CBT-AN-20

Cognitive behavioural therapy for patients with anorexia nervosa

CBT-AN-20 is a 20-session therapy for adults and adolescents with anorexia nervosa (and for other restrictive eating disorders)

Background

Cognitive-behavioural therapy for anorexia nervosa (CBT-AN-20) is a 20-session protocol for working with patients with mild-moderate anorexia nervosa (and other restrictive eating problems, such as atypical anorexia nervosa and Avoidant/Restrictive Food Intake Disorder).

Following the development of CBT-T (a 10-session version of CBT for those with non-underweight eating disorders) and the development of a substantial evidence base that it worked, we decided that we should try bringing the same principles to CBT for underweight patients - relatively brief, focused on early change and exposure, etc. - while ensuring that we addressed issues that have long been problematic in the treatment of eating disorders - e.g., working with the anorexic voice, motivation, effective weight gain strategies.

Having developed and trialled the intervention, we decided that it was time to develop the protocol that is in the manual, which was published in January 2026.

As with CBT-T, we have set up this website to ensure that you are able to access the materials that we have prepared to support your learning and use of CBT-AN-20.

CBT-AN-20

CBT-AN-20 uses similar core principles of CBT (as in CBT-T for non-underweight cases) in a 20-session protocol for mild-moderate outpatient cases of anorexia nervosa. It is focused on adults and older adolescents. Early results indicate that CBT-AN-20 is as effective as 40-session CBT-E.

Like CBT-T, the CBT-AN-20 manual is supported by downloadable clinical tools and psychoeducation materials, as well as skills videos. These resources are all free to access and use for clinical and research purposes (though not for commercial use).

Training sessions are available for teams that would like to enhance their skills base in working with anorexia nervosa.

See the links on this site (above) for more details.

Video role plays

We have a range of videos demonstrating the key skills in CBT-AN-20. Find out more about what is covered in the 20 sessions.

Some of these overlap with the skills used in CBT-T, which are demonstrated in videos accessible from the CBT-T website (https://sites.google.com/sheffield.ac.uk/cbt-t)

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