The results described in this thesis support the strong empirical evidence for the effectiveness of CBT-Ef for patients with an eating disorder and a BMI>17.5. When compared to TAU, we found... Show moreThe results described in this thesis support the strong empirical evidence for the effectiveness of CBT-Ef for patients with an eating disorder and a BMI>17.5. When compared to TAU, we found comparable effects on eating disorder psychopathology, however CBT-Ef is superior in enhancing self-esteem with significantly fewer sessions and within a shorter time. We found no support for the hypothesis that more severe self-esteem problems, higher levels of perfectionism, or more interpersonal problems would obstruct long-term improvement and would therefore need extra attention in an extended protocol. A broader use of CBT-Ef in clinical practice could result in more efficient and accessible treatment for patients with an eating disorder. In another study we found COMET to be effective in enhancing self-esteem in patients with an eating disorder. Since we did not find the predictive value of low self-esteem in CBT-E treatment outcome, we suggest to integrate COMET in an eating disorder treatment only when low self-esteem is pronounced and interferes with making progress. Show less
In the Netherlands the Coping with Depression (CWD; Lewinsohn & Clark, 1984) course for elderly has been implemented in the prevention arm of the community-based mental health care system. The... Show moreIn the Netherlands the Coping with Depression (CWD; Lewinsohn & Clark, 1984) course for elderly has been implemented in the prevention arm of the community-based mental health care system. The study’s aim was the effectiveness (immediate and long-term) of the course in this real life setting. Enrolment of all 318 participants was the responsibility of the mental health care professionals in charge of the course. The immediate effect was studied in a random design using a waitlist group as control group; the long-term effect was analyzed in a naturalistic design. The Center for Epidemiological studies Depression scale (CES-D; Radloff, 1977) was used as the outcome measure. A wide range of variables related to incidence, severity, course and remittance of depression were included as predictors of immediate and long-term outcome. Results. The level of depressive symptoms varied from slight to being severely depressed i.e., meeting the criteria for a major depressive episode (MDE). Effect size: for non-depressed 0.32, for those with a MDE 0.92. The four predictors – anxiety, MDE, previous MDE, and education level - that were statistically significant had no clinical significance and did not justify further triage at intake. At the conclusion of the course 62% still had a CES-D score above 16, which is an indication that a clinical relevant depression is persisting. These participants should be advised to seek further treatment. Show less
