Engaging the adolescent patients in the treatment of eating disorders: strategies and procedures of enhanced cognitive behavior therapy.

Background: Engaging adolescents in treatment for eating disorders presents a significant challenge due to the egosyntonic nature of these conditions and the ambivalence toward change.

Main text: The adolescent version of Enhanced Cognitive Behavior Therapy (CBT-E) prioritizes active patient involvement to foster engagement and long-term commitment to recovery. This treatment employs a structured yet flexible approach to enhance patient engagement. Key strategies include adopting a supportive and collaborative stance, explaining the distinction between the disease model and the psychological CBT-E model, actively involving patients in the decision to change, agreeing on specific homework assignments between sessions, and engaging parents as supportive "helpers." This engagement-focused approach encourages adolescents to take ownership of their recovery. By personalizing interventions and fostering adolescents' active role in understanding the psychological maintaining processes of their eating disorder, deciding to address them, and navigating the process of change, CBT-E empowers them to move toward recovery with increasing independence. Parental involvement is carefully structured to provide support without undermining the adolescent's sense of agency.

Conclusions: Future research should further evaluate engagement-focused adaptations of CBT-E and their impact on long-term treatment outcomes.