"The only way that they can access help quickly": a qualitative exploration of key stakeholders' perspectives on guided self-help interventions for children and young people with eating disorders

Emily Davey; Nadia Micali; Rachel Bryant-Waugh; Sophie D Bennett; Charmayne Lau; Roz Shafran

doi:10.1186/s40337-024-01113-w

"The only way that they can access help quickly": a qualitative exploration of key stakeholders' perspectives on guided self-help interventions for children and young people with eating disorders

J Eat Disord. 2024 Sep 30;12(1):149. doi: 10.1186/s40337-024-01113-w.

Authors

Emily Davey¹, Nadia Micali^{2

3}, Rachel Bryant-Waugh^{4

5}, Sophie D Bennett^{2

6}, Charmayne Lau², Roz Shafran²

Affiliations

¹ UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK. [email protected].
² UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
³ Center for Eating and Feeding Disorders Research (CEDaR), Mental Health Services of the Capital Region of Denmark, Ballerup Psychiatric Centre, Copenhagen, Denmark.
⁴ Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.
⁵ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁶ Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.

Abstract

Background: There is a significant unmet treatment need for children and young people (CYP) with eating disorders. Guided self-help interventions have the potential to expand access to evidence-based treatments. Guided self-help is a type of low intensity psychological intervention where individuals engage with a workbook or online programme, with the support of a health professional. Its primary aim is to equip patients and/or their caregivers with self-management skills. However, little is currently known about the acceptability and suitability of guided self-help interventions for CYP with eating disorders. This study aimed to explore the perspectives of three key stakeholder groups - CYP with lived experience of eating disorders, parents/carers, and healthcare professionals - on guided self-help for this population.

Methods: Qualitative focus groups and semi-structured interviews were conducted with 11 CYP (aged 13-19 years) with lived experience of eating disorders, 12 parents/carers, and 10 healthcare professionals. The study comprised a total of seven focus groups (including 2 with CYP, 3 with parent/carers, and 2 with healthcare professionals), as well as four semi-structured interviews (including 3 with CYP and 1 with a parent/carer). Discussion topics included past experiences of using/delivering guided self-help, the suitability of guided self-help for CYP with eating disorders, and preferences towards the content, structure and modes of guided self-help. Data were analysed using reflexive thematic analysis.

Results: Three themes were generated across all three stakeholder groups. Theme one, Bridging the gap, highlighted the role of guided self-help in increasing access to psychological support for CYP with eating disorders. Theme two, Timing matters, considered the suitability of guided self-help for CYP with eating disorders at different stages of illness and the care pathway. Theme three, One size does not fit all, emphasised the heterogeneity of eating disorders and the need for a personalised and flexible approach in guided self-help.

Conclusions: Findings from this study lay a foundation for the future design and delivery of guided self-help interventions for CYP with eating disorders. Future work must consider these findings in the context of best available research evidence to optimise the potential utility of guided self-help for this population.

Keywords: Children; Eating disorders; Guided self-help; Intervention development; Low intensity psychological intervention; Qualitative study; Young people.

Plain language summary

Eating disorders are prevalent among children and young people, yet accessing effective treatment often involves significant delays. Guided self-help interventions, which are shorter and require less therapist involvement than standard treatments, could help bridge this gap. However, guided self-help is not readily available for this population. The current study explored the perspectives of three key stakeholder groups – children and young people with lived experience of eating disorders, parents, and healthcare professionals – on guided self-help interventions. Overall, findings suggest that guided self-help interventions are perceived as an acceptable treatment option that holds promise in providing timely access to treatment for children and young people with eating disorders. Future work must take into account these perspectives alongside the best available research evidence to optimise the use of guided self-help for this patient group.