Bulimia: Fuelled by Social Media

Check This article was edited and approved for accuracy By Adam Szmerling on November 9, 2021

As you scroll through your Facebook or Instagram feed, how often do images of people with incredible bodies pop up?Chances are – you are confronted with images of people with thin frames or athletic physiques several times a day.

Admiring someone’s physique is perfectly acceptable. However, it can quickly become a cause of concern if you start comparing your body to theirs, taking drastic, unhealthy steps to achieve that ‘look’.

eating disorders statistics

Over time, this may turn into an eating disorder, affecting your physical and mental health. Today, it seems that social-media fuelled eating disorders are becoming increasingly common.

This is why we think it’s important to discuss this issue.

But before we do that, let’s cover some statistics on eating disorders.

  • Of people with eating disorders, 47% have Binge Eating Disorder, 12% have Bulimia Nervosa, 3% have Anorexia Nervosa and 38% have other eating disorders (Paxton et.al., 2012).
  • Women and girls are more likely to experience all types of eating disorders than men and boys, with the exception of Binge Eating Disorder where there is almost equal prevalence (Hay, Girosi& Mond, 2015).
  • Approximately 80-85% of individuals diagnosed with Anorexia Nervosa or Bulimia Nervosa are female and 15-20% of people with Anorexia Nervosa and Bulimia Nervosa are male (Hay, Mond, Buttner& Darby, 2008).

It’s important to recognise that males are also largely affected by this issue. According to the Eating Disorders Resource Catalogue2014, a quarter of those with anorexia are male and are at an increased risk of dying due to delayed diagnosis.

In Australia, approximately one million people live with an eating disorder every year – that’s 4% of the population. And around 15% of women will experience an eating disorder at some point in their life.

Clearly, this is a huge issue.

According to a study by Flinders University and the University of Western Australia, the more social media sites a teenager uses – and the more time spent on them, the more likely they are to suffer from disordered eating. Although this study focussed on year 7 and 8 students, this likely extends to the adult population.

How Dangerous are Eating Disorders?

According to the Eating Disorders Coalition, 2016, a person dies every hour due to an eating disorder.

Eating disorders increase the risk of premature death due to medical complications and are also linked to an increased rate of suicide.

Smink et al., (2012)found that eating disorders have the highest mortality rate of any other mental illness.

So, eating disorders, left unaddressed, can be extremely dangerous.

social media and eating disorders

Social Media & Eating Disorders

As we mentioned earlier, social media can contribute to an unhealthy relationship with food and eating disorders.

Social media can affect your thoughts, perceptions and make unhealthy fads seem “normal. There are thousands of accounts on Instagram, Facebook and other social media channels that advocate for healthy diets and active lifestyles.

This isn’t the problem.

The issue is when these pages promote images of unrealistic and unattainable bodies along with unsustainable diets. An issue also arises when value is constantly placed on attractiveness.

In Western Society, attractiveness and ‘being skinny’ has long been aspired to. Take Barbie, for example; for years this doll was portrayed as having the ideal body type. In 2013, the Daily Mail revealed that if she were a real person, she would not even be able to carry herself around due to her disproportionate body. What sort of message was this doll sending to our children? With advanced technology and the rise of social media, Barbie has now been replaced with thousands of Instagram images instead.

As consumers, we need to stop comparing ourselves to these unrealistic images. If weight loss is the goal, we need to take a hard look at the reality of healthy dieting.  We need to understand that many of these pictures we see on social media are either photo-shopped or the result of years and years of hard work (not a fad or extremely low-calorie diets). Additionally, some of these social media influencers may appear healthy, but may be far from it.

According to a report (the result of an enquiry set up by the British Fashion Council), Dr. Adrienne Key, a psychiatrist said that bulimia is the most common disorder among models, estimating that about 20% to 40% of fashion models experience an eating disorder.

Comparing your body to these images may lead to the development of physical and mental disorders.

Fad Ads on Social Media

If we earned a dollar every time we saw an advertisement or promotion claiming that a fad diet or weight loss machine could get you that desirable waist or rock-hard abs, let’s just say we’d be very rich.

