CBT is the most evidence-based first-line treatment for eating disorders, but Dr. Susan Simpson kept seeing the same pattern in her caseload: roughly half of clients relapsed, and dropout rates ran between a quarter and a third. The shame, perfectionism, and attachment wounds underneath the eating disorder just weren't shifting.
Dr. Susan Simpson is a clinical psychologist,rainer-Supervisor, and Director of SchemaTherapy Training Scotland. She has more than 25 years of experience treating eating disorders and is co-author of
"Schema Therapy for Eating Disorders" and "Tha Therapy." Her newest book, "Breaking Negative Eating Patterns and Remembering Your True Self," translates her clinical model into a self-help guide for clients,
families, and clinicians.
In this episode, you'll learn:
- Why CBT alone leaves a meaningful percentage of eating disorder clients stuck, and what schema therapy adds
- How GLP-1 medications complicate eating disoncept of "food noise"
- The two core emotional needs at the root of most eating disorder presentations: connection/attachment and autonomy
- How schema modes ("parts") function as survlogy, and why you work with them rather thanagainst them
- Why intellectual insight ("I get it, but I gh on its own
- A real case example: how schema therapy helped a client with long-standing anorexia reconnect to unmet childhood
needs
- What group schema therapy looks like, and its evidence base for eating disorders and borderline personality disorder
Timestamps:
0:00 Meet Dr. Susan Simpson and today's topic
0:17 The main eating disorder categories, including ARFID
3:27 Why ARFID took years to be clinically re
4:58 Do eating disorder patterns come in waves?
5:25 How GLP-1 medications complicate eating
6:52 What "food noise" actually means
9:12 Why Dr. Simpson moved from CBT to schema
12:40 The two core emotional needs behind eating disorders
13:50 Schema modes explained: protective part
17:12 Working with, not against, protective parts
20:04 Is schema therapy just CBT with extra s
24:19 Where dietitians and other specialists fit on the team
26:06 Working with ambivalence and readiness
28:50 Food diaries, and knowing your own scope as a clinician
30:41 The part that doesn't want to fully letfood addiction
32:27 Her new self-help book, and who it's for
35:02 Rewriting a clinical model for a generahapter one)
37:06 Case study: healing long-standing anorexia through schema therapy
42:34 A group therapy memory: why clients cank
43:47 How directive vs. non-directive coaching depends on the client's history
46:07 Avoiding transference traps that repeat
47:30 Where to learn schema therapy if you want to go deeper
49:00 The current research on schema therapy
51:03 What group schema therapy looks like in practice
53:38 Closing thoughts and where to find Dr.
Resources mentioned:
- Breaking Negative Eating Patterns and Remembering Your True Self, Dr. Susan Simpson
- Schema Therapy for Eating Disorders, Susan Simpson et al.
- The Cambridge Guide to Schema Therapy, Susan Simpson et al.
- "When Standard Treatments Are Not Enough" - Showcasing Schema Therapy for the Treatment of Anorexia Nervosa and Borderline Personality Disorder, Hepworth & Simpson (2025), Journal of Clinical Psychology: https://doi.org/10.1002/jclp.23801
- Schema Therapy Training Scotland: https://schematherapyscotland.com
- Dr. Simpson's publications on ResearchGate: https://www.researchgate.net/profile/Susan_Simpson/publications
- Dr. Simpson's YouTube channel: https://www.youtube.com/@BreakingNegativeEatingPatterns
This episode covers topics relevant to CE/CEU, NCC.
Free CEU available for Arizona licensure through the Board of Behavioral Health Examiners.
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Website: https://lorainmoorehead.com
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Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.
Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.
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