Group Skills Training for Body Awareness and Managing Emotions

NCT07315763 | Not Yet Recruiting

• 1 other identifier: IRAS 356169
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to evaluate the effectiveness of a skills training group informed by polyvagal theory, when delivered in an NHS setting, for those living with obesity. Polyvagal Theory in Therapy encourages individuals to be curious, respect how their nervous system works, and notice and respond to bodily sensations. Research shows that interoception, which is the ability to sense and understand what is happening inside the body such as recognising hunger, pain, or emotions, may be challenging for people in larger bodies. These challenges have been connected to difficulties in managing emotions which may lead to behaviours such as emotional eating. This points to the need for a therapeutic approach that helps people both notice what's happening in their bodies and trust those signals enough to be able to respond in healthy ways. This project will test whether a novel polyvagal informed skills training group can improve body awareness (interoception) and emotional regulation for people within an NHS specialist weight management service using a single case experimental design. Participants will be randomly assigned a baseline period of either 14 or 21 (phase A of the design) using computer-generated randomisation. During this phase, participants will complete outcome measures. The skills training intervention phase (phase B) will begin immediately following the individual's baseline period. The intervention is the six session group polyvagal theory-informed skills training. A four-week follow-up period will follow the skills training group, during which participants will continue to complete the same outcome measures they had used in the first two phases. This phase will help assess whether immediate treatment gains are maintained and/or whether delayed treatment gains occur. Trend analysis within this phase will show whether improvement or decline occurs post-skills training.

Conditions

Body Awareness; Obesity; Emotional Regulation

Keywords

Body awareness; Specialist Weight Management Service; Polyvagal Theory; Emotional regulation; Polyvagal theory in therapy; Single case experimental design; Skills training; Obesity

Outcome Measures

Primary Outcomes (1)

• Body awareness and emotional regulation visual analogue scales (VAS)

  To be completed once per day. Includes three questions asking participants about their body awareness, taking care of body shifts and the frequency of a chosen behaviour. The questions are 'Over the last 24 hours, how many times were you able to recognise shifts in your body?' , 'Over the last 24 hours, how many times did you take care of the shifts in your body? ' and 'Over the last 24 hours, how many times have you engaged in your chosen behaviour?' to rate on a scale of 0-20.

  16 weeks maximum, from day 1 of the 2- or 3-week baseline, throughout the 9-week intervention and until last day of the 4-week follow up phase.

Secondary Outcomes (3)

• Skills practice visual analogue scale (VAS)

  13 weeks maximum, from day 1 of the 9-week intervention and until the last day of the 4-week follow up phase.

• Difficulties in Emotion Regulation Scale (DERS)

  16 weeks maximum, from day 1 of the 2- or 3-week baseline, throughout the 9-week intervention and until last day of the 4-week follow up phase.

• Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA-2)

  16 weeks maximum, from day 1 of the 2- or 3-week baseline, throughout the 9-week intervention and until last day of the 4-week follow up phase.

Other Outcomes (1)

• The University of Rhode Island Change Assessment (URICA)

  To be completed once before starting the day 1 of baseline phase.

Study Arms (3)

Baseline Phase

NO INTERVENTION

Participants will be randomized to a 2 or 3 week baseline phase.

Intervention Phase

EXPERIMENTAL

The skills training intervention phase will begin immediately following the individual's baseline phase. The intervention is a group polyvagal theory-informed skills training. The skills training phase is six sessions of polyvagal theory-informed skills training delivered in a group that will take place over nine weeks (three weekly sessions and three fortnightly). Each session will be two hours long. The group will focus on understanding the autonomic nervous system, respecting changes in physiology as a result of the autonomic nervous system, and learning strategies to enhance body awareness and manage emotions, such as breathing exercises. Participants will be asked to practice techniques in sessions and applied independently between sessions with the chance to feedback on the application of ideas and techniques each session.

Behavioral: Polyvagal informed skills training group

Follow-up Phase

NO INTERVENTION

After participants have completed the group skills training, there is a 4 week follow-up phase. During this phase, there is no intervention but participants will continue practicing learned techniques independently.

Interventions

Polyvagal informed skills training group BEHAVIORAL

Research has found a connection between obesity and challenges in managing emotions, including emotional eating (Fernandes et al., 2018; Willem et al., 2019; Konttinen et al., 2019). There is currently a lack of treatments designed to address these issues whilst also promoting a curious and accepting relationship with the body. This may be particularly important for this group who may have a history of dieting or experience internalised stigma which can create a disconnect between the person and their body, a factor that many existing approaches fail to address, even though it is known to negatively impact health (Puhl et al., 2020). This study aligns with recent shifts in health policy, which move away from focusing solely on weight loss and instead prioritise non-weight-related health outcomes (Hunger et al., 2020). This group skills training, based on Polyvagal Theory (Porges, 1995), is designed to meet these needs.

