Why are empirically supported treatments for bulimia nervosa underutilized and what can we do about it?

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Abstract
Empirically supported therapies for bulimia nervosa, as well as for other disorders, are rarely utilized. Underutilization is frequently attributed to doubts among psychotherapists about the value of randomized controlled trials and professional resistance to the perceived constraints of manualized therapy. However, controversies about the usefulness of empirically supported therapies have been shaped by lack of access to adequate training and inexperience in delivering these treatments. A proposal for expanding training opportunities is presented along with discussion about how more intensive training for the practicing therapist would affect current controversies regarding the value and relevance of empirically supported therapies for bulimia nervosa and other disorders. © 1999 John Wiley & Sons, Inc. J Clin Psychol 55: 769–779, 1999.