• Working towards goals for the future

Working with other professionals

Working with other professionals and support systems can help the young person get better. Our team includes different professionals that we can work with to make sure the young person and their family get the help they need.

We sometimes work with other people outside the therapy team, like teachers or social workers, to help support the young person and their family. We will always ask for your permission before talking to anyone outside our team.

Checking physical health

We may check the young person’s physical health during therapy. This can include:

• Weighing them
• Checking blood pressure and temperature

How often we do these checks will be agreed by the team.

How often will we meet?

Therapy usually lasts about 12 months.

At first, families usually come every week. Later on, as things get better, sessions may happen less often. The number and length of sessions can change depending on what the family needs.

What do people say about FT-AN?

“Trust the process. You need to persevere even when it feels nothing is working. Keep building on the foundation blocks to help move forward. Working together helps restore relationships that the ED has impacted on.”

“At first it might not make sense and feel pointless. With honesty, listening to each other, talking through issues, it does actually get better.”

“The support from the EDS was immeasurable. Every step of our journey through our son's illness, from the start to the end, we were supported thoroughly. It has been a very steep learning curve but with the support of the professionals in the service it has been a successful one. At the start of the programme, my son was adamant that he didn't have an illness, that he would be fine and didn't need to talk to anyone to get better. We were going in 'blind' and needed to talk just as much as he did to get our heads around it and understand the complexity of his illness. The EDS were informative and supportive and equipped us with the tools, both emotionally and strategically, that we needed to help our son recover. We personally could not have got our son through this without them.”

What is Family Therapy for Anorexia Nervosa (FT-BN)?

FT-BN is a type of family therapy that helps young people who have bulimia nervosa. It is a treatment recommended by NICE (National Institute for Health and Care Excellence). FT-BN focuses on not blaming anyone and helping the family work together to support recovery.

FT-BN has 3 stages:

• Getting to know each other and making things feel safe
• Learning skills to manage symptoms and emotions, and building stronger relationships
• Getting ready to finish therapy and preventing problems from coming back

Who comes to the sessions?

FT-BN believes that family support is key to recovery.

Sessions may include:

• Just the young person
• Just the parents or carers
• The whole family together

We are aware that eating disorders can affect all family members, so brothers, sisters, and other loved ones may also join the appointments.

What happens in a FT-BN session?

FT-BN offers some structured sessions, but sessions can also change depending on what the family needs.

In early sessions, we focus on:

• Managing symptoms
• Learning about bulimia nervosa

Later on, we help with:

• Understanding and managing emotions
• Getting ready to finish therapy and making plans for the future

Working with other professionals

Working with other professionals and support systems can help the young person get better. Our team includes different professionals that we can work with to make sure the young person and their family get the help they need.

We sometimes work with other people outside the therapy team, like teachers or social workers, to help support the young person and their family. We will always ask for your permission before talking to anyone outside our team.

Checking physical health

We may check the young person’s physical health during therapy. This can include:

• Weighing them
• Checking blood pressure and temperature

How often we do these checks will be agreed by the team.

How often will we meet?

Therapy usually lasts about 6 months and includes around 20 sessions.

At first, families usually come every week. Later on, as things get better, sessions may happen less often. The number and length of sessions can change depending on what the family needs.

What do people say about FT-BN?

“Being offered a family approach really helped us as we were unsure how to support our daughter. Having parent-only sessions gave us a safe place to talk and allowed us to learn new skills.”

“I didn’t feel forced into needing to eat loads straight away. ‘Little and often’ was talked about which worked for me at the start. Having time to let me explain how I felt which was leading to the throwing up, helped me stop. I felt that the team were nonjudgmental in the support they offered.”

What is Family Therapy?

Sometimes families go through hard times. People may argue, feel upset, or stop knowing how to help each other. This can happen in any family.

Family Therapy is a way for families to work through these challenges together. It can help them:

• Talk about difficult thoughts and feelings in a safe space
• Understand each other better
• Explore how problems started and what’s making them continue
• Solve problems together
• Use their strengths to support each other and make changes

Taking part in family therapy doesn’t mean someone is to blame. Instead, it’s about working as a team to make things better for everyone.

