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

TY - JOUR

T1 - Experiences of computer-based and conventional self-help interventions for eating disorders

T2 - A systematic review and meta-synthesis of qualitative research

AU - Yim, See Heng

AU - Schmidt, Ulrike

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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.

AB - 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.

KW - eating disorder

KW - meta-ethnography

KW - meta-synthesis

KW - online self-help

KW - qualitative

KW - self-help

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85069928906&partnerID=8YFLogxK

U2 - 10.1002/eat.23142

DO - 10.1002/eat.23142

M3 - Review article

AN - SCOPUS:85069928906

SN - 0276-3478

VL - 52

SP - 1108

EP - 1124

JO - International Journal of Eating Disorders

JF - International Journal of Eating Disorders

IS - 10

ER -