RISE Therapy for Eating Disorders

Overseen By April Smith

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Auburn University

Disqualifiers: Under age 10

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

50 Participants Needed

Trial Summary

What is the purpose of this trial?

Interoception is the process of perceiving one's bodily sensations. Interoception is critical for survival and maintaining homeostasis, as it motivates sensation- and need-specific autonomic reflexes and adaptive behaviors (e.g., eating when hungry, terminating eating upon fullness, drinking when thirsty). Not all individuals have accurate interoceptive abilities. Individuals with eating disorders often have low perception of gastrointestinal, pain, and emotion sensations. Interoceptive dysfunction is believed to influence the development and maintenance of many forms of psychopathology. Identifying effective ways to restore accurate interoceptive processing is an important aim for clinical researchers. The goal of the present study is to continue to test the effectiveness of a training for interoceptive dysfunction that aims to reconnect individuals with eating disorders with their internal sensations, which is called, Reconnecting to Internal Sensations.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Reconnecting to Internal Sensations and Experiences (RISE) for eating disorders?

The research highlights the importance of understanding and treating eating disorders by focusing on bodily and narrative identity, which aligns with the goals of RISE therapy. Additionally, treatments that enhance emotional processing and symbolic thinking, like ILET, have shown promise in addressing eating disorders, suggesting that RISE's focus on internal sensations may be beneficial. ^{1 2 3 4 5}

How is the RISE treatment for eating disorders different from other treatments?

RISE Therapy for Eating Disorders is unique because it focuses on reconnecting individuals with their internal sensations and experiences, addressing the disconnection between bodily and narrative identity often seen in eating disorders. This approach emphasizes understanding and integrating bodily interactions and sensorimotor patterns, which is different from traditional treatments that may not focus as deeply on the embodied self-concept. ^{1 2 6 7 8}

Eligibility Criteria

This trial is for individuals over the age of 10 who have been clinically diagnosed with an eating disorder and are patients at the Louisville Center for Eating Disorders. The study aims to include those who may struggle with recognizing internal bodily sensations.

Inclusion Criteria

I have been diagnosed with an eating disorder.

Be a patient at the Louisville Center for Eating Disorders

I am older than 10 years.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants undergo interoceptive training consisting of four 25-30 minute modules delivered weekly, focusing on body awareness, body sensations and movement, eating, health and self-care, emotional awareness, and understanding the self in relation to others.

4 weeks

4 sessions (online)

Follow-up

Participants are monitored for changes in eating disorder symptoms and interoceptive awareness using self-report assessments.

1 week

Treatment Details

Interventions

• Reconnecting to Internal Sensations and Experiences

Trial Overview The study is testing a training called 'Reconnecting to Internal Sensations and Experiences' (RISE), which is designed to help participants with eating disorders improve their ability to perceive bodily sensations like hunger, fullness, and thirst.

Participant Groups

Group I: Reconnecting to Internal Sensations and Experiences Experimental Treatment 1 Intervention

The interoceptive training consists of four 25-30 minute modules (plus 15-minutes worth of optional weekly practice) that focus on multiple aspects of interoception including: body awareness, body sensations and movement, eating, health and selfcare, emotional awareness, and understanding the self in relation to others. These modules are delivered weekly.

Who Is Running the Clinical Trial?

Auburn University

Lead Sponsor

Trials

81

Recruited

14,600+

Findings from Research

Eating disorders (EDs) are deeply connected to a person's identity and can be influenced by insecure attachments and traumatic experiences, which affect emotional regulation and self-representation.

The paper proposes an integrated psychotherapy model that addresses the complex interplay of bodily identity, trauma, and narrative self-concept in treating EDs, emphasizing the need for a holistic approach to therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Narrative and Bodily Identity in Eating Disorders: Toward an Integrated Theoretical-Clinical Approach. Pellegrini, RA., Finzi, S., Veglia, F., et al.[2022]

Internal Language Enhancement Therapy (ILET) is a novel treatment for eating disorders that combines neurobiology, psychoanalytic theory, and cognitive behavioral techniques to enhance emotional processing.

ILET aims to help patients reconnect with their emotions by identifying triggers and using symbolic language, suggesting that eating disorders manifest when individuals are stuck in a concrete emotional state.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

From red vegetables to sexuality: Resymbolizing the meaning of concrete thought in eating disorders. Pearlman, B.[2020]

Recovery from anorexia nervosa (AN) and bulimia nervosa (BN) after 12 and 18 months is significantly associated with higher levels of mentalization, suggesting that enhancing this skill during treatment could improve outcomes.

Patients who recovered showed greater improvements in autonomy and lower levels of co-morbid symptoms like anxiety and depression, indicating that fostering independence may be a key mechanism in the recovery process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recovery from eating disorder 1 year after start of treatment is related to better mentalization and strong reduction of sensitivity to others. Kuipers, GS., Hollander, SD., van der Ark, LA., et al.[2019]

Eating disorders are difficult to treat due to high rates of comorbidity with personality disorders and other psychological issues, leading to high dropout and relapse rates, particularly in anorexia nervosa, which has the highest mortality rate among psychiatric disorders.

The authors propose a new schematherapeutic approach that combines experiential methods with evidence-based cognitive behavioral therapy (CBT) to enhance patient motivation and improve treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Schematherapy in Eating Disorders - An Integrative Approach to Improve the Outcome]. Archonti, C., de Zwaan, M.[2018]

A contemporary psychodynamic framework highlights that eating disorders are not just influenced by cognitive or biological factors, but also by unmet attachment needs and social pressures, which can lead to maladaptive coping mechanisms.

This model suggests that effective treatment for eating disorders should address both the symptoms and the underlying attachment issues, focusing on interpersonal relationships and emotional regulation, as illustrated by two clinical case examples.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Eating disorders and attachment: a contemporary psychodynamic perspective. Tasca, GA., Balfour, L.[2016]

Eating disorders in women who experienced childhood abuse and neglect can be understood as attempts to manage overwhelming emotions and create a sense of self, often leading to self-destructive behaviors like binge eating and purging.

Effective treatment involves individual therapy to rebuild trust in relationships and group therapy to reduce isolation, helping patients confront their trauma and move towards healing and personal growth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Histories of childhood trauma and complex post-traumatic sequelae in women with eating disorders. Rorty, M., Yager, J.[2019]

Therapists with lived experience of eating disorders (EDLE) utilize their personal experiences to inform their clinical practice, transforming these experiences into valuable guidance for treating clients with eating disorders.

The study identified two key systems that therapists use: the Central System, which helps in applying their lived experiences clinically, and the Checks and Balances System, which ensures they maintain professional boundaries while connecting with clients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Bringing and Removing Self from the Table": Therapists' use and management of eating disorder lived experience in the treatment of clients with eating disorders. King, AA., Russon, JM.[2023]

PROJECT RECOVER is exploring integrated treatment approaches for individuals with both eating disorders (ED) and posttraumatic stress disorder (PTSD), focusing on concurrent delivery of Cognitive Processing Therapy (CPT) alongside intensive ED treatment.

Initial findings indicate that integrating CPT with cognitive-behavioral therapy (CBT) for ED can effectively address the relationship between these disorders, promoting recovery from both ED and PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrating cognitive processing therapy for posttraumatic stress disorder with cognitive behavioral therapy for eating disorders in PROJECT RECOVER. Trottier, K., Monson, CM.[2021]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Narrative and Bodily Identity in Eating Disorders: Toward an Integrated Theoretical-Clinical Approach. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

From red vegetables to sexuality: Resymbolizing the meaning of concrete thought in eating disorders. [2020]

3. Germany pubmed.ncbi.nlm.nih.gov

Recovery from eating disorder 1 year after start of treatment is related to better mentalization and strong reduction of sensitivity to others. [2019]

4. Germany pubmed.ncbi.nlm.nih.gov

[Schematherapy in Eating Disorders - An Integrative Approach to Improve the Outcome]. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

Eating disorders and attachment: a contemporary psychodynamic perspective. [2016]

6. United States pubmed.ncbi.nlm.nih.gov

Histories of childhood trauma and complex post-traumatic sequelae in women with eating disorders. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

"Bringing and Removing Self from the Table": Therapists' use and management of eating disorder lived experience in the treatment of clients with eating disorders. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Integrating cognitive processing therapy for posttraumatic stress disorder with cognitive behavioral therapy for eating disorders in PROJECT RECOVER. [2021]