Live with your body—participants’ reflections on an acceptance and commitment therapy group intervention for patients with residual eating disorder symptoms
Open accessAbstract
Acceptance and commitment therapy (ACT) is a transdiagnostic approach to human suffering that has been trialed in a range of different contexts. This study aimed to examine participants' view of helpful and hindering aspects of an in person ACT group intervention targeting body image in patients with residual eating disorder (ED) symptoms. Thirteen women who completed the intervention were interviewed, and transcripts were analyzed through thematic analysis. Nine themes were identified and sorted into three main themes. The first main theme, ”Taking the plunge”, pointed to the importance of participants own effort, and included subthemes of self-efficacy, self as description, and self-exploration. The second main theme, “A push towards valued ends”, indicated that content of the intervention was helpful, and included subthemes of commitment and behavioral change processes, mindfulness and acceptance processes, and assignments in and between sessions. The third main theme, “The context matters”, described the importance of the contexts of the intervention and life outside of treatment, and included subthemes of the group format, the context outside of treatment, and the timing of the intervention. Through the description of specific content, we conclude that ACT seems to help women with residual ED symptoms and body image issues by fostering motivation to engage in avoided situations and behaviors while striving to live a more valued life.
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This is in line with previous qualitative findings from studies of adults.
“This is in line with previous qualitative findings from studies of adults (Bahattab and AlHadi, 2021; Fogelkvist et al., 2021).”
From “And I Can Remind Myself That I Am All Of This”: adolescents’ experiences of group-based acceptance and commitment therapy (2024) · cites this paper as Fogelkvist et al., 2021
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Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Diagnostic and Statistical Manual of Mental Disorders(DSM)
Leong, F. T. L. (2008) · Sage eBooks · doi:10.4135/9781412963978.n182 · Cited by 10,858 · see citing works
Acceptance and commitment therapy: model, processes and outcomes
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.06.006 · Cited by 6,587 · see citing works
Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00088-8 · Cited by 3,374 · see citing works
Vasileiou, K., Barnett, J., Thorpe, S., & Young, T. (2018) · BMC Medical Research Methodology · doi:10.1186/s12874-018-0594-7 · Cited by 3,115 · see citing works
Psychological flexibility as a fundamental aspect of health
Kashdan, T. B., & Rottenberg, J. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.03.001 · Cited by 3,054 · see citing works
Research summary on the therapeutic relationship and psychotherapy outcome.
Lambert, M. J., & Barley, D. E. (2001) · Psychotherapy: Theory, Research, Practice, Training · doi:10.1037/0033-3204.38.4.357 · Cited by 1,621 · see citing works
A Review of the Quality Indicators of Rigor in Qualitative Research
Johnson, J. L., Adkins, D., & Chauvin, S. (2020) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe7120 · Cited by 1,238 · see citing works
Treasure, J. L., Duarte, T. A., & Schmidt, U. H. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30059-3 · Cited by 1,110 · see citing works
The Future of Intervention Science: Process-Based Therapy
Hofmann, S. G., & Hayes, S. C. (2019) · Clinical Psychological Science · doi:10.1177/2167702618772296 · Cited by 888 · see citing works
(2004) · Cited by 780 · see citing works
Stice, E., Gau, J. M., Rohde, P., & Shaw, H. (2017) · Journal of Abnormal Psychology · doi:10.1037/abn0000219 · Cited by 558 · see citing works
Vall, E., & Wade, T. D. (2015) · International Journal of Eating Disorders · doi:10.1002/eat.22411 · Cited by 553 · see citing works
Recovery from anorexia nervosa and bulimia nervosa at 22-year follow-up
Eddy, K. T., Tabri, N., Thomas, J. J., Murray, H. B., Keshaviah, A., Hastings, E., Edkins, K., Krishna, M., Herzog, D. B., Keel, P. K., et al. (2017) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.15m10393 · Cited by 535 · see citing works
Graham, C. D., Gouick, J., Krahé, C., & Gillanders, D. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.04.009 · Cited by 476 · see citing works
Expanding the lens of evidence-based practice in psychotherapy: A common factors perspective.
Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014) · Psychotherapy · doi:10.1037/a0034332 · Cited by 443 · see citing works
Examining psychological inflexibility as a transdiagnostic process across psychological disorders
Levin, M. E., MacLane, C., Daflos, S., Seeley, J. R., Hayes, S. C., Biglan, A., & Pistorello, J. (2014) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2014.06.003 · Cited by 400 · see citing works
Assessment of body image flexibility: The Body Image-Acceptance and Action Questionnaire
Sandoz, E. K., Wilson, K. G., Merwin, R. M., & Kate Kellum, K. (2013) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2013.03.002 · Cited by 396 · see citing works
Psychotherapy change process research: Realizing the promise
Elliott, R. (2010) · Psychotherapy Research · doi:10.1080/10503300903470743 · Cited by 367 · see citing works
Acceptance and commitment therapy: altering the verbal support for experiential avoidance
Hayes, S. C., & Wilson, K. G. (1994) · The Behavior Analyst · doi:10.1007/bf03392677 · Cited by 354 · see citing works
Vall, E., & Wade, T. D. (2016) · International Journal of Eating Disorders · doi:10.1002/eat.22518 · Cited by 302 · see citing works
Acceptance and Commitment Therapy as a Treatment for Anxiety and Depression
Twohig, M. P., & Levin, M. E. (2017) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2017.08.009 · Cited by 268 · see citing works
Researcher allegiance in psychotherapy outcome research: An overview of reviews
Munder, T., Brütsch, O., Leonhart, R., Gerger, H., & Barth, J. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.02.002 · Cited by 260 · see citing works
Rumination, experiential avoidance, and dysfunctional thinking in eating disorders.
