Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 277: (i) Prevention; (ii) Big Picture; (iii) Exercise/Physical Activity, Part 1 (n = 2); (iv) Trauma, Part 1 (n = 2); (v) Nature of EDs, Part 4 (n = 3); and (vi) April-May Tx, Part 5 (n = 3)
Colleagues (N now = 1459 in 49 countries),
Please (a) continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications); and (b) pass along the following to anyone who would like to join this free email list.
SUPPORT AND TREATMENT LITERACY [and SPENDING TIME WITH WISE, COMPASSIONATE, SKILLED PEOPLE]
Free CHAT in THE LIVING ROOM:
MONDA, 8 JUNE 2026: 7:00 p.m. - 8:00 p.m. Eastern | 4:00 p.m. - 5:00 p.m. Pacific | 11:00 p.m. - 12:00 a.m. UTC
hosted by our own
Sondra Kronberg, MS, RD, CDN, CEDRD (USA)
(Founder and Host of the Chats Program)
Topic: Thought Stickiness/Behavior Stuckness
Received yesterday, 3 June 2026, via a Chats in the Living Room email from my friend and Bolder Model, our own Ms. Sondra Kronberg.
ML NOTE 1: Quoting Sondra, PLEASE FORWARD AND OFFER THIS RESOURCE TO PATIENTS & Colleagues to add to their support - it is a completely collegial, non-competitive, non-promotional joint effort by experts.
ML NOTE 2: For information about previous Morningside Chats, various forms of support for recovery and self-care, and other resources that Sondra and her staff provide, go to: https://www.chatsinthelivingroom.com/
Choose Support • Choose Connection • Choose Recovery
CHATS in THE LIVING ROOM, developed and hosted by Sondra Kronberg
FREE! - live on 8 June 2026: 7:00 p.m. - 8:00 p.m. Eastern | 4:00 p.m. - 5:00 p.m. Pacific | 11:00 p.m. - 12:00 a.m. UTC
RSVP through by clicking the following to sign up and receive your Zoom invite via email: https://tinyurl.com/ujpsb6e9
Topic: Thought Stickiness/Behavior Stuckness
Professional Education and Development Opportunity
The RENFREW CENTER FOUNDATION’S Professional Webinar Series is offering a Free Live/Interactive Webinar entitled
Not Fitting Neatly: Recognizing and Understanding OSFED
WEDNESDAY, JUNE 10, 2026, 12:00 pm - 1:00 pm EST | 9:00 am - 10:00 am PST | 3:00 pm - 4:00 pm UTC
Presented by Samantha DeCaro, PsyD (USA), Director of Clinical Outreach & Education, The Renfrew Center
Received yesterday, 3 June 2026, via an email from the Renfrew Center Foundation.
TITLE: Not Fitting Neatly: Recognizing and Understanding OSFED
DATE/TIME: WEDNESDAY, JUNE 10, 2026, 12:00 pm - 1:00 pm EST | 9:00 am - 10:00 am PST | 3:00 pm - 4:00 pm UTC
PRESENTER: Dr. Samantha DeCaro (USA).
MODE/COST: Virtual (live/interactive)/Free
REGISTER at: https://tinyurl.com/3epm7axk
For questions, please contact events@renfrewcenter.com.
DESCRIPTION: This webinar will explore Other Specified Feeding or Eating Disorder (OSFED), a common yet often misunderstood eating disorder diagnosis that encompasses presentations falling outside the classic AN, BN, or BED criteria. Attendees will learn to recognize the wide range of OSFED presentations, including “atypical” anorexia nervosa, subthreshold bulimia and binge eating disorder, purging disorder, and night eating syndrome, as well as the diagnostic challenges and clinical implications when symptoms do not fit neatly into traditional categories.
The session will cover current research, assessment tools, and evidence-based treatment approaches, with a focus on transdiagnostic interventions, practical clinical application, and strategies for addressing the nuances of this diagnosis.
