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This study investigated the frequency, pattern, and predictors of sudden gains during CBT for eating disorders. Sudden gains were defined as stable and clinically significant symptom reductions occurring between two sessions of treatment (Tang & DeRubeis, 1999). Therapy sessions immediately prior to and following sudden gains were rated and compared to control sessions. Clients (62%) who experienced at least one sudden gain had better post-treatment outcomes. Three distinct types of sudden gains were investigated: total symptom, eating-related, and body-related sudden gains. Preceding the sudden gain, therapists demonstrated increased levels of cognitive interventions and empathy, and clients experienced more cognitive changes and motivation. Eating-related and body-related sudden gains occurred at different points during the course of treatment and were largely independent of one another. Client cognitive change and motivation were most predictive of sudden gains.

Sudden Gains in Cognitive-Behavioral Therapy for Eating Disorders