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Int J Eat Disord. 2019 Oct;52(10):1108-1124. doi: 10.1002/eat.23142. Epub 2019 Jul 25.

Experiences of computer-based and conventional self-help interventions for eating disorders: A systematic review and meta-synthesis of qualitative research.

Author information

1
King's College London, Institute of Psychiatry, Psychology and Neuroscience, Section of Eating Disorders, London, UK.
2
The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.

Abstract

in English, Spanish

OBJECTIVE:

Self-help interventions have been demonstrated to be effective in treating bulimic-type eating disorders (EDs). In particular, computer-based interventions have received increasing attention due to their potential to reach a wider population. This systematic review aimed to synthesize findings from qualitative studies on users' experiences of self-help interventions for EDs and to develop an exploratory framework.

METHOD:

A systematic review and meta-synthesis on seven peer-reviewed qualitative studies on structured computer and book-based self-help interventions for EDs was conducted using Noblit and Hare's (1988) 7-phase meta-ethnography. Four of the selected studies investigated computer-based self-help programs, and three of the studies investigated book-based guided self-help programs.

RESULTS:

Six concepts were synthesized. They included intervention-related factors (anonymity and privacy; accessibility and flexibility; guidance) and user-related factors (agency/autonomy; self-motivation; and expectations/attitudes). The study revealed the "machine-like" and relational properties of the computer; the expansion of treatment time and space in psychological interventions, the changing role of the medical health professional from a "therapist" to a "guide," and a change from understanding interventions as a conclusive treatment plan to a starting point or stepping stone toward recovery.

DISCUSSION:

Computer-based self-help interventions should take advantage of the "machine-like" properties of a computer (neutrality, availability, etc.) as well as its ability to facilitate human interactions. Users should also be facilitated to have a realistic understanding of the purpose of self-help interventions and the place of self-help interventions in their broader treatment plans to moderate expectations and attitudes.

KEYWORDS:

eating disorder; meta-ethnography; meta-synthesis; online self-help; qualitative; self-help; systematic review

PMID:
31343088
DOI:
10.1002/eat.23142

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