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)

Linardon, Jake; Fuller‐Tyszkiewicz, Matthew

doi:10.1002/eat.23947

Cited by 4 publications

(2 citation statements)

References 5 publications

(7 reference statements)

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“…Outcomes were defined and synthesized based on the user journey of a digital intervention, as per prior recommendations (Linardon & Fuller-Tyszkiewicz, 2023). These outcomes included uptake (accessing versus not accessing the intervention), drop-out (failing to complete the post-test assessment), engagement (number of logins, time spent on each module, completion of the program, etc.…”

Section: Data Synthesis and Analysismentioning

confidence: 99%

Predictors, mediators, and moderators of response to digital interventions for eating disorders: A systematic review

McClure,

Fuller‐Tyszkiewicz,

Messer

et al. 2023

Intl J Eating Disorders

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ObjectiveDigital interventions show promise as an effective prevention or self‐management option for eating disorders (EDs). However, it remains unclear how, for whom, and through what mechanisms they work in this population, as a synthesis of outcome predictors, moderators, and mediators is lacking. This systematic review synthesized empirical research investigating predictors, mediators, and moderators of response to digital interventions for EDs.MethodSix databases were searched (PROSPERO CRD42022295565) for studies that assessed predictors, moderators, or mediators of response (i.e., uptake, drop‐out, engagement, and symptom level change) to a digital prevention or treatment program for EDs. Variables were grouped into several overarching categories (demographic, symptom severity, psychological, etc.) and were synthesized qualitatively across samples without a formally diagnosed ED (typically prevention‐focused) and samples with a formally diagnosed ED (typically treatment‐focused).ResultsEighty‐six studies were included. For studies recruiting samples without a formal diagnosis (n = 70 studies), most predictors explored were statistically unrelated to outcome, although participant age, baseline symptom severity, confidence to change, motivation, and program engagement showed preliminary evidence of prognostic potential. No robust moderators or mediators were identified. Few studies recruiting samples with a formal diagnosis emerged (n = 16), of which no reliable predictors, moderators, or mediators were identified.DiscussionIt remains unclear how, for whom, and under what circumstances digital programs targeting EDs work. We offer several recommendations for future research with the aim of advancing understanding of client characteristics and intervention elements that signal success from this intervention modality.Public SignificanceDigital interventions have shown potential as an effective, scalable, and accessible intervention option for EDs. However, responsiveness varies, so advancing understanding of predictors, mediators, and moderators of outcome to digital interventions for EDs is needed. Such knowledge is important for enabling safe and efficient treatment matching, and for informing future development of effective digital interventions.

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Section: Data Synthesis and Analysismentioning

confidence: 99%

Predictors, mediators, and moderators of response to digital interventions for eating disorders: A systematic review

McClure,

Fuller‐Tyszkiewicz,

Messer

et al. 2023

Intl J Eating Disorders

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“…This study is the first to develop and evaluate an online transdiagnostic ultra-brief treatment for depression and anxiety in adults and therefore it is critical for our approach to be critiqued, replicated, and extended. Although there are calls to develop and deliver briefer treatment options for a range of mental health problems, there is no evidence base outlining for whom ultra-brief treatments are appropriate and helpful or the essential (or nonessential) components of ultra-brief treatments (Linardon & Fuller-Tyszkiewicz, 2023). Given this was a remotely delivered and therapist-guided ultra-brief treatment, the delivery of information and provision of therapeutic support (via telephone) happened on separate occasions.…”

Section: Discussionmentioning

confidence: 99%

An online therapist-guided ultra-brief treatment for depression and anxiety: a randomized controlled trial

Bisby,

Balakumar,

Scott

et al. 2023

Psychol. Med.

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Background There are many barriers to engaging in current psychological treatments, including time, cost, and availability. Ultra-brief treatments overcome some of these barriers by delivering therapeutic information and skills using significantly less time than standard-length treatments. We developed a therapist-guided online ultra-brief treatment for depression and anxiety and compared it to an existing 8-week, 5-lesson therapist-guided standard-length treatment and a waitlist control. Methods In a randomized controlled trial, adults with self-reported depression or anxiety were randomized (1:1:1) to the ultra-brief treatment, standard-length treatment, or waitlist control. The primary outcomes were depression symptoms and anxiety symptoms assessed at baseline, 5-weeks later, 9-weeks later (primary timepoint), and 3-months later. The trial was prospectively registered. Results Between 7 February 2022, and 16 August 2022, 242 participants were enrolled in the ultra-brief treatment (n = 85), standard-length treatment (n = 80), and waitlist control (n = 77). Participants were mostly women with an average age of 48.56 years. At 9-weeks post-baseline, participants in the ultra-brief treatment group reported significantly lower depression (between groups d = 0.41) and anxiety (d = 0.53) than the waitlist control. The ultra-brief treatment was non-inferior for anxiety at both 9-weeks and 3-months follow-up. Non-inferiority for depression was observed at 9-weeks. Conclusions The online ultra-brief treatment resulted in significant reductions in depression and anxiety that were non-inferior to a longer treatment course after 9-weeks. Remotely delivered ultra-brief treatments have the potential to provide accessible and effective care for those who cannot, or would prefer not to, access longer psychological interventions.

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A randomized controlled trial of an online single session intervention for body image in individuals with recurrent binge eating

Messer,

Fuller‐Tyszkiewicz,

Liu

et al. 2024

Intl J Eating Disorders

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ObjectiveTheoretical models highlight body image disturbances as central to the maintenance of eating disorders, with empirical evidence finding negative body image to be a robust predictor of treatment nonresponse, relapse and symptom persistence. Accessible, scalable, and inexpensive interventions that can effectively target negative body image across the eating disorders are needed. We developed an online single session intervention (SSI) for negative body image and evaluated its acceptability and efficacy in a randomized controlled trial in individuals with recurrent binge eating.MethodParticipants with recurrent binge eating were randomly assigned to the SSI (n = 99) or a waitlist (n = 101). Assessments were conducted at baseline, 4 week follow‐up, and 8 week follow‐up.Results81% of participants accessed the SSI, demonstrating reasonable uptake. However, issues with attrition were apparent; a 32% study dropout rate was observed at posttest, while a 58% dropout rate was observed at follow‐up. 87% of participants who completed satisfaction measures would recommend the SSI. SSI participants experienced greater improvements in negative body image at both 4 (d = −0.65) and 8 week (d = −0.74) follow‐up. Significant between‐group effects were also observed on most other secondary symptom measures, though no differences were found for motivations and help‐seeking beliefs and intentions.ConclusionBody image‐focused self‐guided SSIs for recurrent binge are largely accepted by those who are retained in the trial, but are associated with significant attrition. Although SSIs are not intended to replace standard treatment, they may help with short‐term symptom management and could play an important role in eating disorder care.Public SignificanceSingle session interventions (SSI) are a potentially accessible, scalable, and cost‐effective way to deliver evidence‐based treatment content to people with eating disorders. This study shows that an online (SSI) designed to target body image among people with recurrent binge eating is accepted and produced short‐term symptom relief.

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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)

Cited by 4 publications

References 5 publications

Predictors, mediators, and moderators of response to digital interventions for eating disorders: A systematic review

Predictors, mediators, and moderators of response to digital interventions for eating disorders: A systematic review

An online therapist-guided ultra-brief treatment for depression and anxiety: a randomized controlled trial

A randomized controlled trial of an online single session intervention for body image in individuals with recurrent binge eating

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