Many ads claim to provide superficial solutions to non-existent problems, aggravating the already serious matter of body image insecurity.

Social media advertisements are extremely clever these days. With our reduced attention spans, advertisers have to get your attention quickly!

This is why images of incredible and often unattainable bodies are used. They stop the scroll! They get your attention first, then they sell you on the product or program.

Celebrities and Eating Disorders

It’s important to understand that body image concerns and eating disorders are not purely a result of the social media age. Many celebrated personalities have dealt with all sorts of eating disorders in the past, from anorexia to to binge eating.

In 1994, Princess Diana of Wales publicly spoke of her issues with bulimia. She was a great role model in that she encouraged those who were suffering to seek professional help and support. This moved many people to speak up about their own struggles and experience with disordered eating.

Lady Gaga is another celebrated personality who has dealt with anorexia and bulimia since she was 15. The renowned pop singer opened up about her fight against bulimia in 2012. Her ‘Born This Way Foundation’ provides resources to help people deal with eating disorders, addiction and other such issues.

As we can see, eating disorders can affect anyone and everyone, especially when we’re constantly refreshing our feeds, and being exposed to content that doesn’t always make us feel good about ourselves.

Here’s a checklist on how you can protect yourself online.

advise how to protect yourself online

1. Do a social media cleanse

Take some time to check out who you’re following on the social media platforms that you use regularly. Make a conscious effort to unfollow channels that make you feel uncomfortable about your body and those that make you feel any less than the amazing person you are. The lesser you engage with such profiles, the better you’ll be able to protect your mental health.

2. Check and verify credentials of social media fitness influencers

While the online world has become a huge space for talented creators, it has also become increasingly easy for anyone and everyone to pose as a fitness or weight loss guru, giving advice on how to lose weight and get fit. But, unfortunately, some of these influencers may not have the adequate knowledge to be providing diet or fitness plans and tips. Sure – their method may have helped them, but there’s a chance it may not work for you, or worse -it could negatively impact your health.

3. Seek information only from credible sources

Instead of looking for meal plans on Instagram or Google – reach out to a certified nutritionist. Often, online algorithms track your activity and will show you ads pertaining to your online searches. So, the more you look for fitness-related content and diets, the more likely you are to get ads from accounts promoting these things. Depending on how good their marketing is – you may feel compelled to click on that ad, and before you know it, you’ve forked out for that fad diet or course.

So always reach out to a certified, credible professional for help when you need it.

It’s important to remember that living with an eating disorder is not easy. It can affect your mental health and physical wellbeing in more ways than you may know. So, if you or someone you know is dealing with an eating disorder, remember that there is help available.

Feel free to speak to one of our professional therapists for eating disorder treatment. You can link up through a confidential and secure video conferencing session – anywhere in Australia. Professional help is just a click away. All you need to do is reach out.

Adam Szmerling

Bayside Psychotherapy was founded by Adam Szmerling in Melbourne, offering counselling and psychotherapy for individuals and couples. Adam's experience with psychotherapy inspired him to help others improve their self-understanding, mental health and wellbeing.

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Cognitive Behavioural Therapy (CBT)


Cognitive Behavioral Therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that aims to change negative patterns of thinking or behaviour. It is based on the idea that our thoughts, feelings, and actions are interconnected and that changing negative thought patterns can lead to changes in feelings and behaviours. CBT helps individuals identify and challenge distorted or unhelpful thinking patterns and beliefs, teaching them to respond to challenging situations more effectively. It is commonly used to treat a wide range of disorders, including depression, anxiety, and phobias. The therapy involves working with a therapist in a structured setting, and the skills learned can be applied to everyday life. With its evidence-based approach, CBT has proven effective for many individuals in managing their psychological challenges.

