YouthNet blog

Thursday Apr 16, 2009

Eating disorders and technology

A little while ago I attended the International Conference on Eating Disorders to find out about advances in internet technology and how they impact on treatment. We're no stranger to eating disorders through the content we have on TheSite.org, and discussions about them on the forums are reasonably regular, so it's interesting to find out what's out there to complement traditional face-to-face treatment and what impact it can have.

 

It was a long and information heavy workshop, but some key themes were drawn from the lecture. The speaker was Steve Wonderlich, Ph.D. Here are five key things that I learned:

1. Technology is primarily used to help people who experience Bulimia and compulsive eating. This is because there are clear ways that it's possible to monitor someone's progress and behaviours if they are binge eating. On the other hand, if someone is experiencing anorexia then it's much harder to use technology to help.

2. It seems that most of the technology is developed either in the US or Europe (mostly outside the UK). Although I'd happily have someone correct me on that!

The technologies discussed tended to take a stepped care approach. I have understood this to mean that treatment comes in steps with varying levels of intervention often starting with self-directed intervention and then more intensive intervention from experts  as the treatment goes forward. Here is a breakdown of the programmes discussed:

• Interapy This includes no face-to-fact contact at all and is CBT based therapy online. The service is aimed at 16+ year-olds and excludes people who are experiencing problems in other areas of their life e.g they're feeling suicidal or abusing drugs. This is interesting for us working on TheSite.org where we're interested in the interconnected nature of problems and take a holistic approach to advice giving. Nevertheless, this programme was seen to be most impressive by the speaker.

• ES[S]PIRIT A German internet-based program for the prevention and early intervention of eating disorders. Its focus is on sub-clinical eating disorders. The most interesting part of this technology was the development of extremely impressive AKQUASI technology which is computer supported treatment of patient treatment response. They have used this technology to send text messages to patients based on their functional and dysfunctional eating behaviours.
  
  
• Student bodies which is "an online psycho-educational intervention designed to help women at risk for developing eating disorders develop healthier dietary practices and improve their body satisfaction." I think it would be interesting to trial this beyond the student arena.
   
• Hans Kordy's Internet bridge project. This includes weekly chat sessions and online self-help groups. We got to see some of the transcripts which were really interesting. We run online chat sessions for peer support on TheSite.org but the self-help angle may be worth exploring. Internet bridge was the project I could generally most identify with as it referred to techniques some of our askTheSite advisors recommend such as writing without disruption about emotionally difficult topics – otherwise known as journaling which patients send to therapists and receive feedback by email.

3. Digital exclusion is still a big issue for those attempting to provide online advice and treatments. Steve Wonderlich has experience of using technology such as PDAs for treatment of eating disorders where patients are contacted up to ten times a day – I imagine this kind of treatment could also transfer to mobile phones.

4. The way internet tools are used is just as important as deciding which tools to use. The ES[S]PRIT project for instance has the amazing AKQUASI technology I mentioned, but I don't think the automated approach is ever going to make a big impact. Perhaps there are better ways the technology could be used? It was interesting to see that trials of this programme got a better response in Germany than the UK.

5. The use of technology to help treat eating disorders tends to have a small, but significant impact. For instance, 14 out of the 80 students who were surveyed about their participation in the ES[S]PIRIT project said that it helped them a lot and 21 said that it helped them a bit.

At YouthNet we describe TheSite.org as a first-stop-shop for information and advice. This means that the website is mainly a first point of call where young people can find out where or how to get further help. Having said that, young people can get ongoing support through peer support on the discussion boards. What's striking about some of the programmes discussed in these talks though, particularly Interapy, is that this is taking technology to the next level where some patients can get everything they need online. Obviously this is quite a controversial concept and perhaps that's never going to be 100% possible or advisable, nor for the majority. Nevertheless, it's interesting to see that some of the formats we already use for support on TheSite.org such as askTheSite and chat sessions, in theory could grow in scope and provide a higher level of support.

Posted by Helen Williams ( 10:46 AM ) Link to this post Comments[0]

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