Online Behavioral Therapy for Bulimia

A new, novel trial lead by researchers at The University of North Carolina and including a team from the Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center will compare, for the treatment of bulimia nervosa, Web-based cognitive behavioral therapy (CBT) that is augmented with weekly, therapist-moderated online chat sessions with face-to-face group therapy (dubbed CBT4BN), the long-time gold standard. Although CBT offered via group therapy provides benefits over individual therapy (eg, patient’s ability to gain from other’s experiences, lower cost), such therapy isn’t available to everyone, due to such factors as living in a rural area, fear of driving to and parking at a medical center, and currently high gas prices.

"As a way to overcome these challenges," said Cynthia M. Bulik, PhD, William and Jeanne Jordan Distinguished Professor of Eating Disorders, and director, UNC Eating Disorders Program, "we've developed a Web site that will deliver the same content as traditional, manual-based cognitive behavioral therapy, but it will take advantage of all the bells and whistles—such as sound, animation and video—that make the best Web sites so compelling."

Participants who are randomized to CBT4BN will participate in chat sessions hosted on a secure server that are moderated by therapists at both sites, with the patients having met them in person early during the study. Effectiveness of CBT4BN will be measured with follow-up assessments on each participant at three, six, and 12 months, as well as at treatment completion.

“If CBT4BN is as effective as CBT delivered in an in-person format, we will be able to provide CBT to individuals who currently are unable to obtain specialty care for the disorder,” said Marsha D. Marcus, PhD, Professor of Psychiatry and Psychology and Service Chief, Center for Overcoming Problem Eating (COPE), and principal investigator at the Pittsburgh site.

What do you think?Can online behavioral therapy provide the same benefits of in-person, group therapy, or even in-person, individual therapy? Does the practice hold promise with other mental disorders? Would you enroll your patients in such a study?