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Psychodynamic Therapy


Psychodynamic therapy, rooted in the theories of psychoanalysis developed by Sigmund Freud, focuses on the unconscious processes as they manifest in a person's present behaviour. The goal is to increase self-awareness and understanding of how past experiences influence current behaviour. It explores unresolved conflicts and traumatic experiences from the past, which may be impacting present-day behaviours and emotions. Therapists often delve into childhood events, dreams, and the relationship between the therapist and client to uncover hidden patterns. By bringing these unconscious feelings and drives to consciousness, individuals can gain insights into their lives, leading to healing and personal growth. While traditionally long-term, many contemporary forms of psychodynamic therapy are shorter-term. It is used to treat a broad range of conditions, including depression, anxiety, and personality disorders.

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Person-Centred Therapy (or Rogerian Therapy)


Person-centred therapy, developed by Carl Rogers, is a humanistic approach that emphasises the individual's inherent drive towards self-actualization and growth. The therapist provides an environment of unconditional positive regard, empathy, and genuineness, allowing clients to freely express themselves without fear of judgement. This nurturing atmosphere facilitates self-exploration and self-acceptance. Central to the approach is the belief that individuals possess an innate ability to find their solutions when given the right conditions. The therapist's role is not to direct or advise, but rather to act as a facilitative companion on the client's journey. The focus is on the here and now, with the aim to enhance the individual's self-awareness, self-worth, and capacity to create positive changes in their lives.

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Hypnotherapy


Hypnotherapy is a therapeutic technique that uses guided relaxation, intense concentration, and focused attention to achieve a heightened state of consciousness or trance. Conducted by certified hypnotherapists, it taps into the subconscious mind, allowing clients to explore suppressed memories, emotions, or negative patterns. The process can facilitate behaviour change by introducing positive affirmations or suggestions. Hypnotherapy is often employed to treat anxieties, phobias, substance addictions, unwanted behaviours, and pain management. It can also be used to uncover and address deeper traumas or past experiences. While many report positive results from hypnotherapy, it requires the individual's willingness and trust in the process. It is crucial to approach it with an open mind and under the guidance of a trained professional.

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Interpersonal Therapy (IPT)


Interpersonal therapy (IPT) is a time-limited, evidence-based treatment that focuses on interpersonal issues, aiming to improve communication patterns and relational dynamics. Developed primarily for depression, IPT operates on the premise that psychological symptoms are often linked to interpersonal problems. It concentrates on four main areas: unresolved grief, role disputes (conflicts with significant others), role transitions (major life changes), and interpersonal deficits (long-standing difficulties in forming and maintaining healthy relationships). Therapists help clients identify and address current interpersonal issues that may contribute to their emotional distress. By enhancing communication and relational skills, IPT seeks to alleviate symptoms and improve interpersonal functioning. Emphasising the here and now, it offers practical strategies and insights for individuals to better navigate their social environments.

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Dialectical Behaviour Therapy (DBT)


Dialectical Behaviour Therapy (DBT) is a cognitive-behavioural treatment developed by Dr. Marsha Linehan, primarily for individuals with borderline personality disorder and chronic suicidality. DBT combines standard cognitive-behavioural techniques with concepts from Buddhist meditation, emphasising both acceptance and change. The therapy addresses emotional dysregulation by teaching patients skills in four key areas: mindfulness (staying present in the moment), distress tolerance (managing crises and accepting situations without change), emotion regulation (understanding and managing intense emotions), and interpersonal effectiveness (communicating and setting boundaries). DBT incorporates both individual therapy and group skills training. Its efficacy has expanded beyond its initial focus, showing promise in treating other disorders like eating disorders, substance use disorders, and mood disorders. It aims to balance self-acceptance with the need for change, fostering both emotional stability and interpersonal effectiveness.

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Integrative or Eclectic Therapy


Integrative or Eclectic therapy combines elements from various therapeutic approaches based on a client's individual needs. Instead of adhering to a single therapy model, integrative therapists are flexible, drawing from multiple theories and techniques to create a personalised treatment. This approach recognizes the value of diverse therapeutic methods and believes no one size fits all. By blending elements from different therapies, integrative practitioners aim to enhance treatment efficacy, tailoring it to the specific issues, preferences, and cultural backgrounds of each client. The underlying principle is that different individuals may benefit from different approaches at different times. Thus, an integrative or eclectic approach is holistic, adaptable, and client-centred, aiming to achieve optimal therapeutic outcomes by using a wider range of tools and insights.

