Cognitive Remediation Therapy, Eh! an Exploratory Study at a Canadian Adult Eating Disorders Clinic/Thérapie De Remédiation Cognitive, Eh! Une éTude Exploratoire À Une Clinique Pour Adultes Canadiens Ayant Des Troubles De L'alimentation

Eating disorders are serious illnesses that have psychological and physical consequences, and are difficult to treat (Klump, Bulik, Kaye, Treasure, & Tyson, 2009; Lock & Fitzpatrick, 2009). Symptoms of the illness can be both socially and occupationally debilitating, and can affect patients' overall satisfaction with life (Agras, 2001). Engagement in the recommended evidence-based treatment is a high priority within the field of adult eating disorders. Despite the frequent use of group therapy in the treatment of adult eating disorders, a longstanding issue has been patient engagement and dropout. Dropout rates are high for individual and group therapy for eating disorders, ranging between 20% and 73% for inpatient and outpatient care (Fassino, Piero, Tomba, & Abbate-Daga, 2009). A patient's decision to prematurely leave recommended treatment has been linked with feeling dissatisfied with the therapy received and the type of treatment being offered (Bados, Balaguer, & Saldana, 2007; Wallier et al., 2009). Although research is beginning to emerge on patient satisfaction in the treatment of eating disorders (Clinton, Bjorck, Sohlberg, & Norring, 2004; Krautter & Lock, 2004; Rosenvinge & Klusmeier, 2000), few studies have examined Canadian adults' satisfaction with group therapy formats or novel group-based approaches aimed at better engaging patients in the early stages of treatment of an eating disorder.Cognitive remediation therapy (CRT) represents a novel prepsychological treatment for eating disorders that can be delivered in a group format, is well liked by patients, and addresses an important gap between initial patient rapport and later engagement in evidence-based treatment (Tchanturia, Davies, & Campbell, 2007; Tchanturia, Lloyd, & Lang, 2013). CRT is well established for use with individuals with schizophrenia to help address weaknesses in the areas of attention, working memory, rigidity, and set-shifting (Harvey & Bowie, 2003; Wykes & Gaag, 2001; Wykes et al., 2007). It has also been adapted for addressing similar concerns in attention-deficit/hyperactivity disorder, learning disabilities, and obsessive compulsive disorder (Buhlmann, Etcoff, & Wilhelm, 2006; Park et al., 2006; Stevenson, Whitmont, Bornholt, Livesey, & Stevenson, 2002). CRT was initially examined as an individual prepsychological intervention for adult inpatients struggling with anorexia nervosa and was later adapted for use with children, adolescents, and adults in outpatient settings across eating disorder diagnoses (Abbate-Daga, Buzzichelli, Marzola, Amianto, & Fassino, 2012; Tchanturia, Campbell, Morris, & Treasure, 2005). More recently, research has found evidence that CRT may represent a feasible and accepted prepsychological outpatient treatment for eating disorders (Brockmeyer et al., 2013; Lock et al., 2013). However, further work is needed, given its preliminary evidence of improved cognitive flexibility and patient acceptability, as well as the few existing studies examining its use with adults in group therapy formats (Genders & Tchanturia, 2010; Tchanturia et al., 2013).Neuropsychological research has revealed trait-based thinking patterns in patients with eating disorders including rigid thinking, problems with set-shifting, and difficulty with zooming out for a big picture perspective (Lang, Stahl, Espie, Treasure, & Tchanturia, 2014; Lopez, Tchanturia, Stahl, & Treasure, 2008; Roberts, Tchanturia, Stahl, Southgate, & Treasure, 2007; Roberts, Tchanturia, & Treasure, 2010; Tchanturia et al., 2005; Tchanturia et al., 2011). On the behavioural level, this translates into difficulty with broader perspective taking, switching between rules for everyday tasks, shifting out of negative mood states associated with the eating disorder, and excessive detail focus on areas that would not otherwise be a focal point if the eating disorder were not present (Roberts et al. …

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