This article presents a case study of anorexia nervosa and obsessive personality disorder as a means of describing the main therapeutic interventions in the framework of “third-generation” therapies. The sessions were videotaped by independent observers. The particulars of the therapeutic relationship (based on functional analytic psychotherapy) and the contextual strategies (based on acceptance and commitment therapy) used are analyzed here. This case highlights progressive positive changes in social behavior, including congruence of values and vital actions, resolution of the eating disorder, greater openness to experience, and decreased pervasive thoughts. The discussion associates these changes with the types of intervention specific to this therapeutic approach.
Agras, W.S., Brandt, H.A., Bulik, C.M., Dolan-Sewell, R., Fairburn, C.G., Halmi, K.A., . . . Wilfley, D.E. ( 2004). Report of the National Institutes of Health workshop on overcoming barriers to treatment research in anorexia nervosa. International Journal of Eating Disorders, 35, 509-521. doi:10.1002/eat.10261
2.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
3.
Berman, M.I., Boutelle, K.N., & Crow, S.J. ( 2009). A case series investigating ACT therapy as a treatment for previously treated, unremitted patients with AN. European Eating Disorder Review, 17, 426-434.
4.
Fairburn, C.G. ( 2005). Evidence-based treatment of anorexia nervosa. International Journal of Eating Disorders, 37, 526-530.
Hayes, S.C. ( 2004). Acceptance and commitment therapy and the new behavior therapies. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 5-29). New York, NY: Guilford.
7.
Hayes, S.C., Follette, V.M., & Linehan, M.M. ( 2004). Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York, NY: Guilford .
8.
Hayes, S.C., Strosahl, K.D., & Wilson, K.G. ( 1999). Acceptance and commitment therapy. New York, NY: Guilford.
9.
Heffner, M., & Eifert, G.H. ( 2004). The Anorexia Workbook: How to accept yourself, heal suffering, and reclaim your life. Oakland, CA: New Harbinger.
10.
Heffner, M., Sperry, J.A., Eifert, G.H., & Detweiler, M. ( 2002). Acceptance and commitment therapy in the treatment of anorexia nervosa: A case example. Cognitive and Behavioral Practice, 9, 232-236.
11.
Karbasi, A.L. ( 2010). Enhanced cognitive-behavioral therapy (CBT-E) for eating disorders: Case study of a client with anorexia nervosa. Clinical Case Studies, 9, 225-240.
12.
Kohlenberg, R.J., & Tsai, M. ( 1991). Functional analytic psychotherapy: Creating intense and curative therapeutic relationships. New York, NY: Plenum.
13.
Kohlenberg, R.J., & Tsai, M. ( 1994). Functional analytic psychotherapy: A behavioral approach to treatment and integration. Journal of Psychotherapy Integration , 4, 175-201.
14.
Linehan, M. ( 1993). Skills training manual for treating borderline personality disorder. New York, NY: Guilford .
15.
Martín-Murcia, F., Cangas, A.J., Pozo, E., & Martínez, M. (2010). Role of social support and family relationships in the eating disorders progression. Revista de Psicopatología y Salud Mental del Niño y del Adolescente , 15, 63-73.
16.
Martín-Murcia, F., Cangas, A.J., Pozo, E., Martínez, M., & López, M. (2008). Eating disorders and personality: A comparative study. Behavioral Psychology, 16, 187-203.
17.
Mehler, P.S., & Andersen, A.E. (1999). Eating disorders: A guide to medical care and complications. Baltimore, MD: Johns Hopkins University Press.
Ro, O., Martinsen, E., Hoffart, A., & Rosenvinge, J. (2005). Two-year prospective study of personality disorders in adults with longstanding eating disorders. International Journal of Eating Disorders, 37, 112-118.
20.
Rosenvinge, J., Martinussen, M., & Ostensen, E. ( 2000). The comorbidity of eating disorders and personality disorders: Meta-analytic review of studies published between 1983 and 1998. Eating and Weight Disorders, 5, 52-61.
21.
Segal, Z., Williams, J., & Teasdale, J. ( 2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: Guilford.
22.
Wilson, K.G., & Roberts, M. ( 2002). Core principles in acceptance and commitment therapy: An application to anorexia. Cognitive and Behavioral Practice , 9, 237-243.