REQUEST FOR RESEARCH PARTICIPATION BY AND/OR ASSISTANCE RECRUITING
People in Australia and the USA who have
Ever received FBT as Patients | Carers who have ever participated in FBT with their loved ones | as well as Clinicians who have ever delivered FBT
from our own Stefania Yee (USA) on behalf of colleagues at Orygen, Revolution in Mind - Youth Mental Health Australia
for a study (ML, paraphrasing, has) entitled
Toward a Better Understanding of Experiences and Perspectives of FBT for Anorexia Nervosa
Received 28 May 2026 via a post from Stefania Yee, on behalf of her colleagues at Orygen, Revolution in Mind - Youth Mental Health Australia, to the Academy for Eating Disorders’ Research Opportunities forum.
ML NOTE 3: Stefania, her colleagues, and I would appreciate it if you would (a) participate in this study if eligible; and/or (b) pass this request along to any and all who might be interested in participating in this survey and qualified to do so, or who work or otherwise know with such people.
[Stefania Yee writes:]
We would very much appreciate if you would consider taking part in this new study aiming to better understand experiences and perspectives of FBT for anorexia nervosa.
We are looking for people in Australia and the US who have ever received FBT as patients, carers who have ever participated in FBT with their loved ones, as well as clinicians who have ever delivered FBT.
Participation typically takes ~10 min for clinicians, and ~15-20 min for people with lived experience and carers.
Participants in Australia will be able to go into a draw to win one of five $150AUD gift vouchers, and participants in the US can go into a draw to with one of five $100USD gift vouchers.
For more information and to participate, please follow this link: redcap.link/xg9bq91e
Any questions, please contact us at eatingdisorders@orygen.org.au.
Please feel free to share this information with others who may be interested in participating.
Research Publication Categories in This Newsletter
(i) Prevention; (ii) Big(ger) Picture: Emotion Regulation; (iii) Exercise/Physical Activity, Part 1 (n = 2); (iv) Trauma/Maltreatment, Part 1 (n = 2); (v) Nature/Correlates of EDs, Part 4 (n = 3); and (vi) April-May Treatment Interlude, Part 5 (n = 3)
CONGRATULATIONS to our own
Drs. Christy Greenleaf (USA) and Maria Fernanda Laus (Brazil) and colleague for publication of the Excercise/Physical Activity review chapter in #3.
Dr. Eva Pila (Canada) and Kelsey Sick (Canada) and colleague for publication of the Excercise/Physical Activity research article in #4.
James Downs (England) for publication of the Trauma commentary article in #5.
Dr. John Fox (England) and colleagues for publication of the Trauma research article in #6.
Drs. Scarlett Croce (Australia), Amy Malcolm (Australia), Andrea Phillipou (Australia), and Christina Ralph-Nearman (USA) for publication of the Nature/Correlates of EDs research article in #7.
Dr. Pamela Keel (USA) for publication of the Nature/Correlates of EDs review article in #9.
PREVENTION, One More
1. Calugi, S., Dalle Grave, A., Cattaneo, G., Chimini, M., & Dalle Grave, R. (2026). Effects of the “Claudia Carraro” universal prevention program on eating disorder risk factors in adolescents: A cluster randomized trial. Journal of Prevention. Advance online publication. https://doi.org/10.1007/s10935-026-00927-5
Email address for correspondence: si.calugi@gmail.com
ABSTRACT. This study evaluated the efficacy of the Claudia Carraro universal prevention program in reducing eating disorder (ED) specific and non-specific risk factors in adolescents. A cluster randomized controlled trial was conducted in Italian secondary schools (N = 1205; mean age = 15.2 ± 0.8 years; 65% girls). Schools were randomized to the intervention (three 2.5 h sessions delivered over three weeks) or no-intervention control group. Assessments were conducted at baseline and 24-week follow-up; the intervention group was also assessed post-intervention. Primary outcomes were ED psychopathology (Eating Disorder Examination Questionnaire, EDE-Q), self-referred physical activity, and adherence to the Mediterranean diet.
