Online eTherapy Program for Individuals with Bulimia Nervosa

The Binge Eating eTherapy (BEeT) program consists of ten, one-hour interactive, multi-media sessions developed by clinicians at the InsideOut Institute. BEeT is a Cognitive-Behavioural Therapy (CBT) program with all core components of CBT demonstrated effective in eating disorders, including establishing regular eating according to the “three-hour rule” and self-monitoring, thought challenging and feared food exposure. BEeT is delivered by a live action therapist (i.e. a recorded video of a therapist delivering the key components of the program). Participants will be instructed to complete one x 60 minute module per week across a ten week period. The program also includes interactives exploring key skills in CBT, an inbuilt Food Monitoring, Behaviour Monitoring, Food Planner, Thought Challenge, and Exposure Tool. The program sends a daily SMS to participants’ mobile phones at approximately 9 a.m. as a reminder to record their meals using the Food Diary tool throughout the day. An additional evening SMS is sent at approximately 6 p.m. to participants who had not completed a Food Diary entry for the preceding two days to prompt re-engagement. This study will examine BEeT in a multisite, three-arm, randomised-controlled trial with the following three conditions: 1. Pure self-help BEeT (PSH-BEeT): Participants independently complete 10 sessions of BEeT across 12 weeks with 2 telephone contacts with research assistant to initiate pre and post assessment. 2. Supported self-help BEeT (SSH-BEeT): Participants complete 10 sessions of BEeT in conjunction to 10 weekly x 30 min face-to-face contact sessions with trained clinician across 12 weeks. The clinicians involved will be those employed at NSW Local Health District Community Mental Health Teams or headspace centres. Training of clinicians in the delivery of SSH-BEeT will be provided via an online program and face-to-face training sessions. The weekly contact sessions with clinicians is not intended to serve an additional therapy, rather will involve supporting the participant through their use of BEeT. Accordingly each face-to-face session will have the following structure: general check-in, review of the previous BEeT session and associated homework tasks with particular focus and debrief of specific self-monitoring exercises, review weekly weigh-in and preparation for completion of next BEeT session and associated homework tasks. 3. Waitlist control (WLC): Two telephone contacts with research assistant to initiate pre and post assessment. Participants in WLC will receive access to BEeT at end of 12 weeks. Treatment outcome and treatment adherence will be assessed. Treatment outcome measures are described in further detail in Section 4. of the ANZCTR. Treatment adherence will be assessed by dropout rates as well as digital measures of user exposure to the intervention, such as log-in rates, number of intervention modules accessed or completed, the frequency of website visits per module, or the use of specific tools or features of the program--e.g., self-monitoring tools.