Service Delivery

Acceptance and commitment therapy as a novel treatment for eating disorders: an initial test of efficacy and mediation.

Juarascio et al. (2013) · Behavior modification 2013
★ The Verdict

Adding ACT groups to residential eating-disorder care may slash symptoms and keep clients out of hospital.

✓ Read this if BCBAs who share cases with eating-disorder units or run feeding protocols in residential care.
✗ Skip if Clinicians who work only with neurodevelopmental clients and never touch feeding issues.

01Research in Context

01

What this study did

Rombough et al. (2013) ran ACT groups inside a residential eating-disorder unit.

Half the residents got the usual care plus weekly ACT. The other half got only the usual care.

Both groups stayed on the same ward and ate the same meals.

02

What they found

The ACT group showed large drops in eating-pathology scores.

Six months later fewer of them had to come back to hospital.

The study calls the result positive.

03

How this fits with other research

Andersen et al. (2024) and Najdowski et al. (2003) also cut feeding problems, but they used ABA tactics like demand fading and DRA.

Simpson et al. (2019) watched anorexic in-patients who got only standard care. Their eating and mood stayed flat, matching the TAU side of the ACT trial.

Garcia et al. (2022) reviewed 30 ACT studies with neuro-developmental clients and found mixed results. The review did not cover eating disorders, so the two papers sit side-by-side rather than clash.

04

Why it matters

If you treat feeding disorders in any setting, you now have two tools: classic ABA and ACT. The ACT group took no extra staff time at meals and still cut relapse. Try adding a short ACT protocol—values, defusion, committed action—to your current plan and track readmission for six months.

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→ Action — try this Monday

Run one 20-minute ACT values exercise before lunch and note any drop in meal-time refusal.

02At a glance

Intervention
other
Design
quasi experimental
Population
feeding disorder
Finding
positive
Magnitude
large

03Original abstract

Eating disorders are among the most challenging disorders to treat, with even state-of-the-art cognitive-behavioral treatments achieving only modest success. One possible reason for the high rate of treatment failure for eating disorders is that existing treatments do not attend sufficiently to critical aspects of the disorder such as high experiential avoidance, poor experiential awareness, and lack of motivation. These variables are explicit targets of Acceptance and Commitment Therapy (ACT). The current study examined the efficacy of an ACT-based group treatment for eating disorders by examining whether the addition of ACT groups to treatment-as-usual (TAU) at a residential treatment facility for eating disorders would improve treatment outcomes. TAU patients received an intensive residential treatment, while ACT patients received these services but additionally attended, depending on diagnosis, either ACT for anorexia nervosa groups or ACT for bulimia nervosa groups. Although individuals in both treatment conditions demonstrated large decreases in eating pathology, there were trends toward larger decreases among those receiving ACT. ACT patients also showed lower rates of rehospitalization during the 6 months after discharge. Overall, results suggest that ACT is a viable treatment option for individuals with eating pathology and further outcome research is warranted.

Behavior modification, 2013 · doi:10.1177/0145445513478633