Of 938 participants with complete data, no significant overall differences emerged between intervention and control groups. However, subgroup analyses revealed that girls in the intervention group showed significant reductions in EDE-Q global score and shape concern at follow-up compared with controls EDE-Q global scores decreased in the intervention group (2.1–1.9) but not in controls (1.9–1.9; p = 0.028), with similar effects for shape concern (2.9–2.6 vs. 2.6–2.6; p = 0.017). In secondary analyses, girls maintained reductions in ED concerns from post-intervention to follow-up, whereas boys showed short-term improvements that were not sustained.
The Claudia Carraro program did not demonstrate significant overall effects on eating disorder risk factors. Exploratory findings suggest small gender-specific effects among girls, but these should be interpreted cautiously given the limited effect sizes and underpowered subgroup analyses. Further research should evaluate targeted or gender-adapted approaches and longer-term outcomes.
BIG(GER) PICTURE II:
Emotion Regulation in Mental Disorders: A Systematic Review and Multilevel Meta-Analysis of Transdiagnostic and Disorder-Specific Impairments
2. Clamor, A., Lincoln, T. M., & Schulze, L. (2026). Emotion regulation in mental disorders: A systematic review and multilevel meta-analysis of transdiagnostic and disorder-specific impairments. Psychological Bulletin, 152(2), 157–200. https://doi.org/10.1037/bul0000512
Email address for correspondence: annika.clamor@medicalschool-hamburg.de
ABSTRACT. Models of mental health emphasize the fundamental role of emotion regulation (ER). Still, it is unknown whether ER impairment varies in severity and type between different disorders. To systematically investigate this question, we searched multiple databases via EBSCOhost for studies comparing adults with mental disorders to nonclinical controls on self-reported ER. We calculated standardized mean differences (SMD) and conducted multilevel meta-analyses to account for nested data.
We included 619 studies (1998–2025) that assessed selected ER questionnaires in 41,590 clinical participants and 36,787 controls. Compared with controls, clinical participants overall reported pronounced difficulties in ER (large SMD = 1.70) and different ER strategy use (moderate to large SMDs: less frequent acceptance = −0.85, problem-solving = −0.63, and reappraisal = −0.63; more frequent avoidance = 1.00, rumination = 1.51, and suppression = 0.73). Difficulties in ER, decreased use of reappraisal, and increased use of rumination and suppression were evident in almost all mental disorders, emphasizing the transdiagnostic relevance of these facets.
In addition, there were specific profiles for disorders with particularly pronounced effect sizes (e.g., difficulties in ER and acceptance in personality disorders; rumination and reappraisal in depressive disorders). An additional review of 25 ecologically momentary assessment studies of ER in daily life aligned with the main findings.
Future research is needed to examine further disorders and the temporal relationship between psychopathology and ER. Nonetheless, there is substantial evidence to assume both universality of ER impairments across disorders and disorder-specific pronunciations. This speaks for using transdiagnostic interventions aimed at improving ER but also points to the need of additional, more targeted interventions for some disorders.
EXERCISE AND PHYSICAL ACTIVITY, Part 1 of 2
3. Greenleaf, C., Laus, M. F., & Hauff, C. (2026). Physical activity and body image. In Yu-Kai Y.-K. Chang & A. Quartiroli (Eds.), Physical activity, exercise, and mental health (31 pp.). Taylor & Francis/Routledge.
Email address for correspondence: cgreenl@uwm.edu
ABSTRACT. Research consistently documents a positive influence of physical activity on body image. Meta-analytic, systematic reviews, and individual studies have documented positive associations as well as causal impacts of physical activity on body image among a variety of populations, including cancer patients and survivors, pregnant women, and youth with obesity. In addition, physical activity is associated with body image across gender, age, race and ethnicity, and disability.
These consistent findings reflect a robust relationship, yet there are nuances and complexities embedded within these findings, as well as limitations in the research. To date, research exploring the influence of body image on physical activity is limited, and theory has not been widely used to ground research examining the relationships between physical activity and body image. More recently, researchers have explored mindful approaches to movement and the body and found that these types of approaches may be particularly beneficial for enhanced body image. Mindful movement approaches, such as intuitive exercise and attuned exercise, center the person and their experience and a sense of connection to the body.
