Drop out from eating disorder treatment: A single-case, multidimensional approach

The treatment of eating disorders is very challenging. Despite the refinement of treatment techniques, relatively high drop-out rates pose a major problem for therapists and researchers in this field. Previous research is fragmented and does not clarify why these patients drop out and what may be done to check the problem. Furthermore, because of methodological issues and medical complications, it may be very difficult to have large samples or randomized clinical trials, therefore a single-case approach may be necessary and/or preferable. This study proposes a multi-dimensional approach to examine the role of patient, therapist and patient-therapist variables in the treatment of eating disorder patients. Over 20 process indices are transcribed, analyzed and monitored in their change over time, session after session. The approach is illustrated with a single-case study regarding a patient with a major eating disorder (AN/BN) who dropped out from inpatient treatment (CBT) after 28 weekly sessions. Results and potential implications for future research are discussed.