Home Health Eating Disorders and Obesity
Screening and Evaluation of Potential Participants
Interested participants are first screened by telephone. During the initial phone screen, it is important to answer any questions the young women may have about the class and to reassure them that they will have a positive experience (our exit interviews with participants show that their experiences are usually very positive). As part of the phone screen, we ask the following question to screen for the presence of body dissatisfaction in potential participants: “This project is designed for young women who have some concerns about their bodies. Would you say that you have concerns or dissatisfaction with your body?” Participants who answer with some type of affirmative response are enrolled. This approach is our preferred one because it does not involve labeling students as high risk, and it is considerably easier and less expensive.
Allotting adequate time for recruitment is also important. If this is the first time the Body Project is being offered, it usually takes at least a month to generate interest in the class, screen potential participants, and begin the first class.
Facilitator Recruitment, Training, and Supervision
Dozens of group facilitators have been trained as part of the numerous efficacy and effectiveness studies that have evaluated the Body Project. Because these groups have been conducted for research purposes, we have developed training and supervision requirements for our staff for quality assurance. The success of the Body Project is likely due in part to the effort we have put into carefully selecting, training, and supervising group leaders.
We consider several issues when selecting group leaders for the Body Project and any ED prevention program. First, we have found that the most successful facilitators are those who are enthusiastic and engaging and incorporate humor into the discussions. Second, a clear understanding and commitment to the underlying theory (cognitive dissonance) behind this intervention is very important, as is knowledge about EDs and cultural pressures for thinness. Third, previous experience conducting group-based interventions is valuable, because general therapeutic issues important in conducting effective interventions are not covered in detail in the manual. Thus, individuals who have a background in counseling, social work, psychology, or nursing or who are trainees in these areas may be particularly good candidates for group leaders. Fourth, we have found that having expertise in EDs and cultural factors that appear to contribute to these disorders is also useful. People with this type of background can interject interesting research findings at opportune times, which increases the participants' level of interest. We developed a Facilitator Fact Sheet for the Body Project that details some interesting findings that facilitators may wish to mention during the sessions, which can be accessed at bodyprojectsupport.org/assets/pdf/materials/facilitator_fact_sheet.pdf.
We encourage all facilitators to review this fact sheet carefully before leading groups.
Body Project leaders should also be informed that this intervention is not intended to be an open-ended discussion or therapy group; its success depends on facilitators adhering closely to the manual. It is possible that any significant deviation from the manual could render the intervention ineffective, or potentially even iatrogenic. Improvements to the intervention have relied heavily on feedback from facilitators and participants, but any changes occur after the program has been delivered in its entirety (see the Body Project Support Web page, bodyprojectsupport.org/).
We recommend that two facilitators deliver the intervention together when possible. Cofacilitating is preferable so that leaders can demonstrate role-plays and work together to make sure that all of the material is being covered clearly within the allotted time frame. If one facilitator is sick, having another allows the session to proceed as scheduled. Finally, we have also found it preferable to have women lead the groups because participants might feel freer to discuss sensitive material and experiences, and the facilitators might be better able to relate to the program theory and content. However, male therapists who are sensitive to the experiences of young women in Western culture can deliver the intervention effectively.
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