{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:45:12Z","timestamp":1792046712578,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Increasing numbers of young people (YP) are seeking support for eating disorders, creating a growing unmet need for timely and accessible treatment. While guided self\u2010help (GSH) interventions have demonstrated effectiveness for other youth mental health difficulties, options for eating disorders remain limited. SPICE (Short Psychological Intervention for Children with Eating Disorders), a transdiagnostic CBT\u2010based GSH program, was developed to address this gap. This qualitative study explored participant perspectives on the mechanisms through which SPICE may support recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>SPICE comprises eight weekly modules supported by a 30\u2010min guided therapy session each week. Six female adolescents with eating disorders and their parents who completed SPICE participated in semi\u2010structured post\u2010intervention interviews. Data were analyzed using critical realist thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four key putative mechanisms were identified: (1) Interpersonal support (from the guide and parents)\u2009as a catalyst\u00a0for\u00a0change and for keeping momentum going. (2) Increased knowledge of eating disorders and associated cognitive\u00a0and\u00a0behavioural factors leading to positive changes. (3) In\u00a0vivo experiential learning as key to implementing specific strategies and taking ownership over change. (4) Context, that is, individual and systemic factors promoting and inhibiting change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Interpersonal relationships were perceived to promote engagement and change. Participants reported that psychoeducation empowered them and their families, while experiential learning helped translate strategies into everyday practice. Flexible and tailored approaches were considered important for improving accessibility and effectiveness. Perceived barriers included complex module content, remote delivery, and competing commitments. Findings provide preliminary support for GSH interventions for eating disorders in YP and identify areas for refining future intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70223","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:04:01Z","timestamp":1792044241000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanisms of Change Within a Short Psychological Intervention for Children With Eating Disorders (\n                    <scp>SPICE<\/scp>\n                    ): A Qualitative Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5769-2433","authenticated-orcid":false,"given":"Clare","family":"Prendergast","sequence":"first","affiliation":[{"name":"South London and Maudsley NHS Trust  London UK"},{"name":"Institute of Psychiatry, Psychology &amp; Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2729-4961","authenticated-orcid":false,"given":"Roz","family":"Shafran","sequence":"additional","affiliation":[{"name":"UCL Great Ormond Street Institute of Child Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5785-1533","authenticated-orcid":false,"given":"Emily","family":"Davey","sequence":"additional","affiliation":[{"name":"UCL Great Ormond Street Institute of Child Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7449-6059","authenticated-orcid":false,"given":"Rachel","family":"Bryant\u2010Waugh","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Trust  London UK"},{"name":"Institute of Psychiatry, Psychology &amp; Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5571-2273","authenticated-orcid":false,"given":"Nadia","family":"Micali","sequence":"additional","affiliation":[{"name":"UCL Great Ormond Street Institute of Child Health University College London  London UK"},{"name":"Center for Eating and Feeding Disorders Research Mental Health Center Ballerup, Copenhagen University Hospital, Mental Health Services CPH  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7840-4158","authenticated-orcid":false,"given":"Julian","family":"Baudinet","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Trust  London UK"},{"name":"Centre for Research in Eating and Weight Disorders (CREW) Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1270-1644","authenticated-orcid":false,"given":"Layla","family":"Colley","sequence":"additional","affiliation":[{"name":"Leicester Medical School University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1076-7112","authenticated-orcid":false,"given":"Sophie D.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology &amp; Neuroscience King's College London  London UK"},{"name":"UCL Great Ormond Street Institute of Child Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/13623613221142730"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23206"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2745"},{"key":"e_1_2_10_5_1","first-page":"349","volume-title":"Systemic Approaches to Manuals","author":"Baudinet J.","year":"2021"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13010"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2196\/24387"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2024.2410336"},{"issue":"1","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"R9","DOI":"10.1016\/j.brat.2012.09.008","article-title":"Enhanced Cognitive Behaviour Therapy for Adolescents With Anorexia Nervosa: An Alternative to Family Therapy?","volume":"51","author":"Dalle Grave R.","year":"2013","journal-title":"Behaviour Research and Therapy"},{"issue":"4","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0301606","article-title":"Guided Self\u2010Help Treatment for Children and Young People With Threshold Eating Disorders: A Pilot Study Protocol","volume":"19","author":"Davey E.","year":"2024","journal-title":"PLoS One"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3171"},{"key":"e_1_2_10_12_1","volume-title":"Maudsley Service Manual for Child and Adolescent Eating Disorders","author":"Eisler I.","year":"2016"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005\u20107967(02)00088\u20108"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.15633"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767430.2022.2076776"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12536"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467\u20109566.13064"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/pst0000176"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.3.022806.091432"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20122"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3028"},{"key":"e_1_2_10_22_1","unstructured":"National Institute for Health and Care Research.2024. \u201cPayment Guidance for Researchers and Professionals.\u201dhttps:\/\/www.nihr.ac.uk\/payment\u2010guidance\u2010researchers\u2010and\u2010professionals."},{"key":"e_1_2_10_23_1","unstructured":"NHS England T.Newlove\u2010Delgado F.Marcheselli et\u00a0al.2023. \u201cMental Health of Children and Young People in England 2023 \u2013 Wave 4 Follow up to the 2017 Survey.\u201d NHS England.https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/mental\u2010health\u2010of\u2010children\u2010and\u2010young\u2010people\u2010in\u2010england\/2023\u2010wave\u20104\u2010follow\u2010up."},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503300601139988"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10567\u2010024\u201000481\u20108"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2007.164.4.591"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2014.940790"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077800410383121"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2023.629"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23720"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767430.2021.1894909"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.70223","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/eat.70223","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.70223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:04:05Z","timestamp":1792044245000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.70223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":30,"alternative-id":["10.1002\/eat.70223"],"URL":"https:\/\/doi.org\/10.1002\/eat.70223","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2026-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"eat.70223"}}