ACT for Anorexia Nervosa

A Guide for Clinicians

Rhonda M. Merwin, Nancy L. Zucker, and Kelly G. Wilson

HardcoverPaperbacke-bookprint + e-book
July 9, 2019
ISBN 9781462540358
Price: $85.00
286 Pages
Size: 8" x 10½"
July 25, 2019
ISBN 9781462540341
Price: $35.00
286 Pages
Size: 8" x 10½"
June 10, 2019
Price: $35.00
286 Pages
print + e-book
Paperback + e-Book (PDF) ?
Price: $70.00 $38.50
286 Pages

This is the first book to present a roadmap for tailoring acceptance and commitment therapy (ACT) to the serious, complex challenges of anorexia nervosa (AN). Leading authorities describe interventions grounded in ACT core processes—Defusion, Acceptance, Attention to the Present Moment, Self-Awareness, Values, and Committed Action. Guidance is provided for conducting functional assessments with adolescents and adults and working toward individualized treatment goals, starting with weight restoration. The book also discusses ways to engage parents and other family members in treatment. It features therapist scripts, sample dialogues, case examples, and reproducible forms and handouts. The large-size format facilitates photocopying; purchasers also get access to a Web page where they can download and print the reproducible materials.

“A treasure trove of clinically useful material aimed at helping individuals change restrictive eating patterns. The principles of ACT, including the use of patients' own values and beliefs to inform their behavioral choices, are well matched to the needs of individuals with AN. With clarity and compassion, the authors offer the clinician practical strategies to help patients move toward health.”

—Evelyn Attia, MD, Department of Psychiatry, Columbia University Medical Center; Director, Center for Eating Disorders, New York Presbyterian Hospital

“This book sits atop a growing body of evidence that psychological flexibility is of direct relevance to patients struggling with AN. It is one thing to know that a set of change processes are relevant, and another to learn how best to target them. This book is the first comprehensive attempt to teach providers how to treat AN using a rich variety of techniques drawn from ACT and the third wave of cognitive-behavioral therapy. ACT is early in its journey as an evidence-based approach in this area, but this well-written book opens up new pathways to explore when existing gold-standard approaches are not enough. Highly recommended.”

—Steven C. Hayes, PhD, codeveloper of ACT; Foundation Professor of Psychology, University of Nevada, Reno

“This book is a gift—it is an accessible read that offers a wealth of new ways to respond to the unrelenting rigidity that can characterize restrictive eating behaviors. Extensive client–therapist dialogues and clinical metaphors help clinicians decode the atypical thinking that supports excessive restriction and illustrate a fresh approach to treatment. The authors are highly experienced, and their personal responses throughout the manual provide much-needed validation for therapists working to manage their own reactions to these challenging clients.”

—Linda W. Craighead, PhD, Department of Psychology, Emory University

“This book gives us the rarest of combinations—authors with a strong command of assessment and treatment of AN, and a stunning array of clinician support tools that allow even the novice therapist to execute the ACT approach with a high degree of fidelity. The writing style is intensely practical; many highly informative case examples and clinical dialogues demonstrate the core features of ACT. The authors do a wonderful job of constructing a biopsychosocial treatment framework that flawlessly balances the role of psychological and medical interventions.”

—Kirk Strosahl, PhD, co-developer of ACT

“The authors have provided an invaluable volume for those interested in understanding or treating this vexing, challenging illness. ACT is particularly well suited to address the cognitive rigidity, avoidance of emotion, and narrowing of experience that characterize AN, and to promote the clarification of personal values needed to build a meaningful life. The book is rich with clinical examples and transcripts, as well as therapist resources and reproducible tools.”

—Marsha D. Marcus, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine

Table of Contents

Introduction: What is ACT?

1. The Phenomenology and Conceptualization of Anorexia Nervosa from an ACT Perspective sample

2. Overview, Orienting Clients to Treatment, and Forming a Therapeutic Alliance

3. ACT Case Formulation, Assessment, and Treatment Planning

4. Weight Restoration

5. Working with Parents, Partners, or Other Family Members of Individuals with Anorexia Nervosa

6. Creating a Context for Change

7. Acceptance: Allowing Unwanted Internal Experiences

8. Helping Clients Author and Engage Personal Values

9. Defusing Language and Contacting the Present Moment

10. Sensing the Self

11. Treatment Progress and Termination and Final Thoughts for the Therapist

About the Authors

Rhonda M. Merwin, PhD, is Associate Professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center. She is Director of the ACT at Duke Program, which conducts training, clinical services, and research in acceptance and commitment therapy (ACT), and is a core clinical, research, and teaching faculty member at the Duke University School of Medicine. Dr. Merwin’s career has focused on using contextual behavioral science to understand and treat anorexia nervosa and maladaptive eating and weight control among individuals with type 1 diabetes. Dr. Merwin is recognized as an ACT trainer and has collaborated with the Duke Center for Eating Disorders since 2006.

Nancy L. Zucker, PhD, is Associate Professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center. She is Director of the Duke Center for Eating Disorders and a core clinical, research, and teaching faculty member at the Duke University School of Medicine. Widely published, Dr. Zucker is an author of the American Psychiatric Association's revised practice guidelines for the treatment of eating disorders, currently under development. Dr. Zucker's clinical work and research focus on how to help young people develop a healthy awareness of their bodies’ signals, and learn to match these signals to actions that allow them to flourish.

Kelly G. Wilson, PhD, is Professor of Psychology at the University of Mississippi. He is a codeveloper of acceptance and commitment therapy (ACT). Dr. Wilson is coauthor of Acceptance and Commitment Therapy, Second Edition, and has published numerous other books, articles, chapters, treatment manuals, and technical reports. Dr. Wilson trains and consults internationally on the design and implementation of behavioral treatments. His work includes the investigation of acceptance, mindfulness, and values-oriented strategies in the treatment of a variety of problems in living, as well as in the basic behavioral science underlying therapeutic change.


Clinical psychologists, psychiatrists, social workers, nurses, dietitians, and other health professionals who treat patients with eating disorders.