Enhancing Integrative Cognitive-Affective Therapy with ecological momentary interventions: A pilot trial

Adrienