Assessing the effectiveness of attention training therapy in the treatment of binge eating within bulimia nervosa and binge eating disorder - a randomised controlled trial.

This study aims to evaluate the efficacy of manual-based Attention Training Therapy (ATT) for individuals with BN and BED compared to a waitlist control condition. The ATT program employed is a modified version of ATT designed and evaluated for social phobia (Donald et. al., 2012). a) The treatment resources and materials to trialed involve a clinician’s manual. This includes the rationale for the session, in session activities, worksheets and homework tasks to be given to the participants on a weekly basis b) Participants in the ATT programme will be introduced to the graded attention and concentration training program task. The three main areas of the program are focusing, strengthening and shifting of attention. ATT will aim at helping participants train their attention away from unhelpful thoughts and re-direct their attention to the ‘task at hand’. Participants will be introduced to attentional exercises using internal stimuli. This includes a body scan exercise to help participants accept their body’s feelings and associated triggers, rather than react emotively to them. Participants are introduced to the idea of ‘symptom surfing’, which is a way of accepting or ‘riding out’ the emotions or triggers, rather than focusing on them or fighting against them. Participants are led through a ‘three minute breathing space’ exercise in which they are trained to remain in the moment, to help them disengage from unhelpful thoughts. Participants will complete a tracking questionnaire each week. Participants will also complete 1) the therapeutic alliance, 2) the group alliance/cohesion assessment, and 3) confidence in treatment questionnaire after week 1, week 3 and week 6. c) A clinical psychologist with a minimum of two years experience working with the treatment of Eating Disorders will deliver the treatment. A co-facilitator will be present who will be a clinical psychology student. d) The mode of delivery is face to face and it will be provided in a group (maximum 8 people per group). e) This treatment is a two hour session once a week over six weeks. f) The location where the intervention occurs is in an urban psychology clinic 3. Given the manual aspect of this intervention, it is not personalized, titrated or adapted to individuals. 4. Group attendance is taken and participants who do not attend will contacted and offered a make up session before the next week to ensure they keep up. No strategies will be used to maintain or improve fidelity.