Peer Support as an Adjunct Treatment for Eating Disorder Patients Waitlisted for Clinical Treatment

The waitlist at Statewide Eating Disorder Service (SEDS) for patients with an ED for subsequent clinical treatment (inpatient, day program, outpatient treatment) is thirty to forty individuals at any given time. They will be randomized to one of three conditions: peer support, trainee health worker support, or wait-list alone. Those in the peer support group and trainee health worker group will be provided with the same book evaluated by Ranzenhofer and colleagues (2020), “Eight Keys to Recovery from an Eating Disorder” developed by a person recovered from an ED (Costin & Grabb, 2011). Individuals in both groups will have a weekly 20-minute audio call via Skype with their peer support worker to discuss the weekly chapter/materials. Mentees will also be able to email their peer support worker for questions on the weekly content. The program will run for 8-weeks with a chapter per week from the book. People on the waitlist as normal will not receive this input. Once appointed, peer workers will participate in 2 x half days of training, using the National Eating Disorder Collaboration training material, which also involves helping people curate a version of their recovery story for sharing in public. The training will be done online via video (Zoom/Skype/Microsoft Teams) and will be led by Professor Tracey Wade (trained psychologist) and Isobel Batt-Doyle (PhD Student). During the RCT, no last names will be used of the peer support workers and they will be assigned a first name. There will be a generic email for mentees to contact through the study which will be overseen by the PhD student. The peer support worker’s introduction bio that includes their lived experience, recovery and what they are doing now will be provided to the mentees. The trainee health worker is the PhD student, Isobel Batt-Doyle. She will not have a bio as the peer support workers do, however the same topics will be off limit and the intervention will remain the same with the exception that participants will know that they have a peer support worker not a trainee health worker. Email will be used for the first introduction then for follow up questions during the intervention. Contact will be a 20-minute zoom call with the mentee and peer support worker (or trainee health worker) to discuss the week’s materials. Weekly materials will include reading a chapter ("Key") and completing the activities of that Key, e.g. KEY 1: Motivation, Patience, and Hope includes the writing assignments: Your Worst Eating Disorder Day; Exploring Your Phase of Recovery; Identifying, Exploring, and Enhancing Your Motivation, and; A Day In My Life When I Am Recovered. The book “Eight Keys to Recovery from an Eating Disorder” has been developed by a trained psychologist for people who are struggling with an eating disorder to work through. It is not specifically designed to be used in conjunction with a peer support worker, however, in a study using peer mentorship, Ranzenhofer and colleagues (2020) used this book/program to base their intervention content. Peer support workers will have a semi-manualised script to work through and will be instructed on what topics they should and should not discuss with their mentee. Certain topics will be out of bounds and if mentees ask questions the peer support worker will point them towards resources, bring back to the content, or tell them they need to talk to their care team. The zoom call will require a view of faces only in order to eliminate body comparisons and reduce risk of relapse. Peer support workers will tell their mentees they will check in once a week, they will email at the end of the week if they have not heard from them. Mentees can email up to twice a week for any follow up questions on the content. Adherence to the intervention will be monitored by participants completing a 20minute session with their peer support worker/trainee health worker and doing the homework (weekly materials reading and activities in the book). The PhD student will supervise the peer support workers and will be supervised by Tracey Wade. Flinders University will supply the books. All mentees will be assessed at baseline, 4- and 8-weeks post-randomisation (the latter representing the end of the intervention), and one-month after treatment commences with SEDS using questionnaires assessing dimensions of recovery. All mentors will be asked to complete questionnaires to allow for assessment of any deterioration in well-being or eating at training, and then every 3 months until the end of the project.