Patient experiences of internet-based enhanced cognitive behavior therapy for eating disorders

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Pub Date : 2025-03-01 Epub Date: 2025-01-23 DOI:10.1016/j.invent.2025.100801

Anne-Charlotte Wiberg , Ata Ghaderi , Thomas Parling , Magdalena Jansson , Elisabeth Welch

{"title":"Patient experiences of internet-based enhanced cognitive behavior therapy for eating disorders","authors":"Anne-Charlotte Wiberg , Ata Ghaderi , Thomas Parling , Magdalena Jansson , Elisabeth Welch","doi":"10.1016/j.invent.2025.100801","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Internet-based Cognitive Behavioral Therapy (ICBT) has shown promise in addressing the treatment gap for eating disorders (EDs), with evidence indicating moderate to large effect sizes. However, some individuals experience no improvement or deterioration in their condition, highlighting the need to understand both successful and unsuccessful outcomes.</div></div><div><h3>Aim</h3><div>This study aimed to explore patients' experiences undergoing Internet-based guided self-help treatment based on Enhanced Cognitive Behavior Therapy (ICBT-E) for bulimia nervosa (BN) and binge eating disorder (BED), focusing on both those who benefited from the treatment and those who did not.</div></div><div><h3>Method</h3><div>Sixteen participants with a diagnosis of full or subthreshold BN or BED, including eight non-responders and eight responders, participated in a semi-structured telephone interview. Data were analyzed using qualitative content analysis.</div></div><div><h3>Results</h3><div>Responders strongly identified with the content, facilitating treatment implementation, while non-responders found the content less relevant to their symptoms. The treatment was overall perceived as time-consuming, but non-responders found it overwhelming and struggled with motivation and self-discipline. Non-responders preferred synchronous communication, while responders valued the flexibility of asynchronous contact. Overall, participants acknowledged the importance of ICBT-E, though non-responders felt it was not tailored to their specific needs.</div></div><div><h3>Conclusions</h3><div>The study highlighted considerations for designing and implementing ICBT-E, including tailoring content to diverse patient symptoms, managing time demands, and considering motivation and self-discipline when assigning this treatment. While ICBT-E shows promise for the widespread dissemination of treatment for EDs, ongoing evaluation of progress during treatment and timely referral to alternative interventions for non-responders are crucial for optimizing outcomes.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"39 ","pages":"Article 100801"},"PeriodicalIF":4.1000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214782925000028","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/23 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Internet-based Cognitive Behavioral Therapy (ICBT) has shown promise in addressing the treatment gap for eating disorders (EDs), with evidence indicating moderate to large effect sizes. However, some individuals experience no improvement or deterioration in their condition, highlighting the need to understand both successful and unsuccessful outcomes.

Aim

This study aimed to explore patients' experiences undergoing Internet-based guided self-help treatment based on Enhanced Cognitive Behavior Therapy (ICBT-E) for bulimia nervosa (BN) and binge eating disorder (BED), focusing on both those who benefited from the treatment and those who did not.

Method

Sixteen participants with a diagnosis of full or subthreshold BN or BED, including eight non-responders and eight responders, participated in a semi-structured telephone interview. Data were analyzed using qualitative content analysis.

Results

Responders strongly identified with the content, facilitating treatment implementation, while non-responders found the content less relevant to their symptoms. The treatment was overall perceived as time-consuming, but non-responders found it overwhelming and struggled with motivation and self-discipline. Non-responders preferred synchronous communication, while responders valued the flexibility of asynchronous contact. Overall, participants acknowledged the importance of ICBT-E, though non-responders felt it was not tailored to their specific needs.

Conclusions

The study highlighted considerations for designing and implementing ICBT-E, including tailoring content to diverse patient symptoms, managing time demands, and considering motivation and self-discipline when assigning this treatment. While ICBT-E shows promise for the widespread dissemination of treatment for EDs, ongoing evaluation of progress during treatment and timely referral to alternative interventions for non-responders are crucial for optimizing outcomes.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

基于互联网的强化认知行为治疗进食障碍的患者体验

基于互联网的认知行为疗法（ICBT）在解决饮食失调（EDs）的治疗差距方面显示出希望，有证据表明中等到较大的效果。然而，有些人的情况没有改善或恶化，这突出了了解成功和不成功结果的必要性。目的探讨基于强化认知行为疗法（ICBT-E）的网络引导自助治疗对神经性贪食症（BN）和暴食症（BED）患者的治疗体验，并对治疗受益和未受益的患者进行研究。方法16例诊断为完全或阈下BN或BED的患者，包括8例无应答者和8例应答者，进行半结构化电话访谈。数据分析采用定性内容分析。结果有反应者对内容有强烈的认同，有助于治疗的实施，而无反应者认为内容与他们的症状不太相关。总的来说，这种治疗被认为是耗时的，但无反应者发现它势不可当，并在动力和自律方面挣扎。非应答者更喜欢同步通信，而应答者看重异步联系的灵活性。总的来说，与会者承认ICBT-E的重要性，尽管没有答复者认为它不是针对他们的具体需求量身定制的。该研究强调了设计和实施ICBT-E的考虑因素，包括根据不同的患者症状定制内容，管理时间需求，以及在分配这种治疗时考虑动机和自律。虽然ICBT-E有望广泛推广急诊科治疗，但在治疗过程中持续评估进展，并及时转诊无反应的替代干预措施，对于优化结果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Medicine-Health Informatics

CiteScore

6.50

自引率

9.30%

发文量

审稿时长

6 weeks

期刊介绍： Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions