Self-help and stepped care treatments for eating disorders

This chapter provides an overview of self- help and guided self- help treatments for eating disorders as well as stepped care models for treatment delivery. Empirical evidence suggests that although guided self-help approaches may have relatively higher efficacy and retention rates than self-help treatment, data from comparison trials are inconsistent. Robust treatment predictors, moderators, and mediators have not been identified other than rapid response as a predictor of outcome for cognitive-behavioral guided self-help, which may be useful in informing stepped care treatment. Stepped care models have received some empirical support and, in addition to potentially reducing treatment costs, may enhance efficacy by providing individuals who are not responsive to initial treatments with alternative or adjunctive interventions. Research using adaptive and tailored designs for treatment is needed to improve treatment efficacy and dissemination. Further research is needed in cost- efficacy, implementation, clinician training models, and patient preferences and acceptability.