Rawal, A., Park, R. J., & Williams, J. M. G. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.05.009 · Cited by 223 · see citing works
A treatment by disorder meta-analysis of dropout from psychotherapy.
Swift, J. K., & Greenberg, R. P. (2014) · Journal of Psychotherapy Integration · doi:10.1037/a0037512 · Cited by 189 · see citing works
Heffner, M., Sperry, J., Eifert, G. H., & Detweiler, M. (2002) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(02)80053-0 · Cited by 162 · see citing works
Juarascio, A., Shaw, J., Forman, E., Timko, C. A., Herbert, J., Butryn, M., Bunnell, D., Matteucci, A., & Lowe, M. (2013) · Behavior Modification · doi:10.1177/0145445513478633 · Cited by 148 · see citing works
Psychological inflexibility and Symptom Expression in Anorexia Nervosa
Merwin, R. M., Timko, C. A., Moskovich, A. A., Ingle, K. K., Bulik, C. M., & Zucker, N. L. (2010) · Eating Disorders · doi:10.1080/10640266.2011.533606 · Cited by 131 · see citing works
Lavender, J. M., Jardin, B. F., & Anderson, D. A. (2009) · Eating Behaviors · doi:10.1016/j.eatbeh.2009.07.002 · Cited by 131 · see citing works
In search of meaning: Values in modern clinical behavior analysis
Plumb, J. C., Stewart, I., Dahl, J., & Lundgren, T. (2009) · The Behavior Analyst · doi:10.1007/bf03392177 · Cited by 127 · see citing works
The role of experiential avoidance, rumination and mindfulness in eating disorders
Cowdrey, F. A., & Park, R. J. (2012) · Eating Behaviors · doi:10.1016/j.eatbeh.2012.01.001 · Cited by 124 · see citing works
Mindfulness and eating disorder psychopathology: A meta‐analysis
Sala, M., Shankar Ram, S., Vanzhula, I. A., & Levinson, C. A. (2020) · International Journal of Eating Disorders · doi:10.1002/eat.23247 · Cited by 119 · see citing works
Bell, L. (2003) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/bf03325011 · Cited by 93 · see citing works
Birgegård, A., Björck, C., & Clinton, D. N. (2010) · European Eating Disorders Review · doi:10.1002/erv.1003 · Cited by 84 · see citing works
Fogelkvist, M., Gustafsson, S. A., Kjellin, L., & Parling, T. (2020) · Body Image · doi:10.1016/j.bodyim.2020.01.002 · Cited by 80 · see citing works
Mancuso, S. G. (2015) · Body Image · doi:10.1016/j.bodyim.2015.10.003 · Cited by 79 · see citing works
Eating Disorders Patients' Views on Their Disorders and on an Outpatient Service
Reid, M., Burr, J. A., Williams, S. J., & Hammersley, R. (2008) · Journal of Health Psychology · doi:10.1177/1359105308095070 · Cited by 78 · see citing works
The client's perspective on (experiences of) psychotherapy: A practice friendly review
Timulák, L., & Keogh, D. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22532 · Cited by 75 · see citing works
Wendell, J. W., Masuda, A., & Le, J. K. (2012) · Eating Behaviors · doi:10.1016/j.eatbeh.2012.03.006 · Cited by 72 · see citing works
Butryn, M. L., Juarascio, A. S., Tronieri, J. S., Kerrigan, S. G., Clark, V., O'Planick, A. P., & Forman, E. M. (2012) · Eating Behaviors · doi:10.1016/j.eatbeh.2012.10.005 · Cited by 71 · see citing works
Timko, C. A., Zucker, N. L., Herbert, J. D., Rodriguez, D., & Merwin, R. M. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.03.011 · Cited by 57 · see citing works
The impact of body image-related cognitive fusion on eating psychopathology
Trindade, I. A., & Ferreira, C. (2013) · Eating Behaviors · doi:10.1016/j.eatbeh.2013.10.014 · Cited by 56 · see citing works
Bluett, E. J., Lee, E. B., Simone, M., Lockhart, G., Twohig, M. P., Lensegrav-Benson, T., & Quakenbush-Roberts, B. (2016) · Eating Behaviors · doi:10.1016/j.eatbeh.2016.10.002 · Cited by 48 · see citing works
Parling, T., Cernvall, M., Ramklint, M., Holmgren, S., & Ghaderi, A. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0975-6 · Cited by 47 · see citing works
Hill, M. L., Masuda, A., Melcher, H., Morgan, J. R., & Twohig, M. P. (2014) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2014.02.005 · Cited by 42 · see citing works
A Pilot Study of an Acceptance-Based Separated Family Treatment for Adolescent Anorexia Nervosa
Merwin, R. M., Zucker, N. L., & Timko, C. A. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.11.001 · Cited by 36 · see citing works
Mindfulness as therapy for disordered eating: a systematic review