Also known as: Group PVTT

Intervention Phase

Eligibility Criteria

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

You may qualify if:

• Able to commit to the duration of the study from baseline to end of follow up period (up to 16 weeks)
• Current service user of Specialist Weight Management Programme
• Aged 18-65.
• Good level of English spoken, reading and writing.
• Identified by the University of Rhode Island Change Assessment (URICA) to be in the Contemplation, Action or Maintenance stage of change.
• Access to device with internet connection to complete online questionnaires and with camera for online group sessions.

You may not qualify if:

• Identified by the University of Rhode Island Change Assessment (URICA) to be in Pre-contemplation stage of change
• Currently in psychological skills training treatment during the 16-week study period
• History of organic brain injury or cognitive impairment
• Clients presenting with suicidal intent

Sponsors & Collaborators

• Ashford and St. Peter's Hospitals NHS Trust: collaborator
• Royal Holloway University: lead

Study Sites (1)

Ashford and St Peter's Hospital NHS Foundation Trust

Ashford, Surrey, TW15 3AA, United Kingdom

Location

Related Publications (8)

• Mehling WE, Acree M, Stewart A, Silas J, Jones A. The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLoS One. 2018 Dec 4;13(12):e0208034. doi: 10.1371/journal.pone.0208034. eCollection 2018.

  PMID: 30513087 BACKGROUND

• Porges SW. Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A Polyvagal Theory. Psychophysiology. 1995 Jul;32(4):301-18. doi: 10.1111/j.1469-8986.1995.tb01213.x.

  PMID: 7652107 BACKGROUND

• Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. Am Psychol. 2020 Feb-Mar;75(2):274-289. doi: 10.1037/amp0000538.

  PMID: 32053000 BACKGROUND

• Konttinen H, van Strien T, Mannisto S, Jousilahti P, Haukkala A. Depression, emotional eating and long-term weight changes: a population-based prospective study. Int J Behav Nutr Phys Act. 2019 Mar 20;16(1):28. doi: 10.1186/s12966-019-0791-8.

  PMID: 30894189 BACKGROUND

• Fernandes J, Ferreira-Santos F, Miller K, Torres S. Emotional processing in obesity: a systematic review and exploratory meta-analysis. Obes Rev. 2018 Jan;19(1):111-120. doi: 10.1111/obr.12607. Epub 2017 Oct 10.

  PMID: 29024361 BACKGROUND

• Willem C, Nandrino JL, Doba K, Roussel M, Triquet C, Verkindt H, Pattou F, Gandolphe MC. Interoceptive reliance as a major determinant of emotional eating in adult obesity. J Health Psychol. 2021 Oct;26(12):2118-2130. doi: 10.1177/1359105320903093. Epub 2020 Jan 31.

  PMID: 32003234 BACKGROUND

• Vasileiou V, Abbott S. Emotional eating among adults with healthy weight, overweight and obesity: a systematic review and meta-analysis. J Hum Nutr Diet. 2023 Oct;36(5):1922-1930. doi: 10.1111/jhn.13176. Epub 2023 Apr 19.

  PMID: 37012653 BACKGROUND

• Willem C, Gandolphe MC, Roussel M, Verkindt H, Pattou F, Nandrino JL. Difficulties in emotion regulation and deficits in interoceptive awareness in moderate and severe obesity. Eat Weight Disord. 2019 Aug;24(4):633-644. doi: 10.1007/s40519-019-00738-0. Epub 2019 Jun 26.

  PMID: 31243741 BACKGROUND

MeSH Terms

Conditions

Obesity; Emotional Regulation

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Self-Control; Social Behavior; Behavior

Study Officials

• Jodie F Ferris

  Royal Holloway University

  PRINCIPAL INVESTIGATOR

• Jodie S Vasiliou, C.Psychol.

  Royal Holloway University

  STUDY CHAIR

• Katie S Ashcroft, DClinPsy

  Royal Holloway University

  STUDY DIRECTOR

Central Study Contacts

Jodie S Ferris

CONTACT

07521858668; jodie.ferris2023@live.rhul.ac.uk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Trainee Clinical Psychologist

Model Details: All participants receive the same intervention/treatment.

Study Record Dates

• First Submitted: November 18, 2025
• First Posted: January 2, 2026
• Study Start: January 27, 2026
• Primary Completion: January 27, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: January 7, 2026

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)