title: Understanding the 'guide' in guided self-help for disordered eating: a qualitative process study.
abstract: OBJECTIVE
  This study aimed to explore how guidance contributes to the outcome of self-help for disordered eating.
  
  
  METHODS
  A sample of guides and clients with a range of disordered eating was interviewed on completion of a randomized control trial and analysed using thematic framework analysis.
  
  
  RESULTS
  Four themes emerged; the necessity of having a guide as a facilitator, features of the therapeutic relationship in clients with positive outcomes, features of the therapeutic relationship in clients with poor outcomes, and client suitability.
  
  
  CONCLUSIONS
  These findings have implications for the delivery of guided self-help interventions for disordered eating. They suggest the value of assessing clients' readiness to change, working with clients with less severe and complex conditions, and the importance of guide qualities and skills.
  
  
  CONCLUSIONS
  Guidance is a necessary adjunct to self-help approaches for the effective treatment of a range of disordered eating and can be delivered by trained non-eating disorder specialists. Guided self-help appears most appropriate for less severe, binge-related eating disorders, including eating disorders not otherwise specified (EDNOS), further work is needed for use with anorexic-type presentations. While it is important to establish and maintain a strong, open, and collaborative therapeutic relationship, client 'readiness' appears fundamental in the relationship and consequent treatment outcome.
authors: Leeds Institute of Health Sciences, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, UK. G.Traviss@leeds.ac.uk
authors: Gemma D
authors: GD
authors: Traviss
authors: Suzanne
authors: S
authors: Heywood-Everett
authors: Andrew J
authors: AJ
authors: Hill
mesh_terms: D000328:Adult; D002983:Clinical Competence; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology; D018579:Patient Selection; D024382:Professional Role; D011369:Professional-Patient Relations; D013811:Psychotherapeutic Processes; D036301:Qualitative Research; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods / Q000523:psychology*; D016896:Treatment Outcome