Enhanced cognitive behavioral therapy (CBT-E) is a type of talk therapy that helps with a variety of mental health conditions. It is an individualized treatment based on your personal situation and preferences. CBT addresses how the combination of thoughts, feelings, and behaviors contribute to your eating disorders. The idea is that your thoughts influence your behavior. The approach focuses on how you have formed your eating behaviors and how you maintain them.

With this CBT, you learn to identify thoughts that are harming you. You assess whether they are accurate and reflect reality. If they are not, we assist you in developing strategies to challenge and overcome these thoughts. We teach you to:

• Recognize when your thoughts or perceptions are inaccurate
• Reevaluate those thoughts and perceptions and reshape them so they do not hurt you
• Better understand the behavior and motivations of other people
• Develop problem-solving skills for social situations
• Develop a greater sense of confidence in your abilities
• Face your fears, rather than avoid them
• Calm and soothe your mind and body

The treatment has four parts. We focus on dysfunctional eating behaviors, over-emphasis on shape and weight, dietary restraint, and the effect of your mood on your eating. We also address issues related to a worsening of symptoms after improvement. This treatment is appropriate for most eating disorders and provides the insight and tools to effectively manage  eating after treatment has completed.

During a session, your therapist will encourage you to discuss your thoughts and feelings. You will use role play to prepare for potentially difficult situations. We may also give you “homework” activities, reading, and practices to try in your daily life.

Our goal is to get you to a place where you can help yourself, where you can be your own therapist. We use various exercises and role plays as well as conversation to help. In general, we focus on helping you cope with current and future situations, rather than dwelling on the past.

Cognitive behavioral therapy is usually considered short-term. The number of sessions will be based on:

• Your specific eating disorder
• The severity of your symptoms
• How long you have had these symptoms
• Speed of your progress
• Your stress levels
• How much help you get from family and friends

At Mount Sinai, we know that many people have more than one diagnosis. Many go back and forth between different diagnoses. For this reason, we concentrate on you, the patient, not the diagnosis.