Realizing the untapped promise of single‐session interventions for eating disorders

Abstract

Objective. Multi-level treatment barriers prevent up to 80% of individuals experiencing eating disorders (EDs) from accessing care. This treatment gap creates a critical need to identify interventions that are accessible, easily completable, and optimized for effectiveness by targeting core mechanisms linked to ED onset and maintenance. We propose single-session interventions (SSIs) as a promising path toward catalyzing innovation in the development of accessible, effective ED interventions. SSIs are structured programs that intentionally involve one encounter with a program or provider; they may serve as standalone or adjunctive clinical supports. All SSIs are built to acknowledge that any session might be someone's last-and that any single session can nonetheless yield meaningful clinical benefit. Method.We define SSIs, summarize research supporting their utility for ED symptoms and other mental health problems, and recommend future directions for work in this domain. Results. SSIs may hold promise to reduce some ED symptoms and risk factors, including restrictive eating and negative body image. Steps toward realizing this promise include (1) testing whether existing evidence-based SSIs (e.g., for depression) can also reduce EDs, risk factors, and symptoms; (2) developing novel SSIs that target modifiable ED risk factors and symptoms largely unaddressed by SSIs, such as purging and binge eating;(3) studying diverse implementation pathways; (4) capitalizing on SSIs' transdiagnostic utility to broaden funding opportunities; and (5) educating ED researchers and clinicians about SSIs. Discussion.Understanding the strengths and limits of mechanism-targeted SSIs for ED-related problems could be a low-risk, high-reward avenue towards reducing EDs at scale. Public Health SignificanceStatement: Most individuals experiencing eating disorders (EDs) never access any form of treatment, creating an urgent need to identify ED interventions built to overcome barriers to engaging with care. This Forum article introduces Single-Session Interventions (SSIs) as a promising path to rapidly developing and testing accessible, evidence-based ED supports; supplementing existing ED treatment models; and reducing the individual, familial, and societal burdens of EDs at scale.

A broad range: From simple and brief to intensive single‐session interventions: Commentary on Schleider et al. (2023)

“…SSI should be the object of scrutiny for empirical evidence in the same way as our current packages of psychological treatments (i.e., listing on credible sites such as APA, Division 5 in USA, or NICE in UK). Schleider et al (2023) have provided insightful directions for future research on SSI for ED, in terms of building such novel interventions that identify single, and potentially modifiable targets of intervention based on empirical research on ED. This is a task that should be led by researchers in collaboration with various actors including the private sector, instead of becoming a series of commercial products that mainly bring in profit to companies that seek new markets and opportunities for financial growth.…”

“…A final important note is the notion of a transdiagnostic approach, which was nicely outlined by Schleider et al (2023). As we are learning more about the processes involved in maintenance and treatment of psychological disorders, SSI might become even more important in both prevention and treatment on a transdiagnostic level.…”

“…Although more empirical evidence for the efficacy of SSI within the field of ED is needed, our response to this question is a definite Yes! In addition to the convincing reasons Schleider et al (2023) provide for such a response, we would also like to mention a few other observations and empirical findings in support of greater attention to SSI.…”

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”

“…early intervention, eating disorders, prevention, single session, treatment, waitlists In their Forum paper entitled "Realizing the untapped promise of single-session interventions for eating disorders," Schleider et al (2023) issue a call for the eating disorder field to better utilize the potential of single-session interventions (SSIs). In other words, developing a "single-session mindset" in relation to intervention research (noting this phrase was originally used to refer to training).…”

The promise of single session interventions for eating disorders: Lessons to be learned from research on digital mental health. Commentary on Schleider et al. (2023)

“…• Addressing questions like these will ideally help improve treatment accessibility and outcomes among people with eating disorders. Schleider et al (2023) introduce the concept of single session interventions (SSIs; structured programs that intentionally involve only one visit or encounter with a clinic, provider, or platform) as a promising path toward catalyzing innovation in the development of accessible interventions for eating disorders (EDs). Schleider et al present evidence from 60 clinical trials supporting the efficacy of SSIs in reducing numerous mental health problems, but acknowledge that research on single-session ED interventions is limited.…”