What is meant by family?

Family can mean different things for different people. In Family Therapy, “family” includes anyone who is important to you and cares about you.

This could be:

• Parents and children
• Grandparents
• Brothers and sisters
• Aunts, uncles, or cousins
• Close friends or carers
• Other adults or professionals

Family Therapy can be helpful for children, young people, and adults experiencing a wide range of difficulties, as well as relationship problems. These include eating difficulties, self-harm, drug and alcohol misuse, the effects of trauma, depression and anxiety.

What happens in Family Therapy?

Family Therapists are specially trained to work with:

• Children and teenagers
• Parents and carers
• Adults and professionals

Their job is not to take sides or blame anyone. They help everyone share their views, listen to each other, and find ways forward together.

Family therapists understand that families have different beliefs, backgrounds, and needs. They will adjust how they work to suit your family and talk with you about how you’d like to work together.

How many sessions will we need?

The number of sessions depends on what your family needs. Your therapist will talk to you about this.

Sessions usually last between 1 hour and 1.5 hours. You’ll also agree together how often you will meet.

Do Family therapists only work with families?

No. Family therapists also work with professionals from other services and help make sure everyone is working together to support you. They sometimes meet with children or adults on their own, if needed.

What families say about Family Therapy.

“When we felt overwhelmed and did not know what else to do, attending Family Therapy helped slow everything down and give us space to agree what was important to discuss.”

“We never found time to sit and talk about concerns and we found ourselves not communicating the way we used to. Having a dedicated space that we all attended meant we could deal with issues together.”

What is Multi Family Therapy (MFT)?

Multi-Family Therapy (MFT) is a type of group therapy for young people with anorexia nervosa and their families. It has been used successfully since 2000 and is based on research that shows it can really help.

MFT brings together 4 to 8 families with similar problems. MFT helps families find new ways of thinking about eating habits and behaviours, and how they can work as a team to support their loved one.

By working together in a group, families can:

• Learn about eating disorders
• Support each other
• Make changes that help with recovery

MFT is often used along with Family Therapy for Anorexia Nervosa (FT-AN). As eating disorders affect the whole family, it’s important that everyone understands the illness and knows how to help.

By joining MFT, families can take big steps forward in recovery and help the young person get better as quickly and safely as possible.

How does the programme work?

Before the programme begins, families are invited to an introductory session. This is a chance to meet the team, learn about eating disorders, and find out what MFT involves.

The following week, families attend a 4-day programme. Everyone takes part in group activities and eats together with support.

After the programme, there are follow-up workshops. These are 1-day sessions spread out over 6 months.

What is a typical day like?

Who comes to MFT?

We invite:

• The young person with the eating disorder
• Parents and other important adults – this could include step-parents and grandparents
• Siblings - they may be asked to join on a specific day. Our team will discuss with families about siblings under the age of seven.

We will talk with each family to help decide who would be most helpful to invite.

What happens in MFT?

In MFT, we combine different kinds of support to help families and young people work through the eating disorder together. This includes:

• Group therapy - talking and sharing in a group
• Family therapy - working as a family to solve problems
• Learning sessions - to understand the illness better
• Creative and supportive activities - fun, hands-on ways to learn and connect

Each activity gives different opportunities to share experiences and ideas to support one another. Our experience shows that doing this as a group really helps families move forward in recovery.

Who runs MFT?

The MFT programme is led by two or three trained therapists, and up to 4 extra team members.

The MFT team may include family therapists, systemic therapists, specialist nurses, clinical psychologists, and dietitians.

How can MFT help?

MFT can help young people and their families:

• Feel stronger and more confident
• Understand the illness better
• Learn useful skills and techniques
• Strengthen family relationships and develop new ones with other families
• ‘Take charge’ of the eating disorder with renewed strength!

What do people say about MFT?

