Interventions of eating disorders encompassing an emotion focus

: an updated systematic review of interventions taking an emotion focus in the treatment of anorexia nervosa and a narrative inquiry of people's stories of an emotion focused therapy group for eating disorders delivered in University Student Wellbeing Services

Abstract

Section A
This systematic review was pre-registered on Prospero (CRD420251174552) and
aimed to evaluate the efficacy of interventions for anorexia nervosa (AN) that integrate emotion, updating a review from 2016. A systematic search was completed across PsycINFO, Web of Science, and PubMed databases in December 2025 returning 887 papers. Fifteen studies met inclusion criteria of evaluating efficacy of interventions for AN encompassing emotion, representing 935 participants. The methodological quality of studies was assessed using the Mixed Methods Appraisal Tool (MMAT, Hong et al., 2018). Seventy-three percent
of studies met ≥80% of criteria, indicating high methodological quality. A narrative synthesis was used to review findings. Three intervention types (cognitive-behavioural, experiential, and psychoeducational) and seven emotional processing subtypes were identified. Effect data were compared between and within intervention groups and subgroups. One study was excluded from the effects synthesis due to high risk of bias. Positive effects were identified
for measures of eating disorder psychopathology and mental health outcomes across eight interventions, indicating that interventions improved outcomes. Interventions producing the largest positive effects targeted multiple emotional processing subtypes. Preliminary efficacy of interventions for AN integrating emotion is suggested. Research exploring the acceptability of interventions for AN integrating emotion is recommended.

Section B
Background: University students are at risk of eating disorders (EDs); however, university Student Wellbeing Services (SWS) offer limited ED interventions.
Aims: This study aimed to explore stories of students and facilitators who attended Emotion Focused Therapy groups (EFT-G) for EDs delivered in university SWS.
Methods: Four university students and four group facilitators took part in narrative style interviews. Narrative analysis was used to analyse the content, structure, and social context of interviews and four research questions were answered.
Results: Accessing support through a SWS was an alternative route to ED treatment that students experienced as validating and necessary. The EFT-G offered a new experience of therapy; taking an emotion-focused approach facilitated a deeper resolution to eating difficulties. Students reflected on gaining an understanding of their emotions and needs and developing their confidence in expressing these. The group format allowed for enhanced emotional processing among students and a sense of universality that challenged experiences of isolation and shame that may drive eating difficulties.
Conclusions: The benefit of taking an emotion-focused approach to working with young people with EDs, in a group format and in a university SWS setting is asserted. Clinical and research implications are raised.

Date of Award	2026
Original language	English
Awarding Institution	Canterbury Christ Church University