HOW EFFICIENT AND ACCEPTED IS A SELF-CARE MANUAL IN COMBINATION WITH SHORT-TERM THERAPY FOR BULIMIA-NERVOSA

We compared 8 fortnightly sessions plus a self-care manual (guided sel f change, GSC) with 16 weekly individual sessions of cognitive behavio ur therapy (CBT). There were 31 sufferers of DSM-lll-R-bulimia nervosa (BN) in each group. Both treatments resulted in, significant improvem ents regarding self and interviewer based measures of bulimia nervosa as well as depression, self-esteem, quality of life and knowledge abou t nutrition, weight and shape. There were no significant differences b etween therapies regarding drop-out rate, compliance with follow-up, a nd the number of patients receiving additional treatment. At none of t he assessments was there a significant difference between GSC and CBT regarding severity of BN, Beck Depression Inventory-score, self-esteem , and quality of life. A significantly higher percentage of CBT-patien ts were abstinent from bingeing for at least one week at the end of tr eatment. Three months later,the GSC-group had caught up in this respec t and knew more about nutition, weight and shape. Only the sum-scores on a BN self-rating scale were worse for GSC than CBT at the end of th erapy and at follow-up. There were no significant differences between the two groups in general treatment satisfaction and judgement about t he usefulness of the therapies. Thus, guided self change with a self-c are manual can save therapist time without impinging significantly on treatment satisfaction and effectiveness.