Demonstrating key skills in delivering CBT-T

Updated 23 February 2022

The videos (hosted on YouTube, links below) show role plays of CBT-T skills, as outlined in the manual (plus one of cue exposure for residual binge-eating). Watch the first video below to get a better idea of the demonstrations:

The videos are labelled by session, but of course that is somewhat arbitrary, as mostly the specific skills might be implemented earlier or later, according to progress in the individual case. Remember, always be flexible with the patient you are working with rather than being rigid, as long as you are staying on track with therapy overall.

A particular thanks to Jess, who did a magnificent job as our role-playing patient.

Session one

  1. Engaging in therapy – need for diaries, weighing, changes in eating

  2. Need to eat and energy graphs

  3. Setting first homework, diary, eating change to overcome binges, weight prediction

  4. Addressing the need to gain weight and overcome binges

Session two

  1. Review eating changes, energy graphs, and predictive weighing

  2. Setting homework – feared foods list

  3. Addressing a lack of progress with weight gain

Session three

  1. Addressing therapy-interfering behaviours

  2. Setting up a behavioural experiment (weight gain)

  3. Understanding feeling full

Session four

  1. Session four review – therapy going well

  2. Reviewing a behavioural experiment (predicted weight gain)

  3. Setting up a behavioural experiment (binge triggers)

  4. Expanding the focus beyond food

Session five

  1. Reviewing a behavioural experiment (binge triggers)

  2. Working with emotions one – Exposure and distraction for triggers to behaviours

  3. Body image 2a – Setting up a survey

  4. Imagery rescripting for body shame based on past experiences

Session six

  1. Body image 2b – Reviewing the survey

  2. Working with emotions two – Attributional work for triggers to behaviours

  3. Body image 3: Setting up a body checking experiment

  4. Body image 4a: Setting up graded exposure

Session seven

  1. Body image 4b: Review of graded exposure

  2. Body image 5a – Body comparison

  3. Cue exposure

  4. Imagery rescripting for trauma-related past experiences

  5. Body image 5a: Preparing for mirror exposure

Session eight

  1. Body image 5b – Starting mirror exposure

  2. Body image 5c – Coping with high anxiety

  3. Body image 5d – Anxiety starting to decline

  4. Body image 5e – Ending mirror exposure and setting homework

Session nine

  1. Body image 5f – Reviewing and revisiting mirror exposure

  2. Problem solving – Addressing a ‘slip’ in therapy

  3. Planning the therapy blueprint

Session ten

  1. Reviewing progress and attributing change internally

  2. Reviewing the therapy blueprint

  3. Planning for self-therapy sessions

  4. Planning for the follow-up sessions

Follow-up one

  1. FU1 Review of progress

  2. FU1 Problem-solving

Follow-up two

  1. FU2 Review and future planning