Integrative Cognitive-Affective Therapy for Bulimia Nervosa

A Treatment Manual

Stephen A. Wonderlich, Carol B. Peterson, and Tracey Leone Smith
With Marjorie H. Klein, James E. Mitchell, and Scott J. Crow

A Paperback Originale-bookprint + e-book
A Paperback Original
September 16, 2015
ISBN 9781462521999
Price: $36.00 $27.00
242 Pages
Size: 8" x 10½"
September 16, 2015
ePub and PDF ?
Price: $36.00 $27.00
242 Pages
print + e-book
A Paperback Original + e-Book (ePub and PDF) ?
Price: $72.00 $39.60
242 Pages

Packed with useful clinical tools, this state-of-the-art manual presents an empirically supported treatment solidly grounded in current scientific knowledge. Integrative cognitive-affective therapy for bulimia nervosa (ICAT-BN) has a unique emphasis on emotion. Interventions focus on helping clients understand the links between emotional states and BN as they work to improve their eating behaviors, defuse the triggers of bulimic episodes, and build crucial emotion regulation skills. In a large-size format for easy photocopying, the book includes 47 reproducible handouts. Purchasers get access to a Web page where they can download and print the reproducible materials.

“This is a recommended book. It would be a valuable addition to any graduate clinical psychology, social work, or psychiatric residency program where eating disorders and specifically, management of BN is discussed.”

Child and Family Behavior Therapy

“Written by an internationally renowned team of eating disorder experts, this book presents a cutting-edge approach to treating BN. ICAT-BN is founded on decades of scientific research into what works in the treatment of psychopathology, and introduces a novel framework for integrating new and established strategies and techniques. This gem of a book is a valuable resource for clinicians.”

—Ruth Striegel Weissman, PhD, Walter A. Crowell University Professor of the Social Sciences, Wesleyan University

“This manual intertwines clinical insights and extensive scientific inquiry. The authors have successfully mapped out their innovative intervention, clearly describing the processes and techniques needed for change and providing a practical plan. The book is rich with clinical examples and clever, meaningful teaching strategies. This is a wonderful addition to the clinician's toolkit and an example of successful translation for the scientist.”

—Janet Treasure, PhD, FRCP, FRCPsych, Director, Eating Disorders Research Unit, Kings College London, United Kingdom

“Wonderlich and colleagues provide elegant conceptual models of the onset and maintenance of BN, integrating findings from psychological science and their own innovative work on the moment-to-moment cognitive and emotional context of disordered eating behaviors. The models are linked to a series of therapeutic strategies and specific interventions, including reproducible patient handouts. A beautifully realized manual.”

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

“Practical, comprehensive, evidence based—if you are going to buy one book on the treatment of BN, this should be it! The heart of the book is the detailed, practical recommendations for treatment that can only come from a group of highly experienced clinicians. ICAT-BN is a compelling integration of three decades of clinical research and practice by some of the field's most rigorous thought leaders. Wonderlich et al. artfully address the dual importance of behavioral symptom management and the often-neglected role of the therapeutic relationship in psychotherapy effectiveness. They also offer a unique perspective on emotional dysregulation as a trigger for binge eating.”

—Craig Johnson, PhD, FAED, Chief Science Officer and Director of the Family Institute, Eating Recovery Center, Denver, Colorado

Table of Contents


I. Conceptual and Clinical Foundations of ICAT-BN

1. An Overview of Bulimia Nervosa: Diagnosis, Complications, and Treatment

2. How Bulimia Nervosa Is Conceptualized in ICAT-BN

3. Emotion Focus, Structure, Goals, and Strategies in ICAT-BN

4. Core Skills and the Therapeutic Alliance in ICAT-BN

II. Four Phases of Treatment Using ICAT-BN

5. Beginning, Engagement, and Education (Phase I)

6. Making Plans for Eating and Managing Urges (Phase II)

7. Modifying Responses to Situational and Emotional Cues (Phase III)

8. Stabilizing Treatment Gains and Termination (Phase IV)

III. ICAT-BN Patient Handouts and Skill Cards

About the Authors

Stephen A. Wonderlich, PhD, is the Chester Fritz Distinguished University Professor in the Department of Clinical Neuroscience at the University of North Dakota School of Medicine and Health Sciences and Director of Clinical Research at the Neuropsychiatric Research Institute. He is also Chairperson of the Eating Disorder Department at Sanford Health in Fargo, North Dakota. Past president of the Academy for Eating Disorders, he is a recipient of the Leadership Award in Research from the Academy for Eating Disorders and the Price Family Award for Research Excellence from the National Eating Disorders Association. Dr. Wonderlich's research interests include the development of new treatments for individuals with eating disorders and the identification of factors that either maintain or increase the risk for eating disorders. Widely published, he serves on several journal editorial boards and has written or edited seven books.

Carol B. Peterson, PhD, is Associate Professor in the Department of Psychiatry and Adjunct Assistant Professor in the Department of Psychology at the University of Minnesota. She is a Fellow of the Academy for Eating Disorders and a member of the editorial board of the International Journal of Eating Disorders. Dr. Peterson's research focuses on the assessment, diagnosis, and treatment of eating disorders, particularly psychotherapy treatment outcome studies. She also maintains a clinical practice and serves as Training Director at the Emily Program, an eating disorders treatment center.

Tracey Leone Smith, PhD, is Associate Professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston. She serves as Psychotherapy Coordinator in Mental Health Services at the Department of Veterans Affairs Central Office. Dr. Smith's research has broadly focused on psychotherapy research, personality disorders, and the interpersonal processes that contribute to the etiology and treatment of mental health problems.

Marjorie H. Klein, PhD, is Professor of Psychiatry (Emeritus) in the Department of Psychiatry at the University of Wisconsin Medical School and in the Women's Studies Program at the University of Wisconsin. Her research has focused primarily on psychotherapy process and outcome research. She has developed methods for assessing patient experiential involvement and change in psychotherapy and measures for personality disorders and personality change. Other research has focused on the role of stress in family functioning and child development. Dr. Klein has published more than 100 journal articles and three books, has given more than 130 presentations, and has served on the editorial boards of seven journals, including the Journal of Psychotherapy Practice and Research and the Journal of Personality Disorders.

James E. Mitchell, MD, is the NRI/Lee A. Christoferson MD Professor and Chair of the Department of Clinical Neuroscience at the University of North Dakota School of Medicine and Health Sciences. He is also the Chester Fritz Distinguished University Professor and serves as president and Scientific Director of the Neuropsychiatric Research Institute. Dr. Mitchell’s research focuses on eating disorders, obesity, and bariatric surgery. Past president of the Academy for Eating Disorders and the Eating Disorders Research Society, he has received the Lifetime Achievement Award for Research in Eating Disorders from the Academy for Eating Disorders, the Award for Research Leadership from the National Eating Disorders Coalition, and the Research Award from the Eating Disorders Research Society. He serves on the editorial boards of the International Journal of Eating Disorders and Surgery for Obesity and Related Diseases, has written over 500 scientific articles, and is author, coauthor, or editor of 19 books.

Scott J. Crow, MD, is Professor of Psychiatry at the University of Minnesota and Director of Research at the Emily Program. He is also Program Director for the Midwest Regional Postdoctoral Training Program in Eating Disorders Research. Dr. Crow’s research focuses on eating disorders and obesity. Past president of the Academy for Eating Disorders, he is Editor-in-Chief of Eating Disorders Review. He has written over 200 scientific articles in the fields of eating disorders and obesity.


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

Course Use

May serve as a supplemental text in graduate-level courses.