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The effectiveness of contingency management in the treatment of patients with anorexia nervosa: A systematic review
Author(s) -
Ziser Katrin,
Resmark Gaby,
Giel Katrin Elisabeth,
Becker Sandra,
Stuber Felicitas,
Zipfel Stephan,
Junne Florian
Publication year - 2018
Publication title -
european eating disorders review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.511
H-Index - 67
eISSN - 1099-0968
pISSN - 1072-4133
DOI - 10.1002/erv.2590
Subject(s) - anorexia nervosa , eating disorders , psychotherapist , contingency management , anorexia , psychology , medicine , intensive care medicine , psychiatry , intervention (counseling)
Abstract Contingency management in stipulating weight gain is routinely used in the treatment of anorexia nervosa, however, empirical investigations concerning its effectiveness have been scarce. This systematic review was conducted according to the PRISMA statement. Of N = 973 hits, 42 full‐texts were included in the qualitative synthesis (11 theoretical texts, 19 case reports, 12 descriptive, cohort, and controlled trials). A central topic in the included publications concerns the enhancement of patients' autonomy through participation in the contingency management process. This heightened autonomy is achieved by using contingency contracts. Positive short‐term effects on weight gain were shown, whereas follow‐up results were heterogeneous. Although contingency contracts are widely used in clinical practice, our systematic review shows that empirical evidence on underlying mechanisms and efficacy is still scarce. Using an explicit treatment contract can enhance patients' motivation, compliance, and autonomy. Clinical practice should see further development including innovative motivation enhancing and conflict dissolving techniques in addressing the pronounced ambivalence often shown by patients with anorexia nervosa.