Technological developments are made at a rapid rate nowadays. Information and Communication Technology (ICT) developments have provided the basis for the formation of a new term known as telemental health. Telemental health extends beyond psychological disorders, living problems, self-development, and preventive care. ICT has a strong impact on the ecosystem of mental health. The main purpose of the selected article is to review different technologies used for the treatment of eating disorders (EDs) In this essay we would like to analyze the extent to which technology has benefited different aspects of EDs treatment like therapy, self-help and aftercare (Shingleton, Richards and Brenner 576). Moreover, we would also analyze the domain or population of the patients which are being benefited with the technology. The authors of the selected article conducted an in-depth quantitative research on the topic under discussion.
The highest level of incorporation achieved by technology and the psychotherapy is the use of e-mails, telephones and video conferencing for the management of psychotherapy. The efficiency of the telemental health process is determined by the measurement of effectiveness for technology-administrated therapy versus conventional ‘face –to- face’ therapy. Robinson and colleges conducted a research and concluded that with the help of e-mails it is easy to reach the number of the patients diagnosed with EDs as compared to conventional processes. They also concluded with the help of e-mails they were also able to reach those patients which were unable to seek treatment earlier (Shingleton, Richards and Brenner 576-77).
In other studies known as “Set Your Body Free” by Wertheim and colleagues, the researchers were able to randomize patients to receive face-to-face treatments with comparison to internet based or delayed treatment. The internet-based treatment involved a real-time asynchronous communication with the therapist. Patients were also able to post “threads” on a discussion board. The researchers tried to explore the patient’s motivation, readiness, self-monitoring of dietary intake and body dissatisfaction. The cultural impacts of eating and body size were also addressed. In the end, they concluded that the participants in the ‘Internet Group’ continued to make gains and significant reduction in the symptoms was recorded. The computer skills of the participants served as a limitation in this research as these skills limit the ability of a participant to relay information or communicate. Similar research was also conducted by Gollins and Paxton but the participants or population in their case were women ((Shingleton, Richards and Brenner 577-78).
In the fourth studies conducted by Mitchel and colleagues discussed in the article selected for the discussion also incorporated ‘face-to-face’ treatment. The technology used in this research was video conferencing and the patients were diagnosed with ‘bulimia Nervosa (BN) or ‘eating disorder not otherwise specified’. Video conferencing allowed both therapist and patient to view each other. The researchers concluded that the areas which are difficult to have access can easily be reached with the help of it. The telecommunication technologies can provide a reliable way for helping the individuals suffering from EDs. With ever increasing improvements in telecommunications and wireless devices, this course of treatment has enormous potential in it (Shingleton, Richards and Brenner 577-78).
b) Self-Help (Guided)
In guided self-help therapy, the individuals having EDs tend to receive ‘own treatment’with the help of therapists. The moderated discussion group and e-mail supported handled by graduate students presented better results. Almost 46% of the participants, which completed the research program report no purge behavior. There were also some improvements in the cognitive symptoms too. Participants reported a significant decline in the eddies and an improvement in the self-monitoring of diet. Another 16-week program was carried out by Taylor and colleges focusing efforts on the binge eating, weight maintenance, and physical activity. The individual patients were given guidance and supportive e-mails. Reports on the progress of the patients were created and a feedback system was developed. The results of the program were a continuous reduction in the bulimic symptoms. 38% of the participants reported that they were in remission or subclinical systems with 3 months into the treatment (Shingleton, Richards and Brenner 578-79).
c) Self-Help (Un-guided)
In this type of therapy, there is no professional guidance required by the patients and they are in control of their treatment. Three studies were selected by the article to review and two of them used CD-ROM as technology. The programs analyzed the common risk factors and cultural factors associated with EDs, self-monitoring of food intake and mood and problem-solving. The researchers concluded that there was a considerable decline in the purging behavior. 42% of the participants completed all required sessions proposed for the treatment. One of the limitations, however, was the fact that patients having severe pathology participated less likely in the program (Shingleton, Richards and Brenner 578-79).
In the third research conducted, the technology used was CD-ROM and the developed program included information regarding nutrition, healthy living, basic CBT principle with detailed examples and exercises. The program contained briefed diagrams, videos incorporated into health issues. The treatment was compared with the conventional clinical CBT treatment and it was seen that there was 13% decline in purge eating in the CD-ROM group. The researchers concluded that CD-ROM based self-help was acceptable and initially preferred mode of treatment for individuals diagnosed with BEDs (Shingleton, Richards and Brenner 579-80).
d) Adjunct to Treatment
Two studies are discussed in the selected article. In the first research, researchers develop a system using wrist watches. The patients diagnosed with BEDs were prompted six times a day on a programmable wristwatch. The system was used to record thoughts, moods and eating habits for the first 2 weeks of the therapy. The participants reduced their binge eatings to 2/week. The second studies carried out by Shapiro and colleagues in 2010 used text messages for gathering data from patients (Shingleton, Richards and Brenner 580). Patients suffering from BEDs submitted nightly text messages reporting their purge diets during the course of their treatment. In response of their text messages system was able to send an automated message response providing individual response. Participants of the research responded positively to the system and generally embraced to text nightly. The patients having an average of ‘14’ purges per week were reduced to ‘2.5’ purges per week and to approximately ‘4’ purges per week post-intervention (Shingleton, Richards and Brenner 580).
e) After Care
Text messaging has been used to carry out stand-alone aftercare interventions. Gulec and colleges investigated an Internet-Based intervention known as “EDINA”. The program involved psychoeducation, a forum for support, professional consulting, individual chat sessions and feedback system with messages. The program gain appreciation from the participants and >80% graded it as “good” or “excellent”. According to the participants, the program helped them to cope with their eating disorders (EDs). More than one-half of the patients were also satisfied with the online support and consultation they receive from therapist during chat sessions (Shingleton, Richards and Brenner 580). Kordy and colleagues concentrated their efforts towards patients which were discharged from inpatient hospitalization. The patients received text messages ‘16’ weeks after their discharge from the hospital. The participants made treatment gains and researchers reported the success of the program. However in a second study which investigated ‘6’ month text messaging the ‘47%’ of the participants did not read their text messages despite their important motivation (Shingleton, Richards and Brenner 580).
The use of technology for the treatment EDs has yielded positive results. Technology used for the treatment ranges from text messages to e-mail support for self-help. E-mail based support proved helpful for those patients who were inaccessible using conventional methods of therapy. They are also helpful for people which under normal circumstances reluctant or do no want to seek therapy. The introduction of technology to less severe population yielded positive results. The limitations of studies reviewed in the selected article were the fact that they were restricted to outpatients (Shingleton, Richards and Brenner 580-81). The technology intervention in the treatment of EDs reduces the role and required effort from the therapist. While using technology for the treatment of the patients suffering from EDs clinicians should consider all technological (bandwidth, use of technology and technology literacy of the patients) and ethical considerations (emotional and legal issues). Technology provides the wide range of opportunities to the clinicians. The method of treatment of the EDs have not been changed enough as compared to the conventional face-to-face therapy, but the factors like self-monitoring and motivation have increased. They can reach patients in innovative ways. Keeping in consideration the precautions technology can enhance the treatment (Shingleton, Richards and Brenner 580-81).
Shingleton, Rebecca M., Lauren K. Richards, and Heather Thompson-Brenner. ‘Using Technology Within The Treatment Of Eating Disorders: A Clinical Practice Review.’. Psychotherapy 50.4 (2013): 576-582. Web. 23 Mar. 2015.