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Narrative Therapy


Narrative therapy is a therapeutic approach that centres on the stories people construct and hold about their lives. Developed by Michael White and David Epston, it posits that individuals give meaning to their experiences through narrative, often influenced by societal norms and beliefs. In this therapy, problems are externalised, allowing clients to view issues as separate from themselves. Therapists help clients "re-author" these narratives, emphasising strengths, achievements, and overlooked potential. By dissecting and reframing these stories, individuals can perceive challenges differently, identify alternative narratives, and construct more empowered versions of their lives. The approach is non-pathologizing, viewing people as experts of their own lives, with the therapist acting as a collaborative partner in the exploration and rewriting process. Narrative therapy fosters resilience, agency, and personal transformation.

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Solution-Focused Brief Therapy (SFBT)


Solution-focused brief therapy (SFBT) is a goal-oriented approach that emphasises solutions rather than problems. Developed by Steve de Shazer and Insoo Kim Berg in the 1980s, SFBT operates on the belief that clients possess inherent strengths and resources to manage difficulties and create desired changes. Instead of delving into the origins of problems, the therapy focuses on envisioning a preferred future and identifying practical steps to achieve it. Sessions often involve questions that help clients recognize successes, however small, and build on them. Questions might explore exceptions (times when the problem was not present) or elicit positive feedback, reinforcing progress. SFBT is typically shorter in duration than other modalities and is applicable across various settings and populations, emphasising resilience, competence, and actionable solutions.

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Gestalt Therapy


Gestalt therapy, developed by Fritz Perls in the mid-20th century, is an experiential and holistic approach focusing on self-awareness and the "here and now." It emphasises personal responsibility and the individual's experience in the present moment, the environment, and the context. The therapy seeks to help clients integrate fragmented aspects of the self, leading to a more unified, authentic whole. Gestalt therapists use creative techniques, including role-playing, dialogue, and experiential exercises, to heighten awareness and resolve unfinished business or "gestalts." Central to the approach is the belief in the innate human capacity for self-regulation and growth when individuals fully experience their feelings and perceptions. Gestalt therapy underscores the importance of the therapist-client relationship, direct engagement, and mutual influence, aiming to foster self-acceptance and personal growth.

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Schema Therapy


Schema therapy, developed by Dr. Jeffrey Young, integrates elements of cognitive-behavioural, psychodynamic, attachment, and gestalt approaches to treat complex disorders, particularly borderline personality disorder. It posits that maladaptive "schemas" or core beliefs form in childhood due to unmet emotional needs. These schemas persist into adulthood, leading to unhealthy life patterns or coping styles. The therapy identifies and addresses these deep-rooted schemas, aiming to replace them with healthier coping mechanisms. Schema therapy uses various techniques like cognitive restructuring, experiential exercises, and behavioural pattern-breaking. Therapists also emphasise a therapeutic relationship marked by "limited reparenting," wherein they provide the support and guidance that clients might have missed in their childhood. By addressing these core beliefs and their origins, schema therapy seeks long-lasting change and healing for individuals with chronic psychological challenges.

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Acceptance and Commitment Therapy (ACT)


Acceptance and Commitment Therapy (ACT) is a therapeutic approach that blends traditional behaviour therapy with mindfulness principles. Developed by Steven C. Hayes in the 1980s, ACT's primary objective is to increase psychological flexibility. It encourages individuals to embrace their thoughts and feelings rather than resisting or feeling guilty for them. The therapy focuses on six core processes: cognitive defusion (distancing from unhelpful thoughts), acceptance (embracing feelings without judgement), present-moment awareness (mindfulness), self-as-context (recognizing a consistent self beyond thoughts), values clarification (identifying what truly matters), and committed action (taking steps aligned with values). ACT posits that pain is a normal part of life and aims to help clients pursue meaningful lives in the presence of pain, rather than avoiding or being dominated by internal distress.

