Therapeutic alliance in two forms of guided self-help for binge eating

Abstract/Summary

The role of therapeutic alliance within psychological treatments for eating disorders (EDs), including those delivered remotely, is well-established. However, few studies have investigated alliance in guided self-help, a widely recommended first-line treatment for EDs characterised by regular binge eating. Using data from a randomised controlled trial, the current study examined both facilitator and patient assessments of alliance within e-mail assisted and face-to-face guided self-help and looked at associations between alliance, ED symptoms, and ED-related impairment. One-hundred and thirteen patients and eleven facilitators completed measures of alliance during and following a course of guided self-help. Whilst ratings were reliable across patients and facilitators, alliance scores were higher in both the patient sample and in the face-to-face condition. Ratings of alliance showed no correlations with ED symptoms at post-treatment and early alliance was not significantly associated with outcome, which could inform how early symptom change is encouraged in guided self-help.