Qualitative patient experiences from the Self-Blame and Perspective-Taking Intervention for eating disorders

Whitney Smith Hagan, Susan Mericle, Bethany J Hunt, Jessica A Harper, Jayme M Palka, Sarah Pelfrey, Carrie J McAdams, Whitney Smith Hagan, Susan Mericle, Bethany J Hunt, Jessica A Harper, Jayme M Palka, Sarah Pelfrey, Carrie J McAdams

Abstract

Background: Problems in social cognition and social support contribute to eating disorders (ED). Group therapy provides an ideal format to create an experiential learning environment focused on understanding social interactions. This pilot study examined the qualitative content of the participants' experiences in the Self-Blame and Perspective-Taking Intervention (SBPI) for ED.

Methods: The SBPI was a 4-week group therapy intervention involving art therapy and psychoeducation that focused on social behaviors in ED patients. Participants received surveys immediately after the intervention and at 1 to 4 weeks after the post-intervention. Thematic analyses of qualitative feedback were performed using Braun and Clarke's thematic analysis framework.

Results: Inductive analyses revealed three main themes: (1) Developing self-acceptance through emotional reflection, (2) Changing expectations with neurosocial knowledge, and (3) Bonding and vulnerability in social interactions; all concepts intentionally targeted by the SBPI. Participants varied in their support of a guideline to exclude personal discussion of ED-related cognitions and behaviors in the group.

Conclusions: As a whole, patients valued the combination of psychosocial education with group experientials focused on social behavior. Positive feedback from the SBPI suggests that adjunctive treatments that target mental-wellness constructs indirectly related to ED pathology may be helpful by allowing patients to see themselves as separable from the illness. Trial registration ClinicalTrials.gov, NCT0487758. Registered 7 May 2021-Retrospectively registered. https://ichgcp.net/clinical-trials-registry/NCT04877158 .

Keywords: Anorexia nervosa; Attributions; Binge eating disorder; Bulimia nervosa; Perspective-taking; Recovery.

Conflict of interest statement

The authors declare that there are no potential conflicts of interest with respect to the research, authorship and publication of this article.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Upper panel, an overview of the art tasks and psychoeducation concepts included in each session. Lower panel, some of the qualitative feedback about the SBPI. Selected comments are color-coded according to the three themes shown in the center; comments with more than one color included codes related to different themes. The specific colored sentence fragments are selected just for illustration; comments were coded as a whole. The three themes are presented as overlapping circles, to symbolize how the emotional experience of an individual (Developing self-acceptance through emotional reflection) are processed using intellectual reasoning (Changing expectations with neurosocial knowledge), and placed in the context of real-world experiences (Bonding and vulnerability in social interactions)

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