{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:25:10Z","timestamp":1780964710648,"version":"3.54.1"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009287","name":"NSW Health","doi-asserted-by":"publisher","award":["61"],"award-info":[{"award-number":["61"]}],"id":[{"id":"10.13039\/501100009287","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro Eating Disorders Rev"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Poor rates of retention associated with digital interventions necessitate understanding of factors influencing engagement. This study presents a secondary analysis of a three\u2010arm, randomised controlled trial of an online self\u2010help treatment for bulimia nervosa (clinician\u2010supported, self\u2010help\u00a0and waitlist control).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The study aimed to understand the effect of added clinician\u2010support, or lack of support, upon user experience and therapeutic alliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>At post\u2010treatment, 61 participants completed a battery of self\u2010report questionnaires assessing user experience and therapeutic alliance. Data were analysed using mixed methods (regression and thematic analyses).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Quantitative analyses indicated clinician\u2010supported participants reported higher levels of treatment satisfaction and therapeutic alliance, however differences were not significant after controlling for covariates. Intervention effectiveness ratings were positively associated with post\u2010treatment reductions in binge episodes and eating disorder psychopathology. Qualitative data were organised into four themes: (1) human support, (2) content, structure and digital set up, (3) process of therapeutic change and (4) positive feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, the intervention was found to have positive ratings of user experience and therapeutic alliance in both supported and unsupported versions. The qualitative analyses revealed a strong preference for human support. The findings shed light on the complex interactions between digital and human elements of blended treatment delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The trial was pre\u2010registered with the Australia New Zealand Clinical Trials Registry (ACTRN12619000123145p)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/erv.3176","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:08:37Z","timestamp":1739318917000},"page":"751-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["User Experience and Therapeutic Alliance of Treatment Completers of Clinician\u2010Supported Versus Self\u2010Help Online Intervention for Eating Disorders: A Mixed Methods Approach"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3097-8320","authenticated-orcid":false,"given":"Sarah","family":"Barakat","sequence":"first","affiliation":[{"name":"InsideOut Institute for Eating Disorders University of Sydney and Sydney Local Health District Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Rom","sequence":"additional","affiliation":[{"name":"InsideOut Institute for Eating Disorders University of Sydney and Sydney Local Health District Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcellinus","family":"Kim","sequence":"additional","affiliation":[{"name":"Sydney Local Health District Mental Health Services Royal Prince Alfred Hospital Sydney 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