“We didn’t know what to expect from the group and wasn’t sure how it would help. Going on the first day was nerve-racking for us all. What we found were people who were struggling just like us, everyone was helpful and supportive. We found it helpful to go back the following day to share what we had done when we got home.”

“My son found it helpful as he hadn’t met anyone else who had been struggling with an ED. It really helped him come out of himself.”

“The group helped us move forward as a family, helped us see our family’s strengths and supported our readiness for discharge from the service.”

What is the Parent and Carers Group for supporters of young people experiencing an eating disorder?

• To give parents and carers a chance to talk and share ideas with others in similar situations
• To help people feel less alone and build a support network
• To help families understand eating disorders in children and teenagers, and how these illnesses affect the whole family
• To help parents and carers feel more confident and develop skills to support their child

Who is the group for?

The group is for any parent, carer, or adult family member of a young person under 19 who has an eating disorder and is getting support from our team.

Who will be there?

Other parents and carers who are looking after a young person with an eating disorder. The young people they care for may be at different stages in their recovery. The group is "closed," which means the same people come each week. This helps everyone feel safe and build trust as the group gets to know each other.

When and where?

The group runs once a week for eight weeks, always at the same time and place. The groups are face to face and held at local, community bases. Each session lasts about two hours. If it’s a school or college holiday, the group might take a break during that time.

What happens in the sessions?

The group is led by staff from the eating disorder team. Each week has a topic to focus on, with time for learning and talking about what matters to group members. There is a break halfway through the session, so people can rest and chat informally.

We appreciate listeners and learners as well as encourage people to share what feels relevant and safe. Handouts will be provided at each session.

What do people say about parent and carer group?

“A very open and friendly group with lots of opportunity to listen and speak.”

“Very useful to hear other parents’ accounts and tips on how they negotiated their journey.”

“It felt good to not feel so alone.”

“Reassured me that other like-minded people also struggle with similar issues.”

“Being able to meet others in a similar situation to us but also gaining more knowledge as a whole.”

What is dietetic support?

Dietetic support means working with a dietitian to understand food, your body, and how to eat in a way that supports your health.

Dietitians don’t just tell you what to eat; they listen, help you make changes step-by-step, and support you as you go through treatment. They use motivational strategies to help you feel more confident and ready to try new things. They also give you education about nutrition and how food helps your body and brain. This can make food feel less scary and more understandable.

Who is dietetic support for?

Dietetic support is for anyone who is finding eating difficult or confusing. This might mean you're eating in a way that does not support your health, are avoiding certain foods, feeling worried about food, or unsure what or when to eat.

What happens in dietetic sessions?

In sessions, the dietitian will talk with you about your eating, how food makes you feel, and what’s going on in your life that might affect eating. They will listen to you and help you work through any worries or questions about food.

They also give you scientific information about how food affects your body and brain, like how it gives you energy, helps you think clearly, and keeps your organs working. This helps you understand why eating well is important; not just what to eat, but why.

Together, you and the dietitian will work out small steps to help make eating feel easier and safer.

What are the goals of dietetic support?

The main goals are to support your recovery, help you eat in a way that optimises your physical and mental health, reduce fear around food, and improve your relationship with eating. Your goals will be personal to you.

How many sessions will I need?

This is different for everyone. Some people have just a few sessions, others may need more. Your dietitian will talk with you and your team to agree on what’s best.

What do I need to do?

Just be honest and open as much as you feel able. You don’t need to know everything. It’s okay to have questions or worries, your dietitian is here to help, not to judge.

Does dietetic support work?

Yes! Many people say dietetics helps them understand their eating better and feel more confident with food. It is one part of a team approach to getting better.

Can family be involved?

Yes. Family or carers can be part of your dietetic support if you want them to be. This can help them understand what you’re going through and how best to support you with food at home.

If you are a young person, involving your family is actively encouraged, as it can make a big difference to your progress and help you feel more supported outside of sessions.

What do people say about dietetic support?

“My dietitian helped me feel less scared of food.”

“I learned how to eat regularly again.”

“They explained things about food in a way I could understand.”