Internet-based maintenance treatment for patients with eating disorders.

Abstract

The sustainability of treatment effects is a major challenge in clinical practice. As in most other mental disorders, patients with eating disorders frequently expedence relapses following treatment termination. This calls for feasible maintenance strategies that can be implemented in clinical routine at reasonable cost and effort for both treatment providers and patients. This article introduces an Intemet-based intervention for maintenance support of patients with bulimia nervosa (BN) and related eating disorders not otherwise specified (EDNOS). The program compdses several online components for psychoeducation, self-help, peer support, and professional counseling. In the present pilot study, 22 women had access to the program for 4 months. The intervention proved feasible and well accepted, and participants' satisfaction with the program was high. Adherence to the vadous program components was overall acceptable. Patterns of utilization support the assumption that patients with eating disorders have heterogeneous needs for support following treatment termination. The study confirms the potential of flexible and individually tailored Intemet-based interventions for the optimization of care for these patients.

Harnessing the power of technology for the treatment and prevention of eating disorders

“…20 The efficacy of two more comprehensive technology-enhanced programs in the maintenance treatment of bulimia nervosa and related EDNOS is currently investigated in ongoing RCTs. Gulec et al 21 study a 16-weeks program that uses a similar monitoring component as described above in order to track participants impairment throughout participation and provide tailored supportive feedback at regular intervals. In addition, participants communicate among one another and with a clinician through online forums and chat sessions that are delivered in group format (weekly) and individual format (on demand).…”

“…Preliminary evidence points to the feasibility and acceptability of the intervention. 21 The potential of a manualized CBT-oriented approach in the aftercare of bulimia nervosa is studied in another trial. 22 The 9-month intervention includes 11 sessions.…”

“…Technologyenhanced programs offer the opportunity for clinicians and treatment centers to provide additional support to patients beyond the termination of inperson treatment. Three approaches for bulimia nervosa and related eating disorders not otherwise specified (EDNOS) [20][21][22] and one approach for anorexia nervosa 23 have been introduced so far. Bauer et al 20 developed and evaluated a system based on mobile phones and text messaging to provide support to patients with bulimia nervosa or related EDNOS following their discharge from inpatient treatment.…”

A Transdiagnostic Internet-Based Maintenance Treatment Enhances the Stability of Outcome after Inpatient Cognitive Behavioral Therapy: A Randomized Controlled Trial

“…These include: (a) greater potential for the integration of acquired skills in daily life due to an emphasis on the patient's active role in self-help treatment, (b) elimination of waiting periods between acute and continuation treatment, (c) access to the programs on a 24/7 basis, and (d) lower costs compared to face-to-face treatments. Several studies have shown promising results with delivering continuation phase treatments over the Internet [16,17,18,19,20,21]. However, to our knowledge, all published studies evaluating the use of this approach to maintain inpatient treatment gains [16,17,20] used only nonrandomized designs.…”

A Randomized Controlled Trial of an Internet-Based Posttreatment Care for Patients with Eating Disorders

“…Some maintenance approaches have also been introduced using technology to maintain treatment gains and to prevent relapse. [38][39][40][41] Overall, the findings are promising with respect to feasibility and efficacy of such interventions, but there is a clear need for further research as only very few adequately powered randomized controlled trials (RCTs) have been completed so far. 42,43 A relapse prevention program using short message service (SMS) and text messaging technology proved feasible 38 and efficacious 39 among patients with BN and related EDNOS.…”