Guided recovery: An interpretative phenomenological analysis of service users' experiences of guided self-help for bulimic and binge eating disorders

The efficacy of Cognitive Behavioral Therapy-based Guided Self-Help for mild to moderate bulimia and binge eating disorders has been well supported. However, limited research has explored in-depth individual experiences of this treatment approach. In depth semi-structured interviews were conducted with four individuals who had completed Cognitive Behavioral Therapy based Guided Self Help (CBT-GSH) for bulimic or binge eating disorders. The interviews were transcribed verbatim and subsequently analysed using Interpretative Phenomenological Analysis (IPA). Three superordinate themes emerged: Autonomy and volition; A dynamic relationship: the guided and the guide; and The unwanted friend. The reciprocal nature of the guide/guided relationship was identified as integral to the success of the therapeutic approach. However, participants expressed initial uncertainty towards the therapeutic process, and experienced an uncomfortable dissonance between a lack of volition in therapy seeking and the need to continually self-prescribe CBT-GSH. The findings affirm the central role of the guide in promoting motivation to engage with therapy and highlight the potential benefits of in-session weighing. However, it may be necessary to provide additional support on commencing CBT-GSH to address concerns about the therapeutic approach in this group.