Factors determining uptake of a CD‐ROM‐based CBT self‐help treatment for bulimia: patient characteristics and subjective appraisals of self‐help treatment

Abstract

Background:Cognitive-behavioural self-help treatments are widely advocated as the first step in the management of bulimia nervosa. Very little is known about the characteristics and attitudes of patients who are able to utilize self-help treatments. Aims: The aim of this study was to identify whether there are any pretreatment differences in patient characteristics and patients' expectations about computerized self-help between those who do or do not take up this type of treatment. Subjects and Methods: 81 patients who were offered a CD-ROM-based selfhelp treatment for bulimia nervosa completed baseline assessments including a questionnaire assessing their attitudes to and past experiences with self-help, confidence in using a computer and knowledge about and ability to manage aspects of their eating disorder. Results: Patients who did not take up the CD-ROM-based treatment had a significantly lower expectation of the usefulness of self-help for themselves but not for others. There were no baseline differences between groups in terms of mean BMI and symptom severity, in particular there were no differences in previous utilization of self-help or attitudes to previous self-help, or differences in confidence in using a computer. Qualitative comments of participants who failed to take up the package highlighted a diverse range of concerns and anxieties about computer treatment, some of which were based on misunderstandings about this treatment. Conclusions: These findings show that patients' views about self-help need to be carefully explored and misconceptions corrected if self-help treatment is to be considered by a subgroup of patients.

Computerised Cognitive Behavioural Therapy for the Prevention and Treatment of Depression and Anxiety in Children and Adolescents: A Systematic Review

“…This appears important since the absence of therapist contact during cCBT has been associated with poorer outcomes (Gellatly et al 2007;Spek et al 2007). Similarly, a lack of therapist contact is often stated as a reason for not taking up cCBT with many stating that they would prefer face-toface contact (Murray et al 2003). This is also reflected in this younger age group where children and adolescents have been found to be sceptical about taking part in cCBT, with their parents being concerned about the lack of faceto-face contact (Stallard et al 2010b).…”

Therapy via videoconferencing: a route to client empowerment?

“…In addition, if the advantages described by previous video therapy clients were to be presented, this might introduce it as a potentially satisfying and beneficial experience. Murray et al (2003) highlighted the importance of preparing clients for technology-based therapies by clarifying what is involved and allaying any anxieties about use of equipment. In their study, misunderstandings about the complexity of using CD-ROMbased CBT self-help treatment interfered with uptake.…”

Young people's perceptions of and reasons for accessing a web‐based cognitive behavioural intervention for bulimia nervosa

“…The first of these was a study of manual-based guided self-help (Banasiak, Paxton, & Hay, 2007), which considered perceived positive and negative factors associated with treatment effectiveness. The second study examined factors that determined uptake of a CD-ROM-based CBT self-help treatment for BN (Murray et al, 2003). In this study, participants who did not take up the treatment had a lower expectation of the usefulness for themselves, but not for others, and had concerns about computer treatment.…”