In looking toward the future, the body of knowledge should continue to be developed using theoretical grounding with a focus on better reflecting diversity among people, social identities, and intersectionality. Finally, research exploring the role of social media and its interaction with physical activity and body image, as well as research examining how body-positive and weight-neutral approaches might influence the physical activity–body image relationship is warranted.
4. Pila, E., Sick, K., & Bailey, J. A. (2026). Self-compassion buffers associations between body-related threats and appearance-motivated physical activity behaviour in daily life. Psychology of Sport and Exercise. Advance online publication. https://doi.org/10.1016/j.psychsport.2026.103178
Full text available for download at: https://tinyurl.com/puwfs9js
ABSTRACT. Young adult women are frequently exposed to body-related threats, such as appearance-related social comparisons, which are theorized to promote appearance-driven motives for physical activity and undermine more adaptive forms of engagement. Self-compassion may function as a protective resource that buffers the motivational consequences of these threats and supports more health-oriented motives for physical activity engagement.
However, the impact of momentary fluctuations in body-related threats and self-compassion on physical activity motives in daily life remains underexplored. The present study examined within- and between-person associations among body-related threats, self-compassion, and physical activity motives in the daily lives of young adult women. A sample of 148 women completed a 7-day mobile ecological momentary assessment (Mage = 20.63 years, SDage = 2.10).
Within individuals, momentary body-related threats were associated with stronger endorsement of appearance-motivated physical activity behaviour. Momentary self-compassion moderated the association between body-related threats and appearance motives, such that higher-than-usual self-compassion attenuated the link between threats and appearance-motivated physical activity behaviour. Between individuals, women with higher average self-compassion reported stronger health motives when body-related threats were more frequent, whereas women with lower average self-compassion reported weaker health motives under similar threat frequency.
Together, these findings suggest that body-related threats primarily shape women’s physical activity motives in the moment and that self-compassion functions as a transient protective resource by buffering appearance-driven motivational responses to threat and supporting health-focused motivation under more frequent threat exposure.
TRAUMA/MALTREATMENT, Part 1 of 3
5. Downs, J. (2026). Conceptualising trauma in eating disorders: A reflexive commentary on the role of neglect, iatrogenic harm, and epistemic injury. Journal of Eating Disorders, 14, 94. https://doi.org/10.1186/s40337-026-01610-0
Full text available for download at: https://tinyurl.com/m3pww69m
ABSTRACT. While links between eating disorders and post-traumatic stress disorder are well established, dominant frameworks have tended to locate trauma primarily outside healthcare, offering limited tools for understanding how neglect, exclusion, coercive practices, and epistemic misrecognition within care may contribute to ongoing distress. Drawing on empirical research, ethical scholarship, and reflexive lived experience analysis, this Comment paper examines how trauma-related symptoms in eating disorders may arise not only from early life adversity, but also through harmful relationships with healthcare, including eating disorder services themselves.
Three interrelated domains of iatrogenic trauma are examined: exclusion and neglect within care pathways; traumagenic dynamics within clinical encounters; and epistemic injury, where individuals are undermined as credible interpreters of their own experience. Together, the author suggests that these processes may contribute to disturbances in self-organisation, dissociation, mistrust, and increased reliance on disordered eating behaviours as coping strategies. The paper argues that failure to recognise trauma arising within healthcare risks misattributing system-generated distress to individual psychopathology, reinforcing disengagement and treatment impasse.
Recognising iatrogenic trauma has important implications for assessment, formulation, and treatment planning, and requires greater attention to acknowledgement, epistemic justice, and collaborative, formulation-driven models of care. Efforts to refine the links between eating disorders and trauma therefore require explicit attention to healthcare-related harm if they are to support more ethical, effective, and humane practice.
