Elizabeth Wasanaar, MD

Belak, L., Deliberto, T., Shear, M., SSean, & Attia, E. (2017). Inviting eating disorder patients to discuss the academic literature: a model program for psychoeducation. Journal of Eating Disorders, 5, 49.

https://doi.org/10.1186/s40337-017-0178-7

Treatment and sustained recovery are challenging when treating a patient with an eating disorder.  Beneficial and persistent change are noted when therapeutic interventions are combined with nutritional restoration.  Psychoeducation, which has been shown to improve knowledge and attitudes towards treatment interventions, is often provided to patients as a compilation of evidence during treatment visits or through education modules.  This paper presents a unique intervention of using a journal club format with the hypothesis that involving patients in critical thinking by reading and engaging with primary literature provides a different perspective on the realities of the disease and could lead to cognitive restructuring that influences treatment outcomes.

Patients were recruited to participate in a weekly “Psychoeducational Research Group” and provided a research article that reflected a current concern on the milieu.  The group leader briefly presented the paper before leading a discussion of the paper.  Group participants were reminded to be compassionate with themselves as they read challenging material and encouraged to raise questions and reactions. Each group had four primary goals: to present objective facts meant to challenge cognitive distortions, to improve insight by providing specific psychoeducation, to provide evidence on how medical complications can resolve with treatment, and to use evidence of determinants of long-term treatment outcomes to identify individual obstacles to recovery.  Patients expressed mostly positive reactions to the group including feeling the group was helpful with challenging negative eating disordered thoughts and useful in working towards treatment goals.

This is an important and unique intervention for our patient population.  Engaging patients by utilizing values like intelligence, curiosity, and desire for knowledge may make patients more available for critical assessment of their own disease and increase perseverance during the difficulties of treatment.  Facilitating this type of discussion can create a neutral space that honors a patient’s ability to engage as a participant in the decision-making process rather than a passive recipient of interventions.

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