Incorporating Narrative Into the Treatment of Youth With Anorexia Nervosa (Virtual)

Incorporating Narrative Into the Treatment of Youth With Anorexia Nervosa

The goal of this clinical trial is to evaluate whether a narrative medicine (NM) curriculum can enhance self-expression, reflection, and resilience in adolescents and young adults with anorexia nervosa.

The main questions it aims to answer are:

• Does participation in an NM curriculum improve self-expression and reflection in individuals with anorexia nervosa?
• Does engaging in creative writing and group discussion promote resilience and emotional processing in this population?

Participants will be 16-25 years old, medically stable for outpatient eating disorder therapy, and actively engaged in treatment. Those with active suicidal ideation, recent non-suicidal self-injury, or a co-occurring personality disorder will not be eligible.

Participants will:

• Attend six weekly workshops focused on themes such as self-definition, kindness, resilience, and possibility
• Engage in close reading of visual or written texts
• Complete creative writing exercises in response to prompts
• Participate in group discussions and sharing

An optional capstone reading event will provide a supportive space for participants to share their work with peers, loved ones, and providers, fostering connection and community.

This study aims to explore the role of narrative medicine in eating disorder treatment and assess its potential benefits for psychological well-being and self-expression.

Study Overview

• Status: Recruiting
• Conditions: Anorexia Nervosa
• Intervention / Treatment: Behavioral: Narrative Medicine (NM) Workshop Series

• Study Type: Interventional
• Enrollment (Estimated): 10
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Anoushka A Sinha, MD, MS; Phone Number: 628-286-6116; Email: anoushka.sinha@ucsf.edu

Study Locations

• United States
  • California
    • San Francisco, California, United States, 94158
      • Recruiting
      • UCSF Nancy Friend Pritzker Psychiatry Building
      • Contact: Sara Buckelew, MD, MPH; Phone Number: 415-502-1649; Email: sara.buckelew@ucsf.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 16-25 years old
• have a DSM-5 diagnosis of AN (confirmed by the UCSF Eating Disorders Program clinical team),
• currently engaged in outpatient eating disorder treatment, ensuring medical stability and capacity for a group-based intervention
• English fluency to engage in reflective writing and discussions
• Cognitive ability to meaningfully participate in narrative-based exercises

Exclusion Criteria:

• Currently medically unstable or require inpatient hospitalization
• History of psychosis, schizophrenia spectrum disorder, bipolar disorder, or personality disorder
• Severe neurocognitive impairment that would prevent engagement with the intervention
• Active suicidal ideation or non-suicidal self-injury within the past two months
• Insufficient English proficiency to participate in group discussions and writing exercises

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Narrative Medicine (NM) Workshop Series; Participants in this study will take part in a six-week Narrative Medicine (NM) curriculum designed to enhance self-expression, reflection, and resilience in individuals with anorexia nervosa. Workshops will be conducted weekly on Zoom and will include: Close reading of visual or written texts related to themes such as self-definition, resilience, kindness, and possibility; Creative writing exercises in response to structured prompts; Group discussions and sharing to foster community, connection, and self-expression

Behavioral: Narrative Medicine (NM) Workshop Series; The Narrative Medicine (NM) Workshop Series is a structured six-week behavioral intervention designed to enhance self-expression, reflection, and resilience in adolescents and young adults recovering from eating disorders. This intervention differs from traditional psychotherapeutic or psychoeducational approaches by integrating literary analysis, creative writing, and guided discussion as therapeutic tools. Each one-hour weekly workshop includes: Close reading of visual or written texts related to themes such as self-definition, resilience, kindness, and possibility; Creative writing exercises in response to structured prompts that encourage self-reflection and personal storytelling; Facilitated group discussions to foster connection, self-expression, and emotional processing in a supportive environment

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants in each session	Feasibility will be measured by participant retention in intervention.	Immediately post-intervention (Week 6)
Satisfaction with intervention components using 5-point Likert scales and semi-structured individual interviews	Acceptability will be measured by questionnaire including 5-point Likert scales and semi-structured individual interviews assessing content relevance, writing prompts, group discussions, and facilitation. Scale title: Intervention Satisfaction Questionnaire (ISQ) Minimum value: 1 (Strongly Disagree) Maximum value: 5 (Strongly Agree) Interpretation: Higher scores indicate greater satisfaction with the intervention (better outcome).	Immediately post-intervention (Week 6)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Social Connectedness	Measured using the Social Connectedness Scale (SCS), which assesses perceived closeness to others and sense of belonging. Scale title: Social Connectedness Scale (SCS) Minimum value: 1 (Strongly Disagree) Maximum value: 6 (Strongly Agree) Interpretation: Higher scores indicate greater feelings of social connectedness and belonging (better outcome).	Pre- (Week 0) and immediately post-intervention (Week 6)
Depression Symptoms	Measured using the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms. Scale title: Patient Health Questionnaire-9 (PHQ-9) Minimum value: 0 (Not at all) Maximum value: 3 (Nearly every day) Interpretation: Higher scores indicate greater severity of depressive symptoms (worse outcome).	Pre- (Week 0) and immediately post-intervention (Week 6)
Anxiety Symptoms	Measured using the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. Scale title: Generalized Anxiety Disorder 7-item (GAD-7) Scale Minimum value: 0 (Not at all) Maximum value: 3 (Nearly every day) Interpretation: Higher scores indicate greater severity of anxiety symptoms (worse outcome).	Pre- (Week 0) and immediately post-intervention (Week 6)
Eating Disorder Severity	Measured using the Eating Disorder Examination Questionnaire (EDE-Q), which captures cognitive and behavioral symptoms of AN, and percent of expected body weight (EBW) at follow-up. Scale title: Eating Disorder Examination Questionnaire (EDE-Q) Minimum value: 0 (No days / Not at all) Maximum value: 6 (Every day / Extremely) Interpretation: Higher scores indicate greater severity of eating disorder psychopathology (worse outcome).	Pre- (Week 0) and immediately post-intervention (Week 6)
Illness-Identity Centrality	Assessed using the Illness Identity Questionnaire, which evaluates self-concept clarity and personal identity coherence. Scale title: Illness Identity Questionnaire (IIQ) Minimum value: 1 (Strongly Disagree) Maximum value: 5 (Strongly Agree) Interpretation: Subscale scores reflect distinct illness identity states; higher scores indicate greater endorsement of that identity orientation	Pre- (Week 0) and immediately post-intervention (Week 6)

Collaborators and Investigators

• Sponsor: University of California, San Francisco
• Investigators: Principal Investigator: Anoushka Sinha, MD, MS, University of California, San Francisco

Publications and helpful links

General Publications

• Knio L, Sridhar H. Phenomenology of Identity: Narrative Medicine Curricula in the Care of Eating Disorders. J Med Humanit. 2025 Dec;46(4):673-696. doi: 10.1007/s10912-025-09929-6. Epub 2025 Jan 27.

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): July 1, 2027

Study Registration Dates

• First Submitted: May 5, 2026
• First Submitted That Met QC Criteria: May 5, 2026
• First Posted (Actual): May 12, 2026

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: May 5, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Feeding and Eating Disorders; Anorexia Nervosa
• Other Study ID Numbers: 24-43017 (b)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No