Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces...
Transcript of Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces...
![Page 1: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/1.jpg)
Motivational Interviewing for Binge Eating Disorder
Stephanie E. Cassin, Ph.D., C.Psych.
![Page 2: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/2.jpg)
Motivational Interviewing (MI)
Developed in the field of addictions
Based on the Stages of Change model
A non-confrontational approach designed to examine and resolve ambivalence
![Page 3: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/3.jpg)
Principles Underlying MI
Express empathy
Develop discrepancy
Avoid argumentation
Roll with resistance
Support self-efficacy
![Page 4: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/4.jpg)
Study Rationale:MI for Binge Eating Disorder (BED)
Substantial symptom overlap between BED and the addictions for which MI was originally developed.
Cassin & von Ranson (2007); von Ranson & Cassin (2007)
On average, MI is more effective in changing eating behaviours than in changing drug and alcohol use.
Burke et al. (2003)
MI reduces the frequency of binge eating to a greater extent than compensatory behaviours.
Treasure et al. (1999)
BED is a prevalent condition with few treatment options.
Grucza et al. (2007); Hudson et al. (2007)
![Page 5: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/5.jpg)
Study Aims
To develop a single session motivational interviewing protocol focused on binge eating.
To test the efficacy of the motivational interviewing protocol in a sample of women with BED.
![Page 6: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/6.jpg)
Phase I: Development of MI Protocol
Discuss interest in study
Elicit self-motivational statements
Explore ambivalence
Discuss “good” things and “not so good” things about binge eating
Discuss life areas affected by binge eating
E.g., impact on physical health, mental health, finances, relationships
![Page 7: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/7.jpg)
Phase I: Development of MI Protocol
Discuss ‘Stages of Change’ Model
Brief assessment of client’s stage of change
Complete decisional balance
Benefits and costs of staying the same versus changing
Bolster self-efficacy
Past experiences in which the individual has shown mastery in the face of difficulties and challenges
![Page 8: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/8.jpg)
Phase I: Development of MI Protocol
Look to the future and explore values
Discrepancy between actual life and ideal life, future with and without binge eating
Assess readiness and confidence for change
Make a change
“If you were considering change, how would you go about making changes?”
![Page 9: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/9.jpg)
Phase I: Development of MI Protocol
Elicit ideas for behavioural alternatives to binge eating
Complete “Plans for Change” worksheet
Change plan consisting of small, manageable steps (Treasure & Schmidt, 1997)
![Page 10: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/10.jpg)
Phase 2: Efficacy of MI for BED
Participants
108 women
Age 18 and over
Diagnosis of BED
![Page 11: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/11.jpg)
Recruitment Sources
0 10 20 30 40 50
Television News
Newspaper/Magazine
Database
Radio
Computer
Community Event
Referred
% of Total Sample
![Page 12: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/12.jpg)
Procedure
Phone screen to determine eligibility
In person appointment at university laboratory
Pre-intervention measures
Intervention
Post-intervention measures
Follow-up assessments conducted by telephone
1, 2, and 4 months
![Page 13: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/13.jpg)
Intervention
Randomized to MI or control group:
MI: ED assessment + handbook + MI session (M = 82 mins.) + letter
Control: ED assessment + handbook
![Page 14: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/14.jpg)
Demographics
No differences between groups
Mean age: 42.5 years (SD = 12.7)
Ethnicity: 89% Caucasian
Marital Status:
45% Married/Cohabiting
32% Single
19% Separated/Divorced
Education:
57% completed college/university degree
26% completed some college/university
![Page 15: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/15.jpg)
Baseline ED Variables
No differences between groups
Mean BMI:
33.2 kg/m2 (SD = 7.8)
Mean BED duration:
15.1 years (SD = 11.6)
Mean binge frequency:
14.1 binges/month (SD = 7.4)
![Page 16: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/16.jpg)
Stage of Change (URICA)
05
101520253035
Pre ContAction
Maintain
MIControl
![Page 17: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/17.jpg)
Change Ratings
0123456789
10
Importance
Readiness
Confidence
MIControl
![Page 18: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/18.jpg)
Self-Efficacy (WEL)
05
1015202530
Negative Emotions
Food Availability
Social Pressure
Activities
MIControl
![Page 19: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/19.jpg)
Binge Frequency (per month)
02468
10121416
BaselineMonth 1
Month 2Month 4
MIControl
Note. Significant group x time interaction (p = .001)
![Page 20: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/20.jpg)
Clinical Significance
MI Control
Binge AbstinenceBinge Abstinence 27.8%27.8% 11.1%11.1%
No longer have BEDNo longer have BED 87.0%87.0% 57.4%57.4%
![Page 21: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/21.jpg)
Body Mass Index (kg/m2)
20
25
30
35
40
Baseline Month 4
MIControl
Note. Significant main effect of time (p = .01)
![Page 22: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/22.jpg)
Depression (BDI)
0
5
10
15
20
25
30
Baseline Month 4
MIControl
Note. Significant group x time interaction (p = .001)
![Page 23: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/23.jpg)
Self-Esteem (RSE)
0
5
10
15
20
25
30
Baseline Month 4
MIControl
Note. Lower scores = higher self-esteem
Note. Significant group x time interaction (p = .003)
![Page 24: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/24.jpg)
Quality of Life (ESWLS)
0
5
10
15
20
25
Baseline Month 4
MIControl
Note. Significant group x time interaction (p = .02)
![Page 25: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/25.jpg)
Satisfaction with Study
01020304050607080
Not at All
Somewhat
Completely
MIControl
![Page 26: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/26.jpg)
Discussion
Self-help handbook alone improved binge eating, but the addition of one MI session significantly improved treatment outcome.
Improvement extended to mood, self-esteem, and quality of life.
It appears that the strength of MI lies primarily in its ability to enhance confidence for change and self-efficacy.
![Page 27: Motivational Interviewing for Binge Eating Disorder webinar... · Burke et al. (2003) MI reduces the frequency of binge eating to a greater extent than compensatory behaviours. Treasure](https://reader033.fdocuments.net/reader033/viewer/2022052017/602f8cc26ffd6e250d14e69a/html5/thumbnails/27.jpg)
Funding Provided By