Eating disorders in an age of digital technology

: A grounded theory exploration of how clinicians understand and work with client social media and internet use in therapy

Abstract

Background: Research and theories on digital well-being encapsulate the uses and functions of digital technologies and their associations with mental health difficulties, including eating disorders. This has led to clinical practice points for clinicians to assess, raise awareness and intervene, for example, by discussing the topic of social media in therapy and encouraging conscious use. However, little is known about how such conversations occur and how clinicians address client and internet use for purposes of eating disorder recovery. Furthermore, the COVID-19 pandemic provided a turning point in clinical work as therapeutic interventions and the professional practice moved online by facilitating access to treatment. Professionals thus find themselves at an intersection of change that could benefit from further investigation.
Aims: This research aimed to understand clinicians' perspectives on client social media and Internet use and how they address digital well-being in eating disorder treatment.
Method: Semi-structured interviews explored how eight UK-based psychologists and therapists understood and worked with clients' social media and Internet use in the context of eating disorder recovery. Constructivist grounded theory was used to analyse the data.
Results: Clinicians reported an active immersion in technology to understand and approach the subject in treatment. This approach supported clinicians in conceptualising a relational entity between the client and their online engagement, identifying harmful dynamics that could be addressed. Clinicians aimed to intervene by empowering clients to cultivate a healthier relationship with social media. This involved moving away from harm, expanding perspectives, challenging and building critical skills, moving towards recovery and fostering emotional awareness, thereby shielding clients from the potential power imbalances in harmful client- online dynamics.
Implications: The findings highlight clinicians' integration of digital technology in eating disorder treatment, providing reflection points to possible adaptations to talking therapies. For example, it emphasises accommodations to assessment and formulation models. Additionally, clinicians’ responsibilities are expanding to the digital realm, thereby bringing new opportunities and challenges.

Date of Award	11 Jun 2024
Original language	English
Awarding Institution	University of Roehampton
Supervisor	Savin Bapir-Tardy (Director of Studies) & Monique Proudlove (Co-Supervisor)