Evidence for feasibility of implementing online brief cognitive‐behavioral therapy for eating disorder pathology in the workplace

• Published in: The International journal of eating disorders 2023-06, Vol.56 (6), p.1254-1268
• Main Authors: Toro, Carla T., Payne, Agatha, Jackson, Tabitha, Russell, Sean, Daly, Guy, Waller, Glenn, Meyer, Caroline
• Format: Article
• Language: English
• Subjects: Behavior modification; binge‐eating disorder; bulimia nervosa; Cognitive Behavioral Therapy; Cognitive therapy; eating disorder; Eating disorders; Feasibility Studies; Feeding and Eating Disorders - therapy; Humans; mental disorders; Self Report; Treatment Outcome; Workplace; workplace wellbeing
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.23961

Objective CBT‐T is a brief (10‐week) cognitive‐behavioral therapy for non‐underweight eating disorders. This report describes the findings from a single center, single group, feasibility trial of online CBT‐T in the workplace as an alternative to health service settings. Method This trial was approved by the Biomedical and Scientific Research Ethics committee, University of Warwick, UK (reference 125/20‐21) and was registered with ISRCTN (reference number: ISRCTN45943700). Recruitment was based on self‐reported eating and weight concerns rather than diagnosis, potentially enabling access to treatment for employees who have not previously sought help and for those with sub‐threshold eating disorder symptoms. Assessments took place at baseline, mid‐treatment (week 4), post‐treatment (week 10), and follow‐up (1 and 3 months post‐treatment). Participant experiences following treatment were assessed using quantitative and qualitative approaches. Results For the primary outcomes, pre‐determined benchmarks of high feasibility and acceptability were met, based on recruiting >40 participants (N = 47), low attrition (38%), and a high attendance rate (98%) over the course of the therapy. Participant experiences revealed low previous help‐seeking for eating disorder concerns (21%). Qualitative findings indicated a wide range of positive impacts of the therapy and the workplace as the therapeutic setting. Analysis of secondary outcomes for participants with clinical and sub‐threshold eating disorder symptoms showed strong effect sizes for eating pathology, anxiety and depression, and moderate effect sizes for work outcomes. Discussion These pilot findings provide a strong rationale for a fully powered randomized controlled trial to determine the effectiveness of CBT‐T in the workplace. Public Significance This study demonstrates the feasibility of implementing an eating disorders intervention (online CBT‐T) in the workplace as an alternative to traditional healthcare settings. Recruitment was based on self‐reported eating and weight concerns rather than diagnosis, potentially enabling access to treatment for employees who had not previously sought help. The data also provide insights into recruitment, acceptability, effectiveness, and future viability of CBT‐T in the workplace.