Guided self-help for eating difficulties
The Transitions team have developed effective Guided Self Help (GSH) resources for eating difficulties utilising digital technology that is NICE concordant.
1-to-1 and Groups
Primary & Secondary Care
Binge Eating Disorder
Guided self-help (GSH) is based on CBT (cognitive behavioural therapy) and includes elements of DBT (Dialectical behaviour therapy), mindfulness and motivational interviewing. GSH sits somewhere between pure self-help (what you might get from a book) and more standard therapeutic interventions.
It is typically 'manualised' and relies on the provision of information and activities for the client to work through. The client takes primary responsibility for working through the treatment manual but is supported by a Guide. GSH interventions are typically brief and presented to a client as, "helping you to become your own therapist."
GSH is an approach directed to various psychological problems and is a mainstay of IAPT (Increasing Access to Psychological Therapies). It has a strong evidence base in eating disorders and is an example of a low-intensity psychological intervention that is placed at the start of a stepped-care model of treatment provision. We have digitised the traditional delivery method transforming the way GSH can be delivered and experienced.
The Transitions Team have developed Working to Overcome Eating Difficulties (WTOED) Guided Self Help resources for clinicians and clinical services to support communities on the whole spectrum of eating difficulties, focusing on the issues and challenges faced that cause worry, rather than diagnosis. It is an approach that is consistent with the latest treatment guidelines.
This GSH intervention takes a transdiagnostic approach. It is suitable for all eating difficulties, including binge eating disorder, bulimia nervosa, and for people whose eating problems have not reached clinical diagnostic thresholds and who may engage in restrictive eating.
It can be used with people early in their eating disorder journey and those who are on their way to recovery. It is suitable for people aged 16. It is not suitable for those with a BMI less than 16 or who are losing weight rapidly. Likewise, very low mood would make it difficult for people to engage in the intervention.
GSH works for those with eating disorders and difficulties. It is superior to pure self-help and shows most of its effectiveness on global eating disorder psychopathology and binge abstinence.
Traviss-Turner GD et al (2017). Guided self-help for eating disorders: A systematic review and meta-regression. European Eating Disorders Review 25: 148-164.
GSH is likely to be cost-effective. It is time limited and uses fewer resources in terms of health care professional time than conventional psychological therapies
This GSH intervention has been found to be clinically effective in a randomised controlled trial, a qualitative process study, and in a setting for people with obesity to manage binge eating.
Traviss GD et al (2011). Guided self-help for disordered eating: A randomised control trial. Behavior, Research & Therapy 49: 25-31.
Traviss GD et al (2013). Understanding the 'Guide' in guided self-help for disordered eating: A qualitative process study. Psychology and Psychotherapy: Theory, Research and Practice 86: 86-104.
Traviss-Turner GD et al (2018). Guided self-help to manage binge eating in a dietetic-led community weight management service. Clinical Obesity 8: 250-257.
Guided self-help is identified specifically in NICE Guidance and NICE Standards for eating disorders:
The main role of the Guide in GSH is to engage the client in the intervention and support them in their efforts to change. The Guide can be a source of information, a motivator, someone who reviews progress, and who will be involved in the intervention evaluation. It follows that key qualities of a Guide are being supportive and facilitatory.
A wide range of individuals have trained in the GSH for ED. Health care professions include:
- Psychologists, psychology assistants, psychological well-being practitioners
- Occupational Therapists
The research suggests that GSH treatment is most successful if the Guide:
- has some knowledge of eating disorders;
- is an effective communicator with behaviour change/counselling skills;
- is able to meet regularly with the client;
- receives support and supervision.
Training is mandatory. This GSH intervention can only be used by those who have been trained in the approach.
The training is group-based, practical, and involves getting hands on with the GSH resources, working with other participants to practice how you will support clients using this resource.
It is delivered by a psychologist and specialist dietitian or therapy assistant. It uses materials within the GSH workbook, case studies and scenarios to enable participants to think through the application of the learning and any challenges they foresee.
Training is over a single whole day and requires a room big enough for group work and teaching. We can supply all resources. We hold training sessions in West Yorkshire twice a year. Alternatively, we can offer bespoke service-specific training local to your area.
We suggest groups of 10-30 work well. Training involves a lot of working in pairs. Prices are based on groups of 10. We can train larger groups at a price variation. Please contact us for more information.
Post-training supervision is in place to allow the Guide to feel supported after their training and ensure the intervention is as effective as possible. Once you start to use the GSH intervention there may be times when things don't go as planned or you have questions about the intervention. Post-training supervision is arranged with a trainer and can be face-to-face, via phone, email, or digital technology.