Title:
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Applying emotion-focused therapy to work with the 'anorexic voice' within anorexia nervosa : a brief intervention
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Anorexia nervosa (AN) is a difficult disorder to treat and there is a lack of clear evidence for effective therapies. One of the main challenges in treating individuals with AN is that they are often ambivalent about engaging in treatment. Accordingly, there is a demand to develop new approaches for the treatment of adults with AN which both better engage clients and explain how and why symptoms are maintained. Qualitative research has identified the experience of an 'anorexic voice' (AV) in individuals with anorexia nervosa (AN). The AV is an internally generated, but distinct, second or third person commentary on thoughts and behaviours relating to eating, weight and shape. It has been hypothesised to contribute to the development and maintenance of AN and provides an interesting formulation of the many challenges encountered in work with this clinical group (such as the egosyntonic nature of the illness). Emotions have been demonstrated to play an important role in the development and maintenance of AN. Maintenance models of AN hypothesise that engaging in ED behaviours helps to avoid or suppress negative emotions. EFT has been considered for the treatment of EDs as this approach involves processing emotional experience in order to deal with difficulties in affect regulation, thus rendering AN as unnecessary in coping with negative emotions. It also offers techniques (e.g. the two-chair dialogue for self-evaluative splits) for dealing explicitly with the AV. It was theorised that working with the AV would increase emotional awareness and/or help clients to cope with and manage emotions in more adaptive ways. The overall aim of the present study was to examine whether a brief form of EFT that focuses on the AV (EFT-AV) is feasible and acceptable as an intervention for adults with AN, presenting to outpatient ED services.
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