Developing the “single‐session mindset” in eating disorder research: Commentary on Schleider et al., 2023 “Realizing the untapped promise of single‐session interventions for eating disorders”

Abstract

Schleider and colleagues' paper on the application of single‐session interventions (SSIs) to eating disorders is timely given the broader focus in mental health on flexible approaches to delivering support at the time the person needs it most. The eating disorder field needs to embrace these innovations including developing a “single‐session mindset” with greater attention paid to testing the relevance of SSI for eating disorders. The use of well‐powered trials of brief, focused and rapidly scalable interventions is an ideal vehicle for generation and evaluation of new and longer interventions. Our future research agenda needs to carefully consider our target audience, the primary outcome variable of most relevance, and the SSI topic that would be most likely to effect change. Research in prevention might focus on weight concern and evaluation of SSIs that focus on self‐compassion or cognitive dissonance related to appearance ideals in the media. Work in early intervention could target denial and disordered eating using SSIs on growth mindset, behavioral activation, and imagery rescripting. Treatment waitlists provide another suitable opportunity, evaluating SSIs that aim to increase hope for change, treatment retention, and kick start early change in therapy, a robust predictor of better treatment outcome.

Equitable access to evidence-based treatment for eating disorders for patients with low-income: identifying barriers and exploring solutions

“…Many more barriers likely exist than those reviewed here. For example, low income is associated with increased stress levels and co-occurring mental health conditions, all of which can interfere with treatment implementation (Wade et al ., 2023) and reduce the effectiveness of psychological treatment (Finegan et al ., 2018). Location-specific barriers related to income also need further exploration (e.g.…”

Recent Advances in Cognitive-Behavioural Therapy for Eating Disorders (CBT-ED)

“…Guided self-help has also demonstrated important steps towards greater efficiency over a limited therapy period [ 20 ], remaining more effective than pure self-help [ 21 , 22 ], and performing better than other internet-based approaches [ 23 ]. There are also early signs that including CBT-ED elements in apps and in single-session interventions can engage patients better and encourage greater change during subsequent therapy [ 24 , 25 •, 26 ]. However, other efforts to enhance efficiency have not always proven effective.…”

Developing a protocol to address co‐occurring mental health conditions in the treatment of eating disorders

“…Rather than at the outset engaging in costly and lengthy randomized controlled trials, the ability to recruit substantially larger and more diverse populations than is usually possible in eating disorder research and to learn how such groups react to single theory‐driven targeted interventions, may be a preferred approach to generate and evaluate new interventions for further elaboration. Information gained by well powered trials of brief interventions has the potential to improve our understanding of what maintains these disorders and how to address obstacles to progress (Cooper & Shafran, 2023; Schleider et al, 2023; Wade, 2023).…”