Patients’ experiences of CBT-T

The following comments were collected as part of a qualitative study of patient experiences of CBT-T (Hoskins et al., 2019). They help to explain why patients find the approach engaging and helpful, even while it is challenging at times.

The comments are listed under the five themes that emerged.

Therapeutic relationship (‘Firm empathy’)

• “She was certainly very sympathetic and empathised when I got upset.”

• “I never felt judged or like I was wasting the clinic’s time and she was really understanding and encouraging.”

• “[Therapist] was very open and approachable. She knew what she was talking about.”

• “[Therapist] made me feel comfortable talking with her, despite me being embarrassed about a lot of my eating habits.”

• “Being able to ask any questions and to actually talk about the thoughts I have and not feel ridiculous/alone.”

• “She was encouraging and supportive, yet knew when to push me to get the most effective results for me.”

• “I felt like I could be honest in every session.”

• “She encouraged me to push myself and question my boundaries and worries head on.”

• “Very good! I felt like I could be honest in every session, I never felt guilty or like I needed to lie about any relapses. [Therapist] was so kind and has helped me so much.”

• “[Therapist] made me feel like I was in a safe space where I could be honest . But she encouraged me to push myself and question my boundaries and worries head on.”

Nature of CBT-T

• “Weekly sessions helped me break down week by week goals and allowed me to stay in touch with my therapist.”

• “I was eating regularly in less time, and we got to the root of why my eating was not ideal.”

• “Sometimes I was disheartened when she was firm because she said I needed to get regular eating every day with no slip ups in order to proceed.”

• “Food diaries also helped me find a healthier routine and allowed me to document and see my progress.”

• “By facing my main problems, I was able to see that I’m much stronger than I thought, and no one else judged me on my size – like I thought they did.”

• “Ideas on how to achieve my goals which were specific to my life rather than general goals.”

Challenging but beneficial

• “At first, I struggled with having to be weighed each week but eventually it became routine and I became much more relaxed about the situation.”

• “Therapist B always understood my reasons for feeling the way I did about certain situations and encouraged me to overcome them by carrying out experiments (such as a survey on my appearance.”

• “The first couple of weeks were HARD because I needed to make immediate changes straight away. But ultimately this was a good thing.”

• “Initially I was quite sceptical but [Therapist] was so positive and encouraging that I learnt to push my boundaries and made a lot of progress.”

Ending therapy

• “It has allowed me to slowly get my life before bulimia back and be happy again.”

• “Intervened at just the right time and provided me support and coping mechanisms to pull me back to a normal healthy lifestyle.”

• “[Therapist] gave me tips on how to carry on with ‘home therapy’, which allows me to carry on tackling this eating disorder confidently on my own.”

Overall experience of CBT-T

• “The only previous therapy I had was counselling and I didn’t find dwelling on horrible past events helpful at all. CBT-T focussed on the present and the future, which gave me a much more positive outlook on the situation.”

• “I have had therapy for depression before and hated it. Nothing really changed from it. But CBT has actually changed my behaviour and thought process for the better.”

• “I am so, so pleased that I carried out this programme.”

• “I really appreciate all your time and effort and can’t thank you enough for helping me.”

Summary

Of course, we do not want to suggest that these experiences are unusual or unique to CBT-T. We are sure that any patients who do well with evidence-based therapies have similar positive stories to tell. We simply want to assure you that these positive patient experiences are found with a brief, focused therapy such as CBT-T.