Customer Reviews

The Dialectical Behavior Therapy Skills Workbook for Bulimia: Using DBT to Break the Cycle and Regain Control of Your Life

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"The Dialectical Behavior Therapy Skills Workbook for Bulimia" is a hands-on workbook for individuals who suffer from bulimia nervosa that can be used alone or can accompany a formal treatment program with a mental health professional. The book has eleven chapters that cover a psychoeducational piece, purpose and behavioral pattern identification, training in and integration of all four DBT skills and maintenance and relapse strategies. The exercises throughout the book facilitate understanding of the concepts, which could otherwise be difficult to grasp for individuals who have never been in treatment. This, coupled with numerous clinical examples, highlights the practical, hands-on nature of the volume. The ultimate premise of DBT, "to create a life worth being present in" is frequently brought up, reminding the reader of the long-term gains they could achieve with treatment. Special acknowledgment should be given to the authors for the clarity in their explanations and the adaptation of DBT to this particular clinical population. Clinicians working with eating disordered patients will find that the book is an excellent tool for patient as an extension of their treatment and for themselves as a resource to expand their technical repertoire. Individuals with bulimia will have a better understanding of the work ahead towards recovery; reading this workbook and putting the skills into practice can very well serve as their first step in the recovery pathway.
Gaston Baslet, M.D., Assistant Professor of Clinical Psychiatry, University of Illinois at Chicago

"The Dialectical Behavior Therapy Skills Workbook for Bulimia," by Drs. Ellen Astrachan-Fletcher and Michael Maslar, is a much needed adaptation of dialectical behavior therapy (DBT) for bulimia. This self-help workbook not only outlines the essential DBT "modules," including Mindfulness Skills, Emotion Regulation, Distress Tolerance, and Interpersonal Skills, but it also does a nice job orienting individuals to both DBT and bulimia. Further, the book is filled with useful and practical hands-on examples, activities, and vignettes to facilitate learning and teach individuals to synthesize their DBT skills. Much like the therapy it is based off of, this workbook takes a nonjudgmental yet encouraging and motivating stance. If used effectively and consistently, the tools in this workbook *will* help in the recovery from bulimia.

While this book is marketed as a "self-help workbook," it is important to highlight that it can be used by treatment providers. As a clinician, I have found that this workbook provides a welcome method for facilitating DBT informed treatment (both individual and group). It is especially useful in translating basic DBT skills for the specific population of individuals suffering from disordered eating.

DBT has been proven a effective strategy for dealing with eating disorders; bulimics often have a distorted sense of reality and priorities, and this workbook can provide the patient with that realization while offering useful tools. As with many bulimia books, it provides background on this disorder, its causes and symptoms and treatments.

There are many exercises aimed toward helping the bulimic understand herself. These are often taxing to do because when one isn't in "bulimic mood", it's difficult to imagine how one feels in "bulimic mood". I found the benefit from the exercises not during or even soon after completing them -- their effect would often hit me weeks later as I came to understand their full implications.

Two exercises stood out to me in particular. One was wherein the patient needed to write out a "purpose" for her life (an important step of DBT). Many bulimics will have trouble with this, as they consider their lives purposeless. The book offers the suggestion of "to be healthier", which is a practical purpose that will appeal to anyone. The other exercise consisted of writing a letter to oneself from the perspective of one's body -- I felt very touched and ashamed as I realized all that my body did and tried to do for me, despite receiving my scorn instead of appreciation.

I subtracted one star because the authors do at times seem a bit patronizing and overly firm -- too clinical and too little compassion -- and being the sensitive issue that bulimia is, I imagine it could turn off patients.

This new book by Drs. Astrachan-Fletcher and Maslar fill a big need in the self-help workbook area by covering the application of DBT skills for bulimic behaviors. This is a useful and timely application of mindfulness-based skills to a significant and often difficult to treat set of behaviors. The book is well written and the handouts are easy to use. I highly recommend it for individuals struggling with disordered eating and therapists looking for additional resources for their clients.

I just spent over a month at an eating disorder treatment center, Timberline Knolls, and had DBT classes twice a week. Understanding the core of DBT has enabled me to grasp this concept even further for the specialized version for Builima. My therapist had recommended this book a few months back and while I started it, I didn't get very far as it was at times confusing when you don't know the four aspects of DBT skills. Now back at home and ready to jump on the recovery train for the long haul, I am excited to get back into the workbook and tackle this disorder that has plagued me for over 30 years.