Psychotherapy for eating disorders can be challenging. Individuals with eating disorders are ambivalent about changing their eating behavior, and many lack conviction that they could feel better without losing weight or maintaining their diet. Eating symptoms become overlearned and habitual over time, and are associated with significant medical risks. Most individuals with eating disorders also experience depression, anxiety, or obsessive-compulsive symptoms that maintain eating disorder symptoms and require clinical attention as well.

The Renfrew Unified Treatment for Eating Disorders and Comorbidity: An Adaptation of the Unified Protocol is a modular treatment manual for a unified treatment approach to address eating disorders and co-occurring emotional disorders, such as anxiety, depression, post-traumatic, and obsessive-compulsive spectrum disorders. The program progresses through core treatment elements that have shown to be effective across evidence-based therapy protocols-including motivation enhancement, emotion awareness, emotion acceptance, cognitive flexibility, behavior change, and exposure therapy-in a format that allows an individual's co-occurring problems to be treated in a unified and personalized format. The different treatment components are unified by their theoretical and practical links to research on the common elements of emotional disorders, such as emotion avoidance, emotional intolerance, negative appraisals, and maladaptive emotion-driven behaviors. The Therapist Guide includes introductory materials that review the research and theoretical basis for treatment, as well as all the necessary material for providing therapy. The Workbook for patients facilitates psychoeducation, administration of the therapy, and distribution of therapy materials. The workbook material may be used in group or individual therapy, and the therapist guide provides suggestions for use in both settings.

The Renfrew Unified Treatment for Eating Disorders and Comorbidity: An Adaptation of the Unified Protocol will allow therapists to treat any eating disorder concurrently with any other emotional disorder, using the same interventions, in a personalized fashion.

Heather Thompson-Brenner, PhD is clinical psychologist in private practice in Cambridge, Massachusetts.

Melanie Smith, PhD, LMHC, CEDS-S is Director Of Training for The Renfrew Centers.

Gayle E. Brooks, PhD, CEDS-S, is Vice President and Chief Clinical Officer for The Renfrew Centers.

Dee Ross Franklin, MA is a Pre-Doctoral Intern at the Neurobehavioral Institute.

Hallie Espel-Huynh is a postdoctoral research fellow at the Weight Control and Diabetes Research Center at Brown University.

James Boswell, PhD is an Associate Professor of Psychology at the University at Albany, State University of New York.

PREPARING FOR TREATMENT

Chapter 1: Eating Disorders and Emotional Disorders

Chapter 2: About This Treatment

Chapter 3: Recording Your Experiences: Eating, Depression, and Anxiety (EDA)

MODULE 1: MOTIVATION AND GOALS

Chapter 4: Motivation and Regular Eating

Chapter 5: Regular Eating (Supplementary Session)

MODULE 2: UNDERSTANDING EMOTION

Chapter 6: The Natural Function of Emotions

Chapter 7: The Three Parts of Emotions (3-Component Module)

Chapter 8: Tracking Emotions Over Time (the "ARC")

MODULE 3: MINDFUL EMOTION AWARENESS

Chapter 9: Mindful Emotion Awareness

Chapter 10: Mood Induction

MODULE 4: COGNITIVE FLEXIBILITY

Chapter 11: Automatic Thoughts and Thinking Traps

Chapter 12: Core Beliefs

MODULE 5: BEHAVIORAL FLEXIBILITY

Chapter 13: Countering Avoidant Behaviors

Chapter 14: Countering Emotion-Driven Behaviors

MODULE 6: CONFRONTING PHYSICAL SENSATIONS

Chapter 15: Interoceptive Exposures

MODULE 7: EMOTION EXPOSURES

Chapter 16: Skills for Emotion Exposures

RELAPSE PREVENTION

Chapter 17: Continuing Progress Into the Future