2. A self-help treatment for people with recurrent binge eating (Overcoming Binge Eating - for details see separate page) - This self-help programme was derived from the cognitive behavioural treatment for bulimia nervosa. It is designed to be followed either on its own or accompanied by a form of support I termed termed "guided self-help". The guided version of the treatment was endorsed by NICE in 2017 as the first step in the treatment of both binge eating disorder and bulimia nervosa. Guided self-help is now used to deliver many different self-help treatments. 

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3. Enhanced cognitive behaviour therapy for eating disorders (CBT-E) - This "transdiagnostic" treatment was designed to be suitable for all forms of eating disorder and it was developed in the late 1990s.  In 2015 both NHS England and the Chief Medical Officer recommended that CBT-E be made available for all patients with an eating disorder, whatever their eating disorder diagnosis and whatever their age, and in 2017 CBT-E was endorsed by NICE. It is now being used worldwide. For more information on CBT-E see the CBT-E website - cbte.co.

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I am lucky that this work has had a substantial impact (as pointed out in this extract taken from the opening section of the Wellcome Trust's 2017 Annual Report).

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Mental Disorders in Low and Middle Income Countries

For the past 10 years I have been working closely with Professor Vikram Patel and his colleagues at Harvard and in India. The goal is to develop effective psychological interventions for common mental disorders, ones which are highly scalable.  To date we have developed a simple, easily learned, treatment for moderate-to-severe depression, the Healthy Activity Program, and a brief problem-solving intervention for teenagers with pronounced depressive or anxiety symptoms. Both treatments have the potential to be used worldwide. 

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Patel V, Weobong B, Weiss HA, Anand A, Bhat B, Katti B, Dimidjian S, Araya R, Hollon SD, King M, Vijayakumar L, Park AL, McDaid D, Wilson T, Velleman R, Kirkwood BR, Fairburn CG. The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial. Lancet 2016; 389: 176-185.

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Digital Technology and the Dissemination of Psychological Treatments

I am also very interested in how to promote the global dissemination of psychological treatments and the use of digital technology to this end. 

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Fairburn CG, Patel V.  The global dissemination of psychological treatments: a roadmap for research and practice.  American Journal of Psychiatry 2014; 171: 495-498.

Fairburn CG, Patel V. The impact of digital technology on psychological treatments and their dissemination. Behavior Research and Therapy 2017; 88:19-25.

 

Three of lines of work are of relevance in this context:

1. The conversion of therapist-delivered psychological treatments into digital interventions - Like self-help books, most digital treatments are designed to delivered either on their own or with limited, often remotely-delivered, support (a form of guided self-help). They are highly scalable as they can be used within health care systems or as direct-to-user public health interventions. As an example, my CREDO colleague Rebecca Murphy has developed a digital form of CBT-E which can be accessed either via a smartphone app or online.  It is currently under evaluation (see cbte.co).

2. The digital training of psychotherapists - My CREDO colleagues and I have also developed a digital method for training therapists. This has proved to be both popular and effective, and it has the enormous advantage of being able to train large numbers of geographically dispersed therapists thereby overcoming a major obstacle to the dissemination of psychological treatments. (For more information, see cbte.co)

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Fairburn CG, Allen E, Bailey-Straebler S, O’Connor ME, Cooper Z.  Scaling-up psychological treatments: A countrywide test of the online training of therapists.  Journal of Medical Internet Research 2017; 19: e214.

Cooper Z, Allen E, Bailey-Straebler S, Morgan KE, O’Connor ME, Caddy C, Hamadi L, Fairburn CG.  Using the internet to train therapists: A randomised comparison of two scalable methods.  Journal of Medical Internet Research 2017;19: e355.

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3. The global dissemination of effective psychological interventions - Lastly, I must refer to the EMPOWER initiative led by Vikram Patel. Its goal is to make effective psychological interventions (of any type) available to all those who might benefit from them, wherever they are. I chair the Advisory Board and Science Council. More information on this new initiative may be obtained here.

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Measures of Eating Disorder Features

Lastly, we have developed several measures of eating disorder features and their effects, the main ones being the Eating Disorder Examination (EDE), the Eating Disorder Examination Questionnaire (EDE-Q) and the Clinical Impairment Assessment (CIA). All three measures are in widespread use and are available in multiple languages.

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Important Postscript

I must stress that little of the work described above was accomplished by me alone: rather, it has also involved many colleagues and collaborators (see Colleagues page).