Mexican American women’s perspectives on a culturally adapted cognitive-behavioral therapy guided self-help program for binge eating.

Abstract

The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)—a low-cost minimal intervention—has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Post-treatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: 1) eating behavior and body ideals are socially and culturally constructed, 2) multifaceted support system is crucial to Mexican American women’s treatment engagement and success, and 3) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women’s experience, but it can be strengthened with increased family and peer support. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings.

Experiences of computer‐based and conventional self‐help interventions for eating disorders: A systematic review and meta‐synthesis of qualitative research

“…One of these involved a series of interviews with service users and intervention guides (Traviss et al, ). The final study explored the use of GSH with Mexican Americans, with the view of adapting an existing program to their cultural needs (Shea et al, ). All study interventions were based on principles of Cognitive Behavioral Therapy (CBT) or Motivational Interviewing.…”

“…The high degree of anonymity may be a unique advantage of computer‐based GSH when compared with bibliotherapy, as for example, a participant noted feeling “embarrassed to pick up self‐help books in the library” (McClay et al, ). One exception was found in Shea et al (), who evaluated a face‐to‐face book‐based self‐help program. Participants in that study stated that they preferred to include their family members in their recovery process and meet other participants face to face for support.…”

“…Across studies, participants consistently mentioned the role of “self” in taking charge of their recovery, such as “taking ownership of this [program]” (Shea et al, ). For example, in the study by Traviss et al () where some self‐help guides were interviewed, one of them observed that participants with more positive outcomes were those who were “willing to take more responsibility.” Leung et al () also included ideas about “taking control” instead of “letting ED control you,” and “…[the program] makes me more determined to fix myself.” It is clear that engagement with the program was seen as being effortful.…”

“…Agency/autonomy Across studies, participants consistently mentioned the role of "self" in taking charge of their recovery, such as "taking ownership of this [program]" (Shea et al, 2016). For example, in the study by Traviss et al (2013) where some self-help guides were interviewed, one of them observed that participants with more positive outcomes were those who were "willing to take more responsibility."…”

Associations between meal patterns, binge eating, and weight for Latinas

“…Psychoeducational materials may also be of use, to educate the client and family members on the presence of disordered eating and the principles of healthy eating. Some components of interpersonal therapy can be helpful; particularly assertiveness training may help clients exert portion control during family meal times . Relationship issues and communication difficulties with family members might be especially important to tackle for CBT to be effective.…”