6. Matthews, K., Williams, M., Nathwani, F., & Fox, J. (2026). Childhood trauma, emotions, and the eating disorder voice. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01610-0
Full text available for download at: https://tinyurl.com/4yc7f5du
ABSTRACT. Background: Many individuals with an eating disorder report experience of an internal ‘voice’ which represents their disorder. However, research exploring the aetiology of this phenomenon is still limited. Past research has identified associations between adverse childhood experiences, emotional difficulties and eating pathology. Recent qualitative evidence suggests that the ‘voice’ specifically may be of relevance in this model; developing during difficult times in an individual’s life and offering a sense of safety and guidance amidst adversity and associated emotional difficulties. The present study aimed to examine the relationship between childhood adversity, emotions, and the eating disorder voice experience.
Method: In total, 148 participants (recruited via social media and Cardiff University) completed self-report measures exploring childhood trauma, beliefs about emotions, difficulties with understanding, expressing, and regulating emotions, eating disorder voice appraisals (specifically, perceived power of the voice), and eating disorder pathology. All participants had self-reported experience of an eating disorder voice, but the sample varied in terms of diagnoses and presentations.
Results: The relative power of the eating disorder voice was found to be significantly positively associated with childhood emotional abuse (but no other forms of abuse), and this relationship was partially mediated by difficulties with emotion regulation. Greater voice power was significantly positively correlated with eating disorder pathology. Conclusions: These findings provide preliminary evidence of associations between childhood experiences, emotion regulation difficulties, and the eating disorder voice. Further research seeking to elucidate this complex phenomenon is recommended. Limitations, future research directions and clinical implications are discussed.
NATURE, CORRELATES, AND COURSE OF EDs, Part 4 of Many
7. Croce, S. R., Malcolm, A. C., Phillipou, A., & Ralph-Nearman, C. (2026). Examining facets of body image disturbance across anorexia nervosa illness and recovery stages. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70103
Full text available for download at: https://tinyurl.com/37aby5br
ABSTRACT. Objective: Research suggests body image disturbance (BID) is a core feature of anorexia nervosa (AN), however, more research is required on how BID may differ across illness and recovery stages. This study aimed to investigate differences in BID facets (body image dissatisfaction and body image perception) among women with AN who were currently ill and at varying recovery stages, and women with no history of eating disorders (non-ED controls).
Method: One hundred ninety-nine women (18–65 years old) meeting criteria for either current AN (AN-C; n = 73), weight-restoration (AN-WR; n = 86), partial recovery (AN-PR; n = 19), or full recovery (AN-FR; n = 21), and a group of non-ED controls (n = 128), completed online self-report measures of BID and AN symptom severity.
Results: The AN-C and AN-WR showed significantly worse body image dissatisfaction and body image perception than the AN-FR and non-ED control groups. Discussion: These findings suggest that BID differs across AN recovery stages and suggests that holistic recovery from AN includes the remediation of BID. The findings highlight the need for treatment to provide continuous support especially after the weight-restoration period when BID may be at its peak.
8. Kahveci, S., Reichenberger, J., Arend, A. K., Mansueto, A. C., Freichel, R., Voderholzer, U., & Blechert, J. (2026). Bidirectional temporal relationships between emotional state and eating across eating disorders: a network approach. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01617-7
Full text available for download at: https://tinyurl.com/2hzmxd23
ABSTRACT. Objective: Several models of eating disorders (EDs) suggest that emotions and eating influence each other in a vicious cycle, producing part of the observed symptoms. However, no research tested whether such cycles exist across EDs. We therefore explored networks of prospective relationships between negative and positive emotions and eating-related behaviors (hunger, food craving, calorie intake, and binges) across EDs and healthy controls (HCs).
Method: These variables were assessed six times a day for eight days in women with restrictive (AN-R, N = 29) and binge-purge (AN-BP, N = 26) Anorexia Nervosa, Bulimia Nervosa (BN, N = 42), and Binge-Eating Disorder (BED, N = 37), and in HCs (N = 57). Prospective relationships were analyzed with modified vector-autoregressive networks.
