Motivation-enhancing interventions for people with eating disorders

Section A: Mixed feelings towards recovery often inhibit eating disorder recovery. This has led to interventions aimed at increasing motivation towards change, however reviews consistently conclude their effectiveness to be limited. The current review took a novel approach in distilling motivation enhancing interventions into their individual practice elements and comparing the common elements across effective and ineffective interventions. The findings identified relative homogeneity across interventions, with motivational interviewing dominating as the main approach to enhancing motivation over the past 20 years. The results are discussed in the context of relevant theory and advocate for the development of novel, evidence-based motivation-enhancing interventions.

Section B: This study investigated the mechanisms of change within a novel chairwork intervention aimed at supporting people with anorexia nervosa to resolve ambivalence through embodying future-self versions. Ten participants’ pre- and post-intervention measures of motivation towards change were used to establish two high, two low, and two medium-change cases. Through qualitative analysis, comparison of these six cases informed the development of a model illustrating the change process required to ‘resolve’ ambivalence. Deepening emotions beyond “bad” underlying feelings to access adaptive emotions seemed important, together with de-centring from and integrating self-parts to guide future change. Study limitations and implications are discussed.