A trial of a relapse prevention strategy in women with bulimia nervosa who respond to cognitive-behavior therapy.

OBJECTIVE: This study examines a relapse prevention strategy for bulimia nervosa (BN). Subjects in a multicenter BN treatment trial who initially achieved abstinence after a course of cognitive-behavioral therapy (CBT) were told to recontact the clinic if they had a recurrence of symptoms or feared such a reoccurrence so that they could receive additional therapy visits.

METHOD: At the end of CBT, subjects whose scores on the Eating Disorders Examination indicated that they were abstinent from binge eating and purging, and therefore considered to be treated successfully, were assigned randomly to follow-up only or to a crisis intervention model. With the crisis intervention model, subjects would receive additional visits if needed.

RESULTS: None of the 30 subjects who relapsed during the follow-up sought additional treatment visits.

DISCUSSION: Simply telling patients with BN who appear to have been successfully treated to come back if they have additional problems, or fear that they are developing such problems, may be an ineffective relapse prevention technique. Alternative strategies, such as planned return visits or phone calls, should be considered as alternative relapse prevention strategies.