iCBT with e-mail support is efficacious in students with bulimic disorders and has lasting effects.

Little is known about what determines uptake and acceptability of internet-based treatments in eating disorders, and users' experience with such treatments. We investigated these factors in participants of a randomized controlled trial of an internet-based cognitive- behavioural treatment (iCBT) package (Overcoming bulimia online). Nine participants were interviewed using purposive sampling. The content of interviews were analyzed using thematic analysis. Additionally, participants received questionnaires about their impressions of iCBT. Participants talked about their experience of using iCBT, its impact and compared it to other treatments. Questionnaire responses echoed themes identified in the interviews. iCBT was received positively as a way of fitting treatment into busy lives. Comments on the layout of some of the package content and the practitioner support offered were identified as areas that could be modified or improved.

Email has been progressively used as a means for providing therapeutic guidance and support for cognitive behavioural treatment (CBT) self-care programmes. Many aspects of the use of email in self-care need to be explored such as the content of therapists' emails. Such information would optimise the delivery of self-care treatments. To date no study has looked at the content of the therapists' emails. We analysed the content of emails (n = 712) sent by therapists to participants (n = 71) of a randomised controlled trial (RCT) of internet-based CBT with email support for bulimic disorders. 14.7% of the emails therapists sent contained at least one CBT comment, while 95.4% had at least one supportive comment and 13.6% had at least one technical comment. The mean time spent on providing email support to each participant across the complete programme was 45 minutes. Emails sent by therapists were mainly supportive in content, with only a small amount of time being required by therapists to provide email support.