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Mindfulness-based cognitive therapy (MBCT)


Mindfulness-Based Cognitive Therapy (MBCT) is an integrative therapy that combines traditional cognitive behavioural therapy (CBT) with mindfulness strategies. Developed to prevent the recurrence of depression, MBCT teaches individuals to become more aware of their thoughts and feelings, fostering a different relationship with them rather than trying to eliminate them. This approach aids in recognizing and disrupting automatic cognitive processes, often preventing depressive relapses. Through meditation exercises and awareness techniques, clients learn to focus on the present moment, reducing rumination and negative thought patterns. Research has shown MBCT to be effective in reducing the recurrence of depression, especially for those with a history of recurrent episodes. Beyond depression, it is also applied to various conditions, promoting mental well-being by cultivating mindfulness and a more adaptive relationship with thoughts and emotions.

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Family Systems Therapy


Family systems therapy, rooted in the work of Murray Bowen, views individuals in the context of their family unit, considering familial relationships, dynamics, and patterns. It posits that an individual's behaviours and emotional well-being are inseparable from the family system they belong to. Distress or dysfunction in one member often reflects broader family dynamics. The therapy seeks to identify and address unhealthy patterns within the family, aiming to foster understanding, improve communication, and resolve conflicts. Therapists observe interactions, facilitate dialogues, and guide family members towards healthier ways of relating. They consider generational patterns, roles, and boundaries. The goal is not just to address the concerns of one member but to enhance the well-being and functionality of the entire family system, recognizing its interconnected nature.

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Cognitive Behavioural Therapy (CBT) References


  • Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440.
  • Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2017). The effects of psychotherapies for major depression in adults on remission, recovery, and improvement: a meta-analysis. Journal of Affective Disorders, 202, 511-517.
  • Wiles, N., Thomas, L., Abel, A., Ridgway, N., Turner, N., Campbell, J., ... & Hollinghurst, S. (2013). Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment-resistant depression: results of the CoBalT randomised controlled trial. The Lancet, 381(9864), 375-384.
  • Johnsen, T. J., & Friborg, O. (2015). The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis. Psychological Bulletin, 141(4), 747.
  • Driessen, E., Van, H. L., Don, F. J., Peen, J., Kool, S., Westra, D., ... & Dekker, J. J. (2013). The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial. American Journal of Psychiatry, 170(9), 1041-1050.
  • Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry, 15(3), 245-258.

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Psychodynamic Therapy References


  • Leichsenring, F., & Rabung, S. (2011). Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis. The British Journal of Psychiatry, 199(1), 15-22.
  • Abbass, A., Kisely, S., & Kroenke, K. (2014). Short-term psychodynamic psychotherapy for somatic disorders: Systematic review and meta-analysis of clinical trials. Psychotherapy and Psychosomatics, 83(5), 265-274.
  • Luyten, P., & Fonagy, P. (2015). The neurobiology of mentalizing. Personality Disorders: Theory, Research, and Treatment, 6(4), 366.
  • Gerber, A. J., Kocsis, J. H., Milrod, B. L., Roose, S. P., Barber, J. P., Thase, M. E., ... & Schneier, F. R. (2011). A quality-based review of randomized controlled trials of psychodynamic psychotherapy. American Journal of Psychiatry, 168(1), 19-28.
  • Munder, T., Wilmers, F., Leonhart, R., Linster, H. W., & Barth, J. (2010). Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients. Clinical Psychology & Psychotherapy, 17(3), 231-239.
  • Town, J. M., Diener, M. J., Abbass, A., Leichsenring, F., Driessen, E., & Rabung, S. (2012). A meta-analysis of psychodynamic psychotherapy outcomes: Evaluating the effects of research-specific procedures. Psychotherapy, 49(3), 276.

