Acceptability, responsiveness, and feasibility of cue exposure therapy targeting expectancy violation in emotional eating and eating self-efficacy : a mixed-methods case study

Abstract

Background: Cue exposure therapy (CET) with expectancy violation is a promising treatment for treating disordered eating, but little is known about its effect on emotional eating and eating self-efficacy, which are both associated with the frequency and severity of disordered eating. Besides, there is limited investigation into the service user’s perceptions towards the treatment. This study aimed to examine service users’ perceptions on the acceptability, responsiveness and feasibility of CET for individuals with negative emotional eating, and the effect of CET on emotional eating and eating self-efficacy. Method: Four female (age 34-43) with negative emotional eating were enrolled in the intervention study of cue exposure therapy targeting expectancy violation (six weekly individual sessions, each session for 45 to 60 minutes). Quantitative measures on emotional eating, eating self-efficacy, weight, mood, quality of life, treatment acceptability and therapeutic alliance were collected at baseline and at posttreatment. Qualitative interviews were conducted with participants after the treatment to obtain participant’s perceptions regarding the intervention’s acceptability, responsivity and feasibility. Results: During qualitative interviews, participants noted that CET is an acceptable and feasible intervention in addressing negative emotional eating and improving eating self-efficacy, which can be facilitated by having graded tasks, written records, and good therapeutic alliance. Expectancy violation, especially on expectancies towards eating self-efficacy and mood regulation, was found to be related to treatment gains. Quantitative data showed a reduction in negative emotional eating and increase in eating self-efficacy at posttreatment compared to baseline. Conclusion: CET targeting expectancy violation is an acceptable and feasible intervention for negative emotional eating, and it could lead to reduction in negative emotional eating and an increase in eating self-efficacy.