A randomised controlled trial of clinician supported vs self-help delivery of online cognitive behaviour therapy for Bulimia Nervosa.

Barakat, S; Burton, AL; Cunich, M; Hay, P; Hazelton, JL; Kim, M; Lymer, S; Madden, S; Maloney, D; Miskovic-Wheatley, J; Rogers, D; Russell, J; Sidari, M; Touyz, S; Maguire, S

A randomised controlled trial of clinician supported vs self-help delivery of online cognitive behaviour therapy for Bulimia Nervosa.

Barakat, S Burton, AL Cunich, M Hay, P Hazelton, JL Kim, M Lymer, S Madden, S Maloney, D Miskovic-Wheatley, J Rogers, D Russell, J Sidari, M Touyz, S Maguire, S

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Psychiatry Res, 2023, 329, pp. 115534
Issue Date:: 2023-11

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Field	Value	Language
dc.contributor.author	Barakat, S
dc.contributor.author	Burton, AL
dc.contributor.author	Cunich, M
dc.contributor.author	Hay, P
dc.contributor.author	Hazelton, JL
dc.contributor.author	Kim, M
dc.contributor.author	Lymer, S
dc.contributor.author	Madden, S
dc.contributor.author	Maloney, D
dc.contributor.author	Miskovic-Wheatley, J
dc.contributor.author	Rogers, D
dc.contributor.author	Russell, J
dc.contributor.author	Sidari, M
dc.contributor.author	Touyz, S
dc.contributor.author	Maguire, S
dc.date.accessioned	2023-12-05T04:31:38Z
dc.date.available	2023-10-06
dc.date.available	2023-12-05T04:31:38Z
dc.date.issued	2023-11
dc.identifier.citation	Psychiatry Res, 2023, 329, pp. 115534
dc.identifier.issn	0165-1781
dc.identifier.issn	1872-7123
dc.identifier.uri	http://hdl.handle.net/10453/173707
dc.description.abstract	High dropout rates and poor adherence associated with digital interventions have prompted research into modifications of these treatments to improve engagement and completion rates. This trial aimed to investigate the added benefit of clinician support when paired alongside a ten-session, online cognitive behaviour therapy (CBT) self-help intervention for bulimia nervosa (BN). As part of a three-arm, phase II randomised controlled trial, 114 participants (16 years or over) with full or subthreshold BN were randomly assigned to complete the intervention in a self-help mode (with administrative researcher contact; n = 38), with adjunct clinician support (weekly 30-minute videoconferencing sessions; n = 37), or a no-treatment waitlist control (WLC; n = 39). Baseline to post-treatment (12-weeks) decreases in objective binge episode frequency were significantly greater for clinician-supported participants as compared to WLC, but not for self-help when compared to WLC. However, due to continued improvements for self-help across follow-up (24-weeks), both arms outperformed WLC when analysed as an overall rate of change across three timepoints. Clinician-supported participants outperformed self-help in regards to laxative use and dietary restraint. Our results demonstrate that good clinical outcomes can be achieved with a relatively brief online CBT-based program even in the absence of structured clinical support, indicating a possible overreliance upon clinician support as a primary adherence-facilitating mechanism.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Psychiatry Res
dc.relation.isbasedon	10.1016/j.psychres.2023.115534
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Psychiatry
dc.subject.classification	3202 Clinical sciences
dc.subject.classification	5203 Clinical and health psychology
dc.subject.mesh	Humans
dc.subject.mesh	Bulimia Nervosa
dc.subject.mesh	Cognitive Behavioral Therapy
dc.subject.mesh	Health Behavior
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Humans
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Health Behavior
dc.subject.mesh	Bulimia Nervosa
dc.subject.mesh	Cognitive Behavioral Therapy
dc.title	A randomised controlled trial of clinician supported vs self-help delivery of online cognitive behaviour therapy for Bulimia Nervosa.
dc.type	Journal Article
utslib.citation.volume	329
utslib.location.activity	Ireland
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Clinical Psychology
utslib.copyright.status	open_access	*
dc.date.updated	2023-12-05T04:31:36Z
pubs.publication-status	Published
pubs.volume	329

Abstract:

High dropout rates and poor adherence associated with digital interventions have prompted research into modifications of these treatments to improve engagement and completion rates. This trial aimed to investigate the added benefit of clinician support when paired alongside a ten-session, online cognitive behaviour therapy (CBT) self-help intervention for bulimia nervosa (BN). As part of a three-arm, phase II randomised controlled trial, 114 participants (16 years or over) with full or subthreshold BN were randomly assigned to complete the intervention in a self-help mode (with administrative researcher contact; n = 38), with adjunct clinician support (weekly 30-minute videoconferencing sessions; n = 37), or a no-treatment waitlist control (WLC; n = 39). Baseline to post-treatment (12-weeks) decreases in objective binge episode frequency were significantly greater for clinician-supported participants as compared to WLC, but not for self-help when compared to WLC. However, due to continued improvements for self-help across follow-up (24-weeks), both arms outperformed WLC when analysed as an overall rate of change across three timepoints. Clinician-supported participants outperformed self-help in regards to laxative use and dietary restraint. Our results demonstrate that good clinical outcomes can be achieved with a relatively brief online CBT-based program even in the absence of structured clinical support, indicating a possible overreliance upon clinician support as a primary adherence-facilitating mechanism.

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http://hdl.handle.net/10453/173707