%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 9
%N 
%P e68846
%T Exploring Therapists’ Approaches to Treating Eating Disorders to Inform User-Centric App Design: Web-Based Interview Study
%A Thomas,Pamela Carien
%A Bark,Pippa
%A Rowe,Sarah
%+ Epidemiology and Applied Clinical Research Department, University College London, 4th Floor, Wings A and B, Maple House, 149 Tottenham Court Road, London, W1T 7NF, United Kingdom, 44 0207 679 9000, pamela.thomas.18@ucl.ac.uk
%K eating disorders
%K binge eating
%K bulimia
%K anorexia
%K qualitative research
%K mental health
%K smartphone apps
%K digital interventions
%K eHealth
%K mobile health
%K artificial intelligence
%D 2025
%7 6.5.2025
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: The potential for digital interventions in self-management and treatment of mild to moderate eating disorders (EDs) has already been established. However, apps are infrequently recommended by ED therapists to their clients. Those that are recommended often have poor engagement and user satisfaction, leading to unsatisfactory outcomes. Barriers to recommendation include patient safety, data privacy, and a perception that they may not be effective. Many existing interventions have limited functionality or do not differ much from manual cognitive behavioral therapy (CBT) or self-help books, which may not adequately support the therapeutic process or sustain user engagement. Objective: This study aims to explore the perspectives of therapists who support people with mild to moderate EDs in the community, exploring their existing treatment approach and how an ED app might fit in the treatment pathway alongside treatment. Methods: Semistructured web-based interviews were completed with ED therapists in the United Kingdom. Participants were recruited from First Steps ED, a specialist community-based ED service, and Thrive Mental Wellbeing, a workplace mental health provider. Five main themes were covered: (1) therapists’ treatment approach, (2) how therapy was implemented in practice, (3) strategies for engaging and motivating clients, (4) perspectives on a potential ED app, and (5) suggestions for app content and design. A structured thematic analysis was validated by 2 researchers. Results: Overall, 12 ED and mental health therapists (mean age 28.7, SD 7.3 y; female therapists: n=7, 58%; male therapists: n=5, 42%) participated. Therapists dealing with complex ED issues went beyond traditional CBT using additional therapeutic techniques and a flexible, person-centered approach to treatment. This included engagement and motivational strategies to support the client, elements of which could be mirrored in an app. Therapists identified the therapeutic relationship as key to success, which might have been hard to replicate in an app. They saw the potential for evidence-based apps across all stages of the treatment pathway. The need to address safeguarding, data privacy, and the potential for triggering content within the app was vital. Conclusions: This study advanced our understanding of how to design and develop clinically safe, evidence-based ED apps that can complement therapy by extending the continuity of care and the self-management and psychoeducation of clients. It emphasized integrative, adaptive CBT that incorporated other therapeutic approaches based on individuals’ needs, which could be replicated in an app, as could the strategies to support engagement and motivation. It gave a cautious yet optimistic perspective on the potential integration of apps into ED treatment across all stages of the treatment pathway, from pretreatment maintenance to posttreatment maintenance. It highlighted various concerns that could be addressed and potential limitations, such as the therapeutic relationship, while recognizing the growing potential of apps with rapid technology and artificial intelligence advancements. 
%R 10.2196/68846
%U https://formative.jmir.org/2025/1/e68846
%U https://doi.org/10.2196/68846