Cognitive behavior therapy for co-occurring of eating and substance use disorders

Cognitive behavior therapy has received empirical support for the treatment of eating disorders, alcohol use disorders, and substance use disorders; however, there is no empirical research on the use of cognitive behavior therapy specifically for comorbid eating disorders and substance use disorders. Common cognitive behavioral treatments of alcohol use disorder and substance use disorders include (1) cue exposure interventions, (2) contingency management interventions, and (3) coping skill interventions. Treatment for eating disorders initially focuses on establishing regular eating, changing disturbed beliefs about dieting, and the importance of shape/weight and transitions into modular-based treatment that targets a number of hypothesized maintaining factors. We present a model for combining these existing approaches into a single treatment that builds on core overlapping interventions targeting behavioral change (e.g., self-monitoring, functional analysis, etc.) and allows for use of modular-based integration of comorbidity-specific interventions targeting aspects of comorbidity (e.g., PTSD) and personality (e.g., impulsivity). Special considerations for treating the comorbid population are discussed.