Using Technology to Improve the Treatment of Eating Disorders

 

Of relevance to global mental health, we partner with the European Commons eCare project to develop and evaluate programs that can be disseminated internationally. The eCare project, directed by Dr. Corinna Jacobi, PhD, involves a consortium of investigators throughout Europe, and Dr. Taylor is one of the senior advisors.

 

Healthy Body Image Program

 

Dr. Taylor is a senior scientist for the Healthy Body Image study alongside Dr. Denise Wilfley, PhD, from Washington University in St. Louis. This trial was funded by the National Institute of Mental Health to increase access to care for eating disorder prevention and intervention on college campuses nationwide. The Healthy Body Image program is an evidence-based platform designed for eating disorder screening, detection, and intervention, using minimal person-based resources. Based on behaviors, body image, risk assessment, and symptoms, students are offered personalized tools or referrals to various campus resources. In partnering with Lantern, students have access to both an online program and an iPhone application. Members of the program also have access to a coach who provides support and feedback throughout the duration of the program. Recruitment for the study is coming to a close in June 2016.

 

The e:Courage Project

 

There are presently many millions of trauma survivors scattered across the globe, large numbers of whom suffer from PTSD (post-traumatic stress disorder) and/or other stress-related problems. While there is a great need for mental health care and assistance among the global population of trauma survivors, services are largely not available nor are they likely to become available in the short term, due to a lack of resources and mental health care infrastructure. In this environment, development and implementation of technology tools that enable self-management of traumatic stress difficulties and empower local indigenous helpers to better serve their community members represents a feasible, potentially effective, and scalable strategy for reaching millions of individuals and strengthening their capacities for self- and other-care.

 

The e:Courage app is intended to reduce suffering and promote resilience for survivors of disaster, war, violence, sexual abuse, and other trauma. It will be designed to strengthen trauma survivor self-care and increase helper effectiveness to support individuals and communities affected by traumas around the world, especially those with limited access to mental health services. The app will offer service direct to trauma survivors, helping them more effectively self-manage their post-trauma problems; enable widespread utilization of a potentially effective technology-based helping tool by indigenous coaches, paraprofessionals, and social networks, thereby greatly increasing the range of possible care providers; and provide assistance to traumatized populations that are underserved, especially in regions of the world where mental health care access is limited or unavailable.

 

Staying Fit/Student Bodies Classic/Student Bodies-Eating Disorders

 

Over the years we have developed a “suite” of online programs to prevent eating disorders, improve body image, and promote healthy weight maintenance implemented in various settings including middle schools, high schools, colleges and universities, communities/YMCAs. More recently, these programs have been used to provide treatment and prevention tools for eating disorders. A Chinese version of StayingFit for middle school students is currently being evaluated in Hong Kong and Shanghai.

 

Online Anxiety Self-Help Group Study

 

There are numerous online interventions and self-help groups available to those looking for mental health help. Most evidence-based psychological interventions, especially those for anxiety, have been shown to reduce symptoms. However, drop-out rates tend to be very high in these community-recruited studies, and there have been very few, if any, studies analyzing the effects of self-help groups on anxiety symptom reduction.

 

In the past few months, we have drafted a study to determine if an online anxiety self-help group reduces anxiety, worry, and avoidance in individuals and in the group altogether. The group will be moderated by a non-clinician, and they will be given access to a number of resources, tools, and articles. Over the span of three months, the group will learn set skills and participate in various intervention strategies as individuals and as a community. We hope that providing more structure compared to most unguided self-help groups will decrease anxiety symptoms both short-term and long-term.

 

Project Mana Maali

 

Under the direction of Nitya Kanuri, we are now in our second year of project Mana Maali, which provides affordable, accessible, evidence-based coaching for anxiety disorders to students at 4 universities in India. Our dream is to have project champions in India, platform development through Bits-Pilani, and an active collaboration among the m²Health Institute, VA PTSD Training/Dissemination/App development, and Penn State.

 

We started this project 2 years ago to address a need -- many students in universities in India are either not getting or not accessing mental healthcare services. In some places, sufficient mental health care resources are not available (e.g., not enough counselors on campus). In most all places, stigma around mental health often prevents many from seeking help when it is available. We've proposed using an online survey to identify those with high levels of anxiety and connect them to a private, online program (supported by our amazing technology partner Lantern) and an online Indian counselor with whom they could connect via messaging or phone to learn new techniques to manage anxiety and get support in practicing them.

 

In doing this work over the last 3 semesters with our partner university BITS Pilani, we've learned that in addition to providing students with more (and private) ways to ask for help, an important component of addressing mental health is also attempting to reduce the stigma around it (and, in turn, increase help-seeking).

 

To do this, we've partnered with White Swan Foundation, an NGO based out of the National Institute for Mental Health and Neuro Sciences (NIMHANS) in Bangalore. White Swan Foundation has created a "knowledge repository" -- translated into several languages -- to address mental health stigma from the angle of awareness, education, and knowledge for the person in need of support, the caregiver, and the general community. They have been graciously supporting us for the last year with educational content to provide to students. You can learn more about them here: whiteswanfoundation.org.

 

YMCA

 

Over the past three years we have been running a version of StayingFit in various sites in the San Francisco YMCAs. Our first effort was to provide a class in StayingFit at the BayView Hunter’s Point YMCA’s Center for Academic Re-entry and Empowerment (CARE). PsyD students led the sessions with students who were learning skills to help them re-enter and succeed in school. Under leadership from Katie Taylor Lynch, (a current PsyD student), we expanded the program to five more YMCAs with different student populations. This year, we partnered with the Mayor’s Youth Employment and Education Program (MYEEP) and distributed StayingFit to high school students at the Buchanan YMCA in San Francisco. In addition to completing the StayingFit program, this group of students learned skills to teach this material to others in the hopes that this program could become more self-sustaining. We hope to continue this effort through our collaboration with the San Francisco YMCAs and MYEEP in the coming years.