A randomised controlled trial comparing online imagery rescripting and psychoeducation on self-compassion among young people who are at risk of developing an eating disorder

Body imagery rescripting: Body imagery rescripting is a therapeutic technique where people rescript an unpleasant visual memory where they might have felt ashamed or embarrassed of their bodies or how their bodies look in a compassionate way. It involves three steps: (1) Reliving (i.e., identify problematic memory; 5 minutes). A person visualize a recent event of an unpleasant body experience where they might have felt ashamed or embarrassed of their bodies or how their bodies look. An example could be peer teasing or negative comments with respect to appearance, or feeling uncomfortable when looking in the mirror. Then they are asked to hold on to or reflect on the feelings they have during this imagery, and identify the earliest event they could remember associated with those feelings. They then write down as much details as possible about this earlier event, in first person, as if it were happening to them “right now”. Immediately after induction, participants complete a brief questionnaire that contains only the state measures in order to assess the impact of the induction. (2) Observing (5 minutes). Participants are asked to imagine and then write about the same memory (i.e., the earliest event) but from an observer's point of view (i.e., in third person), watching what happened to their younger self as it unfolds. Prompts are provided at the end of the writing task for participants to reflect upon what needs to happen in the memory in order for the younger self to feel better or if there’s anything the adult self would like to do to help the younger self in that situation. (3) Rescripting (5 minutes). Participants will then asked to re-imagine the same event in first person, but this time the wiser and more compassionate adult self is with them who can intervene the situation if they want her to. Participants are asked to write about what happened this time with the adult compassionate self presence in as much details as possible. All questionnaires, study instruction and interventions will be delivered online. Participants will receive instructions on body imagery rescripting on a computer screen. And they will be asked to type their responses (e.g., their rescripted memory) in a text box. A quality rating scale has been previously developed to assess intervention fidelity on all three steps of imagery rescripting intervention and will be used to rate fidelity based on participants' typed responses for imagery rescripting. The intervention will be delivered once at baseline (i.e., a single session intervention), and participants will be instructed to do homework (i.e., practice the rescripting step of the imagery rescripting once per day). The duration of the single session intervention will take around 30 minutes. The overall duration of the homework component (i.e., the rescripting step of the imagery rescripting) will be 20 minutes (4 X 5 minutes).