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Person-Centred Therapy (or Rogerian Therapy) References


  • Elliott, R., Greenberg, L. S., Watson, J., Timulak, L., & Freire, E. (2013). Research on humanistic-experiential psychotherapies. Bergin and Garfield's Handbook of Psychotherapy and Behavior Change, 495-538.
  • Cooper, M., O'Hara, M., Schmid, P. F., & Wyatt, G. (2016). The Handbook of Person-Centred Psychotherapy and Counselling. Palgrave Macmillan.
  • Prochaska, J. O., & Norcross, J. C. (2018). Systems of Psychotherapy: A Transtheoretical Analysis. Oxford University Press.
  • Watson, J. C. (2017). Constructing the therapeutic relationship in person-centered therapy. Journal of Psychotherapy Integration, 27(4), 475.
  • Cepeda, L. M., & Davenport, D. S. (2016). Person-centered therapy and solution-focused brief therapy: An integration of present and future awareness. Psychotherapy, 53(1), 27.
  • Murphy, R., & Hutton, P. (2018). Practitioner review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment–A systematic review and meta-analysis. Journal of Child Psychology and Psychiatry, 59(1), 5-19.

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Hypnotherapy References


  • Alladin, A. (2012). Cognitive hypnotherapy: An integrated approach to the treatment of emotional disorders. Journal of Cognitive Psychotherapy, 26(4), 272-284.
  • Elkins, G., Barabasz, A., Council, J., & Spiegel, D. (2015). Advancing research and practice: The revised APA Division 30 definition of hypnosis. American Journal of Clinical Hypnosis, 57(4), 378-385.
  • Jensen, M. P., Jamieson, G. A., Lutz, A., Mazzoni, G., McGeown, W. J., Santarcangelo, E. L., ... & Terhune, D. B. (2015). New directions in hypnosis research: Strategies for advancing the cognitive and clinical neuroscience of hypnosis. Neuroscience of Consciousness, 2015(1), niv012.
  • Elkins, G., Barabasz, A., Council, J., & Spiegel, D. (2015). Advancing Research and Practice: The Revised APA Division 30 Definition of Hypnosis. International Journal of Clinical and Experimental Hypnosis, 63(1), 1-9.
  • Lynn, S. J., Rhue, J. W., & Kirsch, I. (2010). Handbook of clinical hypnosis (2nd ed.). Washington, DC: American Psychological Association.
  • Alladin, A. (2012). Cognitive hypnotherapy: An integrated approach to the treatment of emotional disorders. John Wiley & Sons.

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Interpersonal Therapy (IPT) References


  • Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2016). The effects of psychotherapies for major depression in adults on remission, recovery, and improvement: A meta-analysis. Journal of Consulting and Clinical Psychology, 84(3), 262.
  • Markowitz, J. C., & Weissman, M. M. (2012). Interpersonal psychotherapy: Past, present and future. Clinical Psychology & Psychotherapy, 19(2), 99-105.
  • Mufson, L., Dorta, K. P., Wickramaratne, P., Nomura, Y., Olfson, M., & Weissman, M. M. (2017). A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents. Archives of General Psychiatry, 64(6), 577-584.
  • Cuijpers, P., Geraedts, A. S., van Oppen, P., Andersson, G., Markowitz, J. C., & van Straten, A. (2011). Interpersonal psychotherapy for depression: A meta-analysis. The American Journal of Psychiatry, 168(6), 581-592.
  • Belsher, B. E., Beevers, C. G., & Neimeyer, R. A. (2012). Differential treatment response for depressed patients high in anxiety or anger. Journal of Consulting and Clinical Psychology, 80(5), 852.
  • Lemmens, L. H., Galindo-Garre, F., Arntz, A., Peeters, F., Hollon, S. D., Derubeis, R. J., & Huibers, M. J. (2017). Exploring mechanisms of change in cognitive therapy and interpersonal psychotherapy for adult depression. Behaviour Research and Therapy, 94, 81-92.

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Dialectical Behaviour Therapy (DBT) References


  • Kliem, S., Kröger, C., & Kosfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modeling. Journal of Consulting and Clinical Psychology, 78(6), 936.
  • Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2014). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on Social Work Practice, 24(2), 213-223.
  • Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., ... & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475-482.
  • Chapman, A. L. (2016). Dialectical behavior therapy: Current indications and unique elements. Psychiatry (Edgmont), 3(9), 62.
  • Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour Research and Therapy, 59, 40-51.
  • Paris, J. (2017). Is hospitalization useful for suicidal patients with borderline personality disorder?. Journal of Personality Disorders, 31(1), 58-66.

