Treating Eating Disorders with DBT The MED-DBT Protocol

People with eating disorders who also struggle with co-occurring high-risk or dysregulated behaviors are often not well served by standard eating disorder therapies. From pioneering treatment developers Anita Federici and Lucene Wisniewski, this book presents a groundbreaking adaptation of dialectical behavior therapy (DBT) for individuals with multidiagnostic eating disorder (MED) presentations. MED-DBT is affirming, non-stigmatizing, and evidence informed. It integrates the full DBT model--including individual therapy, skills training, phone coaching, and consultation team--with strategies for treating eating behaviors, body image, interoception, and medical instability. Featuring rich case examples, the book is grounded in extensive clinical experience and state-of-the-art neurobiological research. A reproducible MED-DBT Diary Card and other useful tools can be photocopied or downloaded and printed. 

Anita Federici, PhD, CPsych, is founder of The Centre for Psychology and Emotion Regulation in Midland, Ontario, Canada. She holds an Adjunct Faculty position at York University and is a Fellow of the Academy for Eating Disorders. Internationally recognized for her expertise in eating disorders and dialectical behavior therapy, Dr. Federici specializes in building sustainable, evidence-informed care systems through strategic consultation, implementation support, and team-based training for hospitals and organizations worldwide. Her work integrates clinical expertise and systems design to support the development of scalable, person-centered care pathways, particularly for underserved populations and clients with complex treatment needs. Dr. Federici has delivered more than 400 lectures, workshops, and invited talks, and has published peer-reviewed articles and book chapters.

Lucene Wisniewski, PhD, is Adjunct Assistant Professor of Psychological Sciences at Case Western Reserve University and founder and Chief Clinical Officer of the Center for Evidence Based Treatment in Shaker Heights, Ohio. A Fellow of the Academy for Eating Disorders (AED), she has served on AED’s board of directors and as co-chair of the Borderline Personality Disorder special interest group. Dr. Wisniewski is a recipient of the Outstanding Clinician Award from AED and the Champion of Evidence-Based Psychological Interventions Award from the Association for Behavioral and Cognitive Therapies. She received a Fulbright Specialist Program Award to work with Comenzar de Nuevo AC, a nonprofit eating disorder facility in Monterrey, Mexico. Dr. Wisniewski has taught workshops and continuing education seminars worldwide and has authored numerous peer-reviewed articles and book chapters.

I. An Introduction to MED-DBT
1. The MED-DBT Program: Development and Foundations
2. Assessment for Treatment: Is MED-DBT a Good Fit for Your Client?
II. MED-DBT Theories and Treatment Assumptions
3. Introduction to the Adapted Biosocial Theory: A Focus on Biology
4. The Adapted Biosocial Theory: A Focus on Invalidating Environments
5. Assumptions about MED-DBT Clients 
6. Building Your MED-DBT Team
7. Dialectical Dilemmas in MED-DBT Treatment
III. Getting Ready for Treatment
8. Laying the Foundation: Early Steps in the MED-DBT Pretreatment Phase
9. Strengthening Commitment: Later Tasks in MED-DBT Pretreatment
10. The Life Worth Living Discussion
11. What to Target and When
IV. The MED-DBT Protocol
12. Individual Session Structure 
13. MED-DBT Diary Cards
14. Behavior-Chain Analysis and Missing-Links Analysis in MED-DBT
15. Considerations for Teaching DBT Skills
16. Adaptations for Phone Coaching
17. Contingency Management in MED-DBT
18. Consult Teams in MED-DBT
19. Transitions and Ending Well
List of Abbreviations
References
Index