Peer mentoring for eating disorders: results from the evaluation of a pilot program

Abstract

Background Eating disorders (EDs) are serious psychiatric illnesses that have high rates of morbidity and mortality, and low long-term recovery rates. Peer mentor programs (PMPs) have been associated with reduced psychiatric hospitalisation and shorter lengths of stay for those with other severe mental illnesses. The present study evaluated the feasibility and preliminary efficacy of a PMP for individuals with EDs in improving symptomatology and quality of life. Methods Thirty mentees and seventeen mentors were recruited. The PMP involved thirteen sessions over 6 months. Participants completed measures assessing ED symptomatology, quality of life (QoL), mood and perceived disability. Changes in symptomatology before and after the PMP were tested by Wilcoxon signed rank tests. Semi-structured interviews were conducted for qualitative evaluation of the PMP. Results The program was deemed to have moderate feasibility with eight of 30 mentees, and two of 17 mentors withdrawing. Completion rates ranged from 2 to 16 sessions, and between 3 and 45 weeks. Mentees demonstrated improvements in body mass index, QoL, ED symptomatology, mood (depression, anxiety and tension/stress) and perceived disability from pre- to post-program. Mentors demonstrated significant increases in ED symptomatology, but no worsening of QoL, mood or perceived disability. Qualitative findings from both mentees and mentors were positive: emergent themes included hope for recovery, a sense of agency and inspiration gained from interaction with someone with lived experience of an ED. Conclusions This pilot study suggests feasibility of the PMP for individuals with EDs. Mentees demonstrated improvements in ED symptomatology, QoL, mood and perceived disability. However, the increase in ED symptomatology reported by the mentors over the PMP highlights potential risks and the need for thorough monitoring while preliminary evaluation is undertaken. The mentoring relationship was a positive experience for both mentees and mentors, instilling an increased hope for recovery in mentees and an opportunity for mentors to reflect on their own recovery with increased confidence. The novel relationship formed throughout mentorship highlights a potential gap in current clinical support services, which warrants further exploration within a controlled trial. Trial registration Australian and New Zealand Clinical Trials Registration Number: ACTRN12617001412325. Retrospectively registered: 05/10/2017. Date of first enrolment: 20/01/2017. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373741&isReview=true Electronic supplementary material The online version of this article (10.1186/s40337-019-0245-3) contains supplementary material, which is available to authorized users.

Peer mentorship as an adjunct intervention for the treatment of eating disorders: A pilot randomized trial

“…Consistent with prior work (Beveridge et al, ; Perez et al, ), peer mentorship appeared feasible among patients with eating disorders, based on high acceptability ratings, low dropout rate, and good attendance rate. The rate of program completion was 80%, which is comparable with 73% retention in a prior feasibility study of peer mentorship for patients with eating disorders (Beveridge et al, ).…”

“…Consistent with prior work (Beveridge et al, ; Perez et al, ), peer mentorship appeared feasible among patients with eating disorders, based on high acceptability ratings, low dropout rate, and good attendance rate. The rate of program completion was 80%, which is comparable with 73% retention in a prior feasibility study of peer mentorship for patients with eating disorders (Beveridge et al, ). Findings pertaining to attendance, feasibility, and intervention preference suggest that connecting with someone who has “been there” is a preferred treatment modality that can engender high patient engagement, which is particularly notable for patients with eating disorders, often characterized by high ambivalence about change.…”

“…In an observational study, Perez, Van Diest, and Cutts () compared individuals receiving online mentorship to those waiting for a mentor and found that individuals receiving mentorship reported better QOL and missed fewer treatment sessions compared to those who were unmatched. In a feasibility study comparing baseline and postintervention outcomes in 30 individuals receiving 6 months of mentorship, approximately 75% of participants completed the program, and they showed improvement in body mass index (BMI), eating disorder symptoms, general psychological well‐being, and QOL (Beveridge et al, ). Qualitative studies suggest that mentorship may be particularly helpful for feeling understood and instilling hope that recovery is possible (Ramjan, Fogarty, Nicholls, & Hay, ; Ramjan, Hay, & Fogarty, ).…”

Facilitators and barriers in anorexia nervosa treatment initiation: a qualitative study on the perspectives of patients, carers and professionals

“…These include increases in treatment motivation, hope, knowledge (insider information), and decreases in fear and stigma [ 33 , 38 , 39 ]. Potential risks could include overestimation of treatment effects [ 39 ] and maladaptive social comparisons (peer contagion effect) [ 40 , 41 ]. Nonetheless, based on the present results, it seems highly promising to further investigate the influences of successfully treated former patients (‘positive role models for treatment’) on the treatment initiation of so far untreated individuals with AN.…”

Peer mentoring for individuals with an eating disorder: a qualitative evaluation of a pilot program

“…To address the shortcomings of the research noted above, a study of the feasibility and acceptability of a sixmonth, one-to-one peer-mentoring program (PMP) for people with eating disorders was conducted (for detailed results, see [40]). It was found that mentees involved in the program demonstrated improvements in ED symptomatology, quality of life, mood, and perceived disability.…”