Preparing for Eating Disorders Treatment Through Compassionate Letter-Writing

NCT04174703 | Enrolling By Invitation

• 1 other identifier: 41135
• Study Type: interventional
• Target: 160
• Locations: 1 country
• Sites: 1

Brief Summary

Compassion-focused therapy (CFT) seeks to lower shame and help people develop compassion for personal distress and shortcomings. There is increasing evidence to support the benefits of incorporating CFT-based interventions into the treatment of eating disorders (EDs). Building on the investigators' prior research, this study will examine the effects of a two-week CFT-based self-compassion letter-writing intervention on patients with eating disorders. Participants will be recruited from the wait-list of patients scheduled to begin treatment at the outpatient St. Joseph's Healthcare Hamilton Eating Disorders Program, and will be randomly assigned to the two-week letter-writing intervention or to a control group. Results will inform the integration of new empirically-derived interventions into ED treatments to improve the currently dismal rates of ED recovery.

Conditions

Eating Disorders; Anorexia Nervosa; Bulimia Nervosa; Binge-Eating Disorder; Compassion

Outcome Measures

Primary Outcomes (3)

• Weight- and Body-Related Shame and Guilt Scale (WEB-SG)

  Self-report questionnaire with 12 questions on a 5-point Likert scale (scored 0-4). Total scores range from 0-48, with higher decrease in score indicative of a better outcome (i.e. higher decrease in levels of shame and guilt).

  Change from baseline to post-2 weeks of intervention/control condition

• Self-compassion Scale (short form; SCS-SF)

  Self-report questionnaire with 12 questions on a 5-point Likert scale (scored 1-5). Total scores range from 12-60, with higher increase in score indicative of a better outcome (i.e. higher increase in levels of self-compassion).

  Change from baseline to post-2 weeks of intervention/control condition

• Readiness to Change Eating Behaviours

  Self-report questionnaire with 3 questions on a 10-point Likert scale (scored 1-10). Total scores range from 3-30, with higher increase in score indicative of a better outcome (i.e. higher increase in readiness to change disordered eating behaviours).

  Change from baseline to post-2 weeks of intervention/control condition

Secondary Outcomes (2)

• Eating Disorder Examination Questionnaire (EDE-Q)

  Change from day 1 to week 25 of group eating disorder treatment

• Clinical Impairment Assessment (CIA)

  Change from day 1 to week 25 of group eating disorder treatment

Study Arms (2)

Self-compassionate letter-writing intervention

EXPERIMENTAL

An online self-compassionate letter-writing task once per day (10-20 minutes each) for 2 weeks

Other: Self-compassionate letter-writing intervention

Control condition

NO INTERVENTION

Interventions

Self-compassionate letter-writing intervention OTHER

Participants in this condition will be asked to engage in an online self-compassionate letter-writing task once per day (10-20 minutes each) for 2 weeks.

Self-compassionate letter-writing intervention

Eligibility Criteria

• Age: 17 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• DSM-5 diagnosis of anorexia nervosa, bulimia nervosa, or binge eating disorder
• Eligible to start group eating disorders treatment at St. Joseph's Eating Disorder Program
• years of age or older

Sponsors & Collaborators

• University of Waterloo: lead
• St. Joseph's Healthcare Hamilton: collaborator

Study Sites (1)

St. Joseph's Healthcare Hamilton

Hamilton, Ontario, L8N3K7, Canada

Location

Related Publications (3)

• Kelly AC, Waring SV. A feasibility study of a 2-week self-compassionate letter-writing intervention for nontreatment seeking individuals with typical and atypical anorexia nervosa. Int J Eat Disord. 2018 Aug;51(8):1005-1009. doi: 10.1002/eat.22930. Epub 2018 Aug 13.

  PMID: 30102787 BACKGROUND

• Kelly AC, Wisniewski L, Martin-Wagar C, Hoffman E. Group-Based Compassion-Focused Therapy as an Adjunct to Outpatient Treatment for Eating Disorders: A Pilot Randomized Controlled Trial. Clin Psychol Psychother. 2017 Mar;24(2):475-487. doi: 10.1002/cpp.2018. Epub 2016 May 30.

  PMID: 27237928 BACKGROUND

• Kelly AC, Carter JC, Zuroff DC, Borairi S. Self-compassion and fear of self-compassion interact to predict response to eating disorders treatment: a preliminary investigation. Psychother Res. 2013;23(3):252-64. doi: 10.1080/10503307.2012.717310. Epub 2012 Aug 24.

  PMID: 22917037 BACKGROUND

MeSH Terms

Conditions

Feeding and Eating Disorders; Anorexia Nervosa; Bulimia Nervosa; Binge-Eating Disorder

Condition Hierarchy (Ancestors)

Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Mental Disorders

Study Officials

• Allison Kelly, PhD

  University of Waterloo

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Masking Details: The care providers will not be told which condition each participant was assigned to.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Half of the study participants (n=80) will be placed into the self-compassionate letter-writing intervention group, and half of the study participants (n=80) will be placed into a control group.

Study Record Dates

• First Submitted: November 4, 2019
• First Posted: November 22, 2019
• Study Start: September 29, 2020
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: January 28, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)