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Integrative or Eclectic Therapy References


  • Norcross, J. C., & Goldfried, M. R. (Eds.). (2019). Handbook of psychotherapy integration (3rd ed.). Oxford University Press.
  • Cook, J. E., Biyanova, T., & Coyne, J. C. (2010). Barriers to adoption of new treatments: An internet study of practicing community psychotherapists. Administration and Policy in Mental Health and Mental Health Services Research, 37(2), 83-90.
  • Watson, J. C., Gordon, L. B., Stermac, L., Kalogerakos, F., & Steckley, P. (2010). Comparing the effectiveness of process‐experiential with cognitive‐behavioral psychotherapy in the treatment of depression. Journal of Consulting and Clinical Psychology, 74(6), 1030.
  • Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge.
  • Cooper, M. (2019). The challenge of counselling and psychotherapy research. Counselling Psychology Review, 24(3-4), 88-96.
  • Cuijpers, P., van Straten, A., Andersson, G., & van Oppen, P. (2010). Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 77(6), 909.

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Narrative Therapy References


  • Vetlesen, A. J. (2015). Narrative exposure therapy: A short-term treatment for traumatic stress disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 54(8), 688-696.
  • Mørkved, N., Winje, D., Dovran, A., Arefjord, K., Johnsen, I. H., Kroken, R. A., ... & Thimm, J. C. (2019). A pilot study of narrative exposure therapy in adolescents and young adults with borderline personality features and self-harm. Frontiers in Psychology, 10, 656.
  • Robjant, K., & Fazel, M. (2010). The emerging evidence for Narrative Exposure Therapy: A review. Clinical Psychology Review, 30(8), 1030-1039.
  • Grysman, A., & Hudson, J. A. (2013). Gender differences in autobiographical memory: Developmental and methodological considerations. Developmental Review, 33(3), 239-272.
  • Thomaes, K., Dorrepaal, E., Draijer, N., Jansma, E. P., Veltman, D. J., & van Balkom, A. J. (2014). Can pharmacological and psychological treatment change brain structure and function in PTSD? A systematic review. Journal of Psychiatric Research, 50, 1-15.
  • McLeod, J. (2013). An introduction to counselling. McGraw-Hill Education (UK).

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Solution-Focused Brief Therapy (SFBT) References


  • Franklin, C., Trepper, T. S., Gingerich, W. J., & McCollum, E. E. (2011). Solution-focused brief therapy: A handbook of evidence-based practice. Oxford University Press.
  • Kim, J. S. (2014). Examining the effectiveness of solution-focused brief therapy: A meta-analysis. Research on Social Work Practice, 24(3), 304-315.
  • De Shazer, S., & Dolan, Y. (2012). More than miracles: The state of the art of solution-focused brief therapy. Routledge.
  • Bond, C., Woods, K., Humphrey, N., Symes, W., & Green, L. (2013). Practitioner review: The effectiveness of solution-focused brief therapy with children and families: A systematic and critical evaluation of the literature from 1990–2010. Journal of Child Psychology and Psychiatry, 54(7), 707-723.
  • Stams, G. J., Deković, M., Buist, K., & de Vries, L. (2011). Efficacy of solution-focused brief therapy: A meta-analysis. Clinical Psychology Review, 31(4), 605-617.
  • Gingerich, W. J., & Peterson, L. T. (2013). Effectiveness of solution-focused brief therapy: A systematic qualitative review of controlled outcome studies. Research on Social Work Practice, 23(3), 266-283.