Results: Unlike HCs, ED groups showed many emotion-eating relationships. Calorie intake predicted subsequent increased negative or reduced positive affect in every ED, and so did binges in AN-BP, BN, and BED; post-binge negative affect was predicted to last up to 10 h. AN-R showed positive emotional eating, with more desire to eat and hunger during positive mood, while BED showed negative emotional eating, with worry predicting desire to eat and hunger, and irritation predicting calorie intake directly.
Binges were not predicted by negative emotions, likely due to a long temporal distance between measurements. All EDs showed restriction-promoting feedback loops mediated by negative affect following calorie intake. In particular, AN-BP showed a panic-like cycle wherein a lack of hunger predicted worry, and this worry predicted a further reduction in hunger. Discussion: Post-eating dysphoria was present in all EDs, while restriction-promoting feedback loops were present in most EDs.
9. Keel, P. K. (2026). Invited narrative review of purging disorder: What we know, why it matters, and future priorities. International Journal of Eating Disorders. Advance online publication. https://doi.org/10.1002/eat.70141
Email address for correspondence: keel@psy.fsu.edu
ABSTRACT. Objective: This narrative review provides an accessible overview of purging disorder for clinicians, researchers, policymakers, and the public, emphasizing the importance of accurate communication and early detection for effective intervention. Method: Key findings are synthesized on diagnostic characteristics, prevalence, risk factors, cultural and gender considerations, comorbidity, functional impairment, and treatment needs.
Results: Although currently embedded in the DSM-5 “Other Specified Feeding and Eating Disorders” (OSFED) category, research demonstrates that purging disorder has distinct clinical features, medical risks, and developmental pathways. Discussion: This narrative review highlights ongoing debates regarding classification and outlines public-health priorities for improving detection, research, and care.
APRIL - MAY TREATMENT INTERLUDE, Part 5 of Many
10. Holgersen, G., Nordby, E. S., Espeset, E. M. S., & Nordgreen, T. (2026). The acceptability, adherence, and preliminary effectiveness of a digital treatment for adolescents with subthreshold eating disorders. Findings from an open feasibility trial in routine clinical care. Journal of Eating Disorders, 14, 115. https://doi.org/10.1186/s40337-026-01596-9
Full text available for download at: https://tinyurl.com/2h94nvjn
ABSTRACT. Background: Digital interventions have the potential to enhance treatment for eating disorders. Yet research remains limited, especially among adolescents. The aim of the present study was to evaluate whether a therapist-guided digital treatment for adolescents with subthreshold eating disorders was feasible within routine clinical care. The primary objectives of the trial were to evaluate the acceptability, adherence, and preliminary effectiveness of the novel intervention.
Methods: An open feasibility trial of a novel digital treatment was conducted within routine clinical care. Participants were adolescents aged 15–18 years with subthreshold eating disorders. Acceptability was assessed among the adolescents during and post treatment, adherence was evaluated through engagement with treatment modules and dropout, whereas preliminary effectiveness was assessed by examining positive and negative symptoms change from pre to post treatment. Primary clinical outcomes included eating disorder symptomatology and psychosocial impairment, whereas secondary outcomes were quality of life, emotion dysregulation, depression, and anxiety.
Results: A total of 24 adolescent girls participated in the digital treatment. The mean age was 16 years (range: 15–18, SD: 0.78). The findings suggest that the treatment was feasible, with favourable acceptability ratings and satisfactory adherence. The linear mixed model analyses showed significant improvement in eating disorder symptomatology and social impairment. Non-significant improvements were observed for the secondary clinical outcomes. Importantly, no serious negative effects were reported.
Conclusions: The findings suggest that the therapist-guided digital treatment for adolescents with subthreshold eating disorders is both acceptable and well tolerated within routine clinical care, underscoring the potential of digital approaches to effectively complement existing treatment care. Trial registration: ClinicalTrials.gov: NCT06306586.
