Digital tools could make eating-disorder support easier to reach, but the professionals in this study did not see an app replacing therapy. They saw something more careful: digital help working alongside a human relationship.
Digital mental health interventions (DMHIs) are getting increasingly important for mental health care. In the case of eating disorders (EDs), DMHIs are still in early stages. Few studies so far investigated the views of mental health professionals for EDs on the integration of DMHIs in routine care. Objective To gain insights into the experiences, perspectives, and expectations of mental health professionals for EDs regarding DMHIs and to identify requirements for the future integration of DMHIs into routine care. Methods Semi-structured qualitative telephone interviews with 24 German mental health professionals treating patients with EDs were conducted. A content analysis following a deductive-inductive approach asked for experiences, advantages and chances, disadvantages and boundaries, desired functions and properties, target groups, and general conditions and requirements for DMHIs for patients with EDs. Results Only few professionals reported experiences with DMHIs besides video-based psychotherapy during the pandemic. From the therapists point of view, DMHIs have the potential to deliver low-threshold access for patients with EDs. Useful functionalities were seen in digital meal records, skills training, and psychoeducation. However, a stable therapeutic alliance was reported as an important prerequisite for the successful integration into care. Therapists expressed concerns in case of severe anorexia nervosa or suicidality. The participants felt to be informed inadequately on recent developments and on the evidence base of DMHIs. Conclusions Mental health professionals for EDs show positive attitudes towards DMHIs, however many barriers to the integration in routine care were observed. The highest potential was seen for the use of DMHIs in addition to outpatient care and in aftercare. Specific requirements for DMHIs are related to different areas of the healthcare spectrum and for the different symptom profiles in anorexia nervosa, bulimia nervosa and binge eating disorder. Targeted DMHIs are needed and appropriate especially for concepts of blended care.
Transcript
Digital tools could make eating-disorder support easier to reach—but the professionals in this study did not see an app replacing therapy. They saw something more careful: digital help working alongside a human relationship. Digital mental health interventions are becoming increasingly important for mental health care, but in eating disorders they are still at an early stage.
So far, few studies have examined how mental health professionals view bringing these interventions into routine care for eating disorders. The evidence base is still limited: eating-disorder digital interventions remain early-stage, and few studies have examined professionals’ views on integrating them into routine care.
The study set out to understand professionals’ experiences, views, and expectations about digital mental health interventions for eating disorders. It also aimed to identify what would be needed to bring digital support into routine care.
The study asked how much professionals already use digital interventions in treatment, what advantages they see, and what risks they perceive. It also focused on the specific requirements for bringing digital applications into routine care.
Here is the everyday picture: digital support could work like a low step at the entrance to care, rather than a full treatment building. It may offer a first contact to people in remote areas or people not yet receiving medical treatment. For people who feel shame or fear stigma, digital support might be a first step toward support or eating-disorder care.
Digital teaching about the condition was also seen as useful. But a low doorway is not the same as a safe treatment plan. Professionals were aware of risks and limits for patients and for healthcare provision. Their concerns included data security, support that is not personal enough, and digital help that may not be adequate or sufficient.
In some cases, they even saw a danger that the disorder itself could worsen. That caution was linked to missing information. Many professionals wanted more scientific evidence about how digital treatments work, when they should be used, and when they should not be used.
Nearly all felt they had not been trained and informed adequately about standards and about suitable digital interventions that were available. The overall view was positive, but few professionals had already used digital interventions in daily practice.
Legal issues, data-protection rules, and the quality of technical equipment were major barriers. Professionals saw the greatest potential when digital support added to outpatient treatment or helped with aftercare, not when people used it alone without conventional psychotherapy.
They also said helpful functions should be tailored to different eating disorders, especially in care that combines digital tools with professional treatment. The central message is balance: digital support may open a door, teach useful skills, and help after treatment, but it needs human care, stronger evidence, and safeguards for people at greater risk.
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