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An internet-based program to enhance motivation to change in females with symptoms of an eating disorder: a randomized controlled trial

Published online by Cambridge University Press:  16 October 2013

K. Hötzel ,
R. von Brachel ,
U. Schmidt ,
E. Rieger ,
J. Kosfelder ,
T. Hechler ,
D. Schulte  and
S. Vocks
K. Hötzel*
Affiliation:
Department of Psychology, Clinical Psychology and Psychotherapy, Osnabrück University, Germany Department of Psychology, Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Germany
R. von Brachel
Affiliation:
Department of Psychology, Clinical Psychology and Psychotherapy, Osnabrück University, Germany Department of Psychology, Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Germany
U. Schmidt
Affiliation:
Section of Eating Disorders, Institute of Psychiatry, King's College London, UK
E. Rieger
Affiliation:
Research School of Psychology, Australian National University, Australia
J. Kosfelder
Affiliation:
Department of Social Sciences and Cultural Studies, University of Applied Sciences Düsseldorf, Germany
T. Hechler
Affiliation:
German Pediatric Pain Center, Children's and Adolescents' Hospital, Witten/Herdecke University, Datteln, Germany
D. Schulte
Affiliation:
Department of Psychology, Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Germany
S. Vocks
Affiliation:
Department of Psychology, Clinical Psychology and Psychotherapy, Osnabrück University, Germany
*
* Address for correspondence: K. Hötzel, Dipl.-Psych. Osnabrück University, Department of Psychology, Clinical Psychology and Psychotherapy, Knollstraße 15, 49069 Osnabrück, Germany. (Email: [email protected])
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Abstract

Background

Previous research has demonstrated an association between low motivation to change and an unfavorable treatment outcome in patients with an eating disorder. Consequently, various studies have examined the effects of motivational enhancement therapy (MET) on motivation to change and treatment outcome in eating disorders. In each of these studies, MET was administered in a face-to-face setting. However, because of its anonymity and ease of access, the internet provides several advantages as the format for such an intervention. Therefore, the current study investigated the effects of an internet-based program (‘ESS-KIMO’) to enhance motivation to change in eating disorders.

Method

In total, 212 females were accepted for participation and assigned randomly to the intervention condition (n = 103) or waiting-list control condition (n = 109). The intervention consisted of six online MET sessions. Before and after the intervention or waiting period respectively, participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the Stages of Change Questionnaire for Eating Disorders (SOCQ-ED), the Pros and Cons of Eating Disorders Scale (P-CED), the Self-Efficacy Scale (SES), and the Rosenberg Self-Esteem Scale (RSES). A total of 125 participants completed the assessment post-treatment. Completer analyses and intent-to-treat analyses were performed.

Results

Significant time × group interactions were found, indicating a stronger increase in motivational aspects and self-esteem, in addition to a stronger symptom reduction on some measures from pre- to post-treatment in the intervention group compared to the control group.

Conclusions

Internet-based approaches can be considered as useful for enhancing motivation to change in eating disorders and for yielding initial symptomatic improvement.

Keywords

Anorexia nervosabulimia nervosainternet interventionmotivation to changemotivational interviewing
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 9 , July 2014 , pp. 1947 - 1963
Copyright
Copyright © Cambridge University Press 2013 

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