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Gestalt Therapy References


  • Roubal, J. (Ed.). (2016). Gestalt therapy in clinical practice: From psychopathology to the aesthetics of contact. Siracusa: Gestalt Press.
  • Brownell, P. (2016). Handbook for theory, research, and practice in gestalt therapy (2nd ed.). Newcastle upon Tyne: Cambridge Scholars Publishing.
  • Elliott, R., Watson, J. C., Goldman, R. N., & Greenberg, L. S. (2011). Learning emotion-focused therapy: The process-experiential approach to change. American Psychological Association.
  • Perls, F., Hefferline, R. F., & Goodman, P. (2010). Gestalt therapy: Excitement and growth in the human personality. Start Publishing LLC.
  • Yontef, G., & Jacobs, L. (2010). Gestalt therapy. In Corsini Encyclopedia of Psychology (4th ed.). Wiley.
  • Brown, M., & Pedder, J. (2015). Introduction to psychotherapy: An outline of psychodynamic principles and practice (4th ed.). Routledge.

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Schema Therapy References


  • Arntz, A., & Jacob, G. (2012). Schema therapy in practice: An introductory guide to the schema mode approach. Wiley.
  • Giesen-Bloo, J., & Arntz, A. (2013). Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of general psychiatry, 63(6), 649-658.
  • Rafaeli, E., Bernstein, D. P., & Young, J. (2011). Schema therapy: Distinctive features. Routledge.
  • Nordahl, H. M., & Nysæter, T. E. (2015). Schema therapy for patients with borderline personality disorder: a single case series. Journal of Behavior Therapy and Experimental Psychiatry, 48, 69-77.
  • Cockram, D. M., Drummond, P. D., & Lee, C. W. (2010). Role and treatment of early maladaptive schemas in Vietnam veterans with PTSD. Clinical psychology & psychotherapy, 17(3), 165-182.
  • Bamelis, L. L., Evers, S. M., Spinhoven, P., & Arntz, A. (2014). Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. American Journal of Psychiatry, 171(3), 305-322.

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Acceptance and Commitment Therapy (ACT) References


  • Hayes, S. C., & Hofmann, S. G. (Eds.). (2012). Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. New Harbinger Publications.
  • Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review. Clinical psychology review, 33(8), 965-978.
  • A-tjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp, P. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30-36.
  • Öst, L. G. (2014). The efficacy of Acceptance and Commitment Therapy: An updated systematic review and meta-analysis. Behaviour research and therapy, 61, 105-121.
  • Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2012). A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior modification, 36(6), 742-766.
  • Levin, M. E., Hildebrandt, M. J., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior therapy, 43(4), 741-756.

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Mindfulness-Based Cognitive Therapy (MBCT) References


  • Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., ... & Segal, Z. (2016). Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse. JAMA Psychiatry, 73(6), 565-574.
  • Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169.
  • Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical psychology review, 37, 1-12.
  • van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., ... & Piet, J. (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical psychology review, 37, 26-39.
  • Strauss, C., Cavanagh, K., Oliver, A., & Pettman, D. (2014). Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: A meta-analysis of randomised controlled trials. PLOS ONE, 9(4), e96110.
  • Crane, C., & Kuyken, W. (2013). The implementation of mindfulness-based cognitive therapy: Learning from the UK health service experience. Mindfulness, 4(3), 246-254.

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Family Systems Therapy References


  • Carr, A. (2014). The evidence base for couple therapy, family therapy and systemic interventions for adult-focused problems. Journal of Family Therapy, 36(2), 158-194.
  • Lebow, J. L. (2014). Couple and family therapy: An integrative map of the territory. American Psychological Association.
  • Sexton, T. L., & Datchi, C. (2014). The development and evolution of family therapy research: Its impact on practice, current status, and future directions. Family Process, 53(3), 415-433.
  • Asen, E., & Fonagy, P. (2012). Mentalization-based therapeutic interventions for families. Journal of Family Therapy, 34(4), 347-370.
  • Sprenkle, D. H. (Ed.). (2012). Effectiveness research in marriage and family therapy. American Association for Marriage and Family Therapy.
  • Miller, S. D., Hubble, M. A., & Duncan, B. L. (Eds.). (2013). Handbook of solution-focused brief therapy: Clinical applications. John Wiley & Sons.

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