Psychotherapy in anorexia nervosa: What does the absence of evidence mean?

Table 1 Descriptive characteristics of two “novel” treatments for Anorexia Nervosa

SSCM (previously, nonspecific supportive clinical management[16])

MANTRA[19]

“Nonspecific supportive clinical management was developed for the present study, and its aim was to mimic outpatient treatment that could be offered to individuals with anorexia nervosa in usual clinical practice. It combined features of clinical management and supportive psychotherapy. Clinical management includes education, care, and support and fostering a therapeutic relationship that promotes adherence to treatment. Supportive psychotherapy aims to assist the patient through use of praise, reassurance, and advice. The abnormal nutritional status and dietary patterns typical of anorexia nervosa were central to nonspecific supportive clinical management, which emphasized the resumption of normal eating and the restoration of weight and provided information on weight maintenance strategies, energy requirements, and relearning to eat normally. Information was provided verbally and as written handouts” (p. 742)

“MANTRA, aims to tackle maintaining factors related to rigid thinking styles (e.g., perfectionism and obsessive-compulsive personality traits), avoidance of strong emotion, pro-anorectic beliefs and responses of close others. The modularised treatment that has resulted from this model maintains a focus on specific changes required in eating and weight within a motivational interviewing and cognitive behavioural therapy frame-work, including individualised case conceptualisation, in addition to summary letters from the therapist to the patient. Due to its modularized nature, it results in a targeted treatment of AN that is matched to the clinical symptoms, personality traits and neuropsychological profile of participants” (pp. 2-3)

SSCM: Specialist supportive clinical management; MANTRA: Maudsley model of anorexia nervosa treatment for adults; AN: Anorexia nervosa.