TY  - JOUR
AB  - Intensive forms of enhanced cognitive behavioural therapy for eating disorders (CBT-E) are sometimes characterized within contemporary clinical discussions as rigid, prescriptive, or incompatible with patient autonomy. Such representations, however, appear difficult to reconcile with the theoretical foundations and clinical principles of the model. Since its original formulation, CBT-E has been conceived as a collaborative, formulation-based treatment explicitly designed to promote flexible self-regulation rather than externally imposed behavioural control.
This commentary examines the conceptual confusion that can arise when structured therapeutic support for severe eating disorders is equated with coercion, externally driven regulation, or loss of autonomy. In patients with severe eating disorder psychopathology, malnutrition, cognitive rigidity, and impaired self-regulatory capacity may substantially compromise the ability to make flexible, adaptive choices. In this context, structured interventions may serve not as a negation of autonomy but as a temporary therapeutic scaffold aimed at restoring it.
The paper also discusses how polarized representations of evidence-based treatments may contribute to therapist drift, fragmented implementation, and reduced confidence in empirically supported interventions. Particular attention is given to the risk of framing structured behavioral treatments and person-centered approaches as mutually exclusive categories.
The contemporary challenge in eating disorder treatment is not choosing between structure and autonomy but developing clinically sophisticated models that integrate collaborative care, subjective experience, and evidence-based practice without reducing them to false dichotomies.
AU  - Marco, Massa
DA  - 2026-06-26
DO  - 10.32044/ijedo.2026.08
KW  - CBT-E
Eating disorders
Anorexia nervosa
Self-regulation
Autonomy
Therapist drift
Intensive treatment
Evidence-based treatment
Collaborative empiricism
Eating disorder psychopathology
L1  - internal-pdf://3640413534/202608.pdf
LA  - English
M3  - Commentary
PY  - 2026
SE  - 47
SP  - 5
ST  - Intensive CBT-E for Eating Disorders: Beyond the False Dichotomy Between Structure and Autonomy
T2  - IJEDO
TI  - Intensive CBT-E for Eating Disorders: Beyond the False Dichotomy Between Structure and Autonomy
UR  - https://onlineijedo.positivepress.net/articoli/10.32044/ijedo202608/?lang=en
VL  - 8
ID  - 11
ER  -