11. Sinha, A., Tsevat, R. K., Lin, M., Downey, A. E., & Buckelew, S. M. (2026). “Name it to tame it”: Piloting a narrative medicine clinical intervention for adolescents and young adults with anorexia nervosa. Journal of Eating Disorders. Advance online publication. https://doi.org/10.1186/s40337-026-01612-y
Full text available for download at: https://tinyurl.com/5b9ff63c
ABSTRACT. Purpose: Anorexia nervosa (AN) is highly morbid, particularly in adolescence. Narrative-based interventions, which employ storytelling and self-reflection, have improved outcomes for patients with various conditions, but narrative medicine specifically has not been studied in adolescents with AN. This study piloted and evaluated a narrative medicine clinical intervention for adolescents and young adults (AYAs) with AN in an outpatient setting.
Methods: Participants (ages 16–25), stable for outpatient care and in therapy for AN, were recruited through eating disorder clinics and community referrals. The clinical intervention consisted of a 6-week narrative medicine workshop series around themes including identity, embodiment, and resilience. Surveys assessed the intervention’s acceptability, while clinical instruments assessed mental health and eating disorder symptoms; Wilcoxon signed-rank tests evaluated pre- and post-intervention differences. Semi-structured interviews elucidated participants’ experiences of the intervention, and thematic analysis identified emergent themes.
Results: Eight participants enrolled, and seven completed the study. The mean age was 21 ± 4 years, and 75% were female. All participants found the intervention highly acceptable. Mean PHQ-9 scores improved after the intervention (13 to 10, p = 0.046). In qualitative analysis, four themes emerged: gaining insight into one’s condition, connecting over shared experiences, recognizing progress to be made, and viewing the workshops as a different type of treatment.
Conclusions: This clinical intervention represents a novel application of narrative medicine for AYAs with AN. Narrative medicine was highly acceptable to participants, who derived meaning and social connection. Future studies may expand the intervention to larger, more diverse populations and further elucidate clinical outcomes and mechanisms for change. Trial registration: ClinicalTrials.gov (Identifier: NCT06849830)
12. Bray, M., Heruc, G., & Wright, O. R. L. (2026). Collaboration in team outpatient eating disorder care: Clinician’s perspectives. Journal of Eating Disorders, 14, 118. https://doi.org/10.1186/s40337-026-01593-y
Full text available for download at: https://tinyurl.com/mtc6dcyj
ABSTRACT. Clinical practice guidelines recommend team outpatient eating disorder treatment, yet the organisation and delivery of team care vary considerably in practice. This qualitative study explored clinicians’ attitudes toward and experiences of team outpatient eating disorder treatment, including multidisciplinary and interprofessional care. Nineteen Australian clinicians (dietitians, mental health professionals, and general practitioners) with at least two years’ experience working in outpatient eating disorder teams participated in semi-structured interviews. Data were analysed using Braun and Clarke’s reflexive thematic analysis.
Three themes and three sub-themes were identified. Theme 1, Preference for Interprofessional Ways of Working, captured clinicians’ preference for highly integrated and collaborative approaches, including perceived benefits for team functioning, clinician wellbeing, and client care; the related sub-theme Dismantle Systemic Hierarchies to Foster Trust, Respect, and Collaboration highlighted structural barriers to collaboration.
Theme 2, Interprofessional Education (IPE) as the Foundation for Collaborative Practice, emphasised IPE as a key enabler of collaborative capacity; while its sub-theme IPE Develops Shared Philosophies and Values described the role of IPE in developing shared conceptual and philosophical foundations for collaborative care. Theme 3, Communication as the Strategy for Sustaining Collaborative Practice, underscored communication as central to day-to-day coordination; its sub-theme Leverage Role Overlap Through Effective Communication illustrated how communication supported role integration.
Overall, clinicians described highly collaborative team care as desirable, and shaped by education, communication infrastructure, and systemic constraints. Future research should examine approaches to strengthen interprofessional education, improve communication systems and structures, and support collaboration within existing treatment models and service contexts.