Does personalized feedback improve the outcome of cognitive-behavioural guided self-care in bulimia nervosa? A preliminary randomized controlled trial

Objectives: Feedback has long been a part of psychosocial and health behaviour interventions and with the advent of computerised assessment and treatment tools, is gaining greater importance. The aim of the present study was to evaluate the addition of personalized feedback to a guided cognitive-behavioural (CBT) self-help programme for patients with bulimia. nervosa. Design: Randomised-control led trial. Method: 61 patients with DSM-IV bulimia nervosa. or eating disorder not otherwise specified (EDNOS) were randomly allocated to receive 14 sessions of cognitive behavioural guided self-care with or without added personalised feedback on current physical and psychological status, risk and problems, and variables facilitating or hindering change. Feedback to patients was delivered in a number of ways: (a) personalised letters after assessment and at the end of treatment, (b) a specially designed feedback form administered half-way through treatment, (c) computerised feedback about bulimic and other symptoms, such as anxiety, depression and interpersonal functioning repeated at intervals throughout treatment and follow-up. Results: Outcome was assessed using patient-rated measures of bulimic symptoms at the end of treatment and at 6-month follow-up. The data were analysed using maximum likelihood methods of assess group differences at the follow-up. Added feedback did not have an effect on take-up or drop-out from treatment. However, it improved outcome by reducing self-induced vomiting and dietary restriction more effectively. Conclusions: The findings lend support to the notion that the addition of repeated personalised feedback improves outcome from guided CBT self-help treatment and deserves further study.