Masuda, A., & Hill, M. L. (2013) · Neuropsychiatry · doi:10.2217/npy.13.36 · Cited by 36 · see citing works
Bacon, T., Farhall, J., & Fossey, E. (2014) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465813000209 · Cited by 36 · see citing works
Lee, E. B., Ong, C. W., Twohig, M. P., Lensegrav-Benson, T., & Quakenbush-Roberts, B. (2018) · Eating Disorders · doi:10.1080/10640266.2017.1366229 · Cited by 26 · see citing works
Challenge, focus, inspiration and support: Processes of values clarification and congruence
Fitzpatrick, M. R., Henson, A. M., Grumet, R., Poolokasingham, G., Foa, C. L., Comeau, T., & Prendergast, C. N. (2016) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2016.02.001 · Cited by 20 · see citing works
Fogelkvist, M., Parling, T., Kjellin, L., & Gustafsson, S. A. (2016) · Journal of Eating Disorders · doi:10.1186/s40337-016-0120-4 · Cited by 19 · see citing works
Brosof, L. C., Egbert, A. H., Reilly, E. E., Wonderlich, J. A., Karam, A. M., Vanzhula, I. A., Steward, T., & Levinson, C. A. (2019) · Eating Behaviors · doi:10.1016/j.eatbeh.2019.101340 · Cited by 14 · see citing works
Casey, M.-B., Murphy, D., Neary, R., Wade, C., Hearty, C., & Doody, C. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.03.005 · Cited by 14 · see citing works
Assessment of eating disorders: interview or self-report questionnaire
Fairburn, C. G., & Beglin, S. J. (1994) · International Journal of Eating Disorders · doi:10.1002/1098-108x(199412)16:4
Flagged first, then by citations
1 of the 55 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Hayes, S. C., Strosahl, K., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York: Guilford Press.
Cited by
Sorted by citations
Sevilla, A. L. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.11.001 · Cited by 19 · see citing works
Ruan, J., Cheng, H., Wu, L., Mak, Y. W., Zhang, X., Liang, J., Ma, H., Li, S., & Yeung, W. F. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.09.003 · Cited by 17 · see citing works
Seery, C., Leonard-Curtin, A., Naismith, L., King, N., Kilbride, K., Wrigley, M., Boyd, C., McHugh, L., & Bramham, J. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.08.005 · Cited by 16 · see citing works
Bouws, J., Henrard, A., de Koning, M. B., Schirmbeck, F. N., Grothe, S. V. G., van Aubel, E., Reininghaus, U., de Haan, L., & Myin‐Germeys, I. (2023) · Early Intervention in Psychiatry · doi:10.1111/eip.13442 · Cited by 13 · see citing works
“None of the other qualitative studies on ACT for psychiatric illnesses (Bacon et al., 2014; Bahattab & AlHadi, 2021; Bloy et al., 2021; Fogelkvist et al., 2021)”
BackgroundVirtually Accompanied Eating in the Outpatient Therapy of Anorexia Nervosa
Vogel, M., Gil, A., Galaz, C., Pascuala Urrejola, N., Lacalle, L., Jara, R., Verónica Irribarra, P., Vuskovic, M. L., Costa, D. S. A., & Espinoza, G. (2023) · Nutrients · doi:10.3390/nu15173783 · Cited by 3 · see citing works
“Group engagement can generate a sense of connection usually not found with peers or families during the course of illness [19].”
BackgroundBrovold, F., Laugen, N. J., & Grøtte, T. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1458421 · Cited by 2 · see citing works
O’Brien, J., Evans, S., Hoon, E. A., Birch, S., Mazza, C., McIver, S., Pépin, G., Harris, J., & O’Shea, M. (2026) · Journal of Eating Disorders · doi:10.1186/s40337-026-01729-0
- Authors
- Fogelkvist, M., Parling, T., Kjellin, L., & Gustafsson, S. A.
- Affiliations
- Örebro University (SE)
- Region Stockholm (SE)
- Corresponding author
- Fogelkvist, Maria
- Venue
- Journal of Contextual Behavioral Science
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 20
- Pages
- 184-193
- ISSN
- 2212-1447 (ISSN-L)
- OpenAlex
- W3156541338
- Cited by
- 7
- References
- 55
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 5
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Contextual Behavioral Science (publishedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- acceptance and commitment therapy, eating disorders, body image, group intervention, participant perceptions, self-efficacy, mindfulness, acceptance, transdiagnostic treatment, women
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