Mixed methods pilot evaluation of interpersonal psychotherapy for body image for adolescents

Abstract

Body dissatisfaction is common in adolescence and associated with poor outcomes. The aim of this mixed method pilot evaluation was to determine acceptability, feasibility and preliminary efficacy of Interpersonal Psychotherapy for Body Image (IPT-BI), a school-based group intervention for young people with high levels of body dissatisfaction. Eighteen participants (11–13 years, 78% female) took part in two IPT-BI groups ( n = 10; n = 8). Feasibility was measured by recruitment and attrition rates; acceptability using a treatment satisfaction questionnaire and focus groups; and clinical outcomes at baseline, each session and post intervention. The majority of young people (72%, n = 18/25) who were referred or expressed interest went on to take part. Average session attendance was 100% and 89%. Participants expressed high levels of treatment satisfaction with 94% ( n = 16/17) rating IPT-BI as ‘quite helpful’ or ‘very helpful’ and 94% ( n = 16/17) stating they would recommend it to others. Preliminary exploration of efficacy showed significant improvements in body image and significant reductions in interpersonal difficulties and appearance-based conversations. Young people valued specific IPT-BI skills (role play, communication strategies), alongside generic therapeutic factors (therapeutic alliance, group cohesion). IPT-BI is feasible and acceptable with promising provisional clinical outcomes indicating the need for a fully powered randomised controlled trial.

School‐ and community‐based counselling services for children and young people aged 7–18 in the UK: A rapid review of effectiveness, implementation and acceptability

“…Accessible referral systems were noted as important, especially the ability to self‐refer (Spratt et al, 2007) in order to remove the need to access counselling through teachers and other school staff (Fox & Butler, 2007). Studies found that secondary school learners considered it positive that they could access counselling during the school day (Duffy et al, 2021; McArthur et al, 2016) and suggested that having the option to drop‐in to the service before deciding to have counselling could support their understanding and decision‐making process (Le Surf & Lynch, 1999). However, learners also felt there could be negative impacts on educational outcomes if sessions were held at the same time each week (Duffy et al, 2021).…”

“…Learners were concerned about how confidentiality would be approached in a school setting and whether it would be maintained by counsellors (Fox & Butler, 2007; Le Surf & Lynch, 1999; McArthur et al, 2016; Prior, 2012b). Learners identified that they were concerned about the privacy of the counselling location and that this should be discrete but easily accessible (Duffy et al, 2021; Fox & Butler, 2007; Le Surf & Lynch, 1999; Parsons & Dubrow‐Marshall, 2018).…”

“…Many of the participants did not know about the service or had misconceptions about the service, which inhibited access (Duffy et al, 2021;Fox & Butler, 2007;Government W, 2011aGovernment W, , 2011bHamilton-Roberts, 2012;Hennigan & Goss, 2016;Lalor et al, 2006;Le Surf & Lynch, 1999;McArthur et al, 2016;Parsons & Dubrow-Marshall, 2018;Pattison, 2010;Prior, 2012aPrior, , 2012bSpratt et al, 2007). In addition, there were issues with the counselling space and its location leading to concerns about confidentiality (Duffy et al, 2021;Fox & Butler, 2007;Le Surf & Lynch, 1999;Parsons & Dubrow-Marshall, 2018). It was also found that it is important to tailor the therapeutic approach for the age range and the needs of the child receiving counselling.…”

“…Access was also identified across the settings as being an important aspect of implementation (Duffy et al, 2021;Fox & Butler, 2007;Government W, 2011aGovernment W, , 2011bHamilton-Roberts, 2012;Hennigan & Goss, 2016;Le Surf & Lynch, 1999;McArthur et al, 2016;Parsons & Dubrow-Marshall, 2018;Pattison, 2010;Prior, 2012aPrior, , 2012bSpratt et al, 2007). The role of staff signposting learners to services (Fox & Butler, 2007;Parsons & Dubrow-Marshall, 2018;Prior, 2012aPrior, , 2012bSpratt et al, 2007) and having staff support learners' autonomy in the decision-making process by emphasising the learner's choice was emphasised as an important aspect in enabling access (Prior, 2012a(Prior, , 2012b.…”

“…Studies found that secondary school learners considered it positive that they could access counselling during the school day (Duffy et al, 2021;McArthur et al, 2016) and suggested that having the option to drop-in to the service before deciding to have counselling could support their understanding and decision-making process (Le Surf & Lynch, 1999). However, learners also felt there could be negative impacts on educational outcomes if sessions were held at the same time each week (Duffy et al, 2021). It was identified that even if the school created an accessible environment for counselling, there was still a key issue with waiting lists due to lack of counselling staff and therefore a delay in learners accessing necessary support (Government W, 2011a(Government W, , 2011bHamilton-Roberts, 2012;Parsons & Dubrow-Marshall, 2018).…”