A study of the effectiveness of Experiential Awareness Therapy for the treatment of Eating Disorders

INTERVENTION: Experiential Awareness Therapy is a manualised group therapy for people with eating disorders. Sessions comprise of studying course material, group discussions, experiential contemplation/meditation, calm‐abiding meditation and gentle movement‐based exercises. Facilitators will promote participant Reflective Functioning through explicit mentalising as theoretically taken from Mentalising Based Therapy. Emotional processing will be promoted by participants being guided to embody emotions and understanding the personal relevance of the emotion as taken from Emotion Focused Therapy. Where appropriate maladaptive schema will be challenged as taken from Emotion Focused Therapy and Mentalising Based Therapy. Session content will be structured around a Mahayana understand of the Four Noble Truths, see below for session content. Session Content 1‐ Overview This section will give participants an in‐depth overview of the conceptualisation of the aetiology and maintaining factors of ED, 2‐ Self‐compassion Participants are guided to engender a sense of self‐compassion, and explore the adverse effects of holding harmful feeling towards oneself 3‐Valid cognition/emotion Participants are taught skills to critically evaluate their perceptions, beliefs and resultant emotions. Participants will be aided to understand the purpose of emotions and therefore premise for increasing emotional awareness. 4‐ Suffering Participants are guided to contemplate and understand the suffering involved with ED. Participants will gain an awareness and acceptance of this existential condition. This intervention aims to increase motivation and challenge the ego‐syntonic nature of ED. 5‐ Fixation Participants explore the role fixation on weight and shape plays in ED maintenance. 6‐ Self vs person Participants explore sense of self as a construct. Highlighting the psychological benefits of experiencing themselves as a ‘whole person’ 7‐Cause and effect In‐depth exploration of causes and conditions that maintain ED 8‐ Recovery Participants are challenged regarding the belief that ED is advantageous to sense of self‐worth, and as a component of their identity. ED is instead contemplated as a compounded phenomena arising from causes and conditions in their life that arose, and are subject to change. 9‐ Path to recovery Participants discuss application of skills learned in the course. Participants are guided to understand how to apply these skills in systematic, sustainable manner to work towards recovery 10‐ Compassion Participants are guided on how to utilise an ‘other regarding’ attitude skilfully. Support and guidance is further given for applying the ‘path’ to recovery Participants will be given activities to complete between therapy sessions. Activities given to participants to undertake between sessions include meditation, gentle movement based activities, self‐soothing activities (when distressed), and mindfulness to become aware of psychological functioning in relation eating disordered pathology. Participant adherence to the intervention will be monitored via an attendance checklist and a self‐report record book of daily usage/ practicing of skills taught in the intervention. The facilitating psychologist adherence will be monitored through all therapy sessions being audio recorded and 20% of sessions being reviewed by an independent party for fidelity to the manual. Experiential Awareness Therapy is a 10 session manualised group therapy, ran over ten weeks. Each session runs for 2 hours. Sessions will be delivered in person to groups of approximately 10 participants. Sessions will be delivered within a private therapy space. CONDITION: Eating Disorders ; Difficulties in Emotional Regulation Scale will be utilised as a generally measure of ER The intervention will be conducted by a registered psychologist with expertise in eating disorder treatment. The psychologist is a registered member of Australian Psychological Society and Australian Health Practitioner Regulation Agency. PRIMARY OUTCOME: A change in eating disorder symptomology as measured in the Eating Disorder Examination ‐ Questionnaire A change in emotional regulation (ER) will be measured as a composite factor ; Differentiation of Self Inventory will be utilised to measure hyperactivating and deactivating aspects of ER. A change in Reflective Functioning (RF). This primary outcome will be measured as a composite factor. ; Toronto Alexithymia Scale‐20 will be utilised as a generally measure of RF, ; Cognitive fusion Questionnaire will be utilised to measure the 'psychic‐equivalence' aspect of RF. ; Multiscale Dissociation Inventory will be utiliised to measure the 'pretend mode aspect' of RF. SECONDARY OUTCOME: A change in psycho‐social functioning will be measured as a composite factor. ; Depression Anxiety Stress Scale will be utilised to measure psychological functioning ; Social Adaptation Self‐evaluation Scale will be utilised to measure social functioning INCLUSION CRITERIA: Participants will be required to meet a minimal of a subthreshold rating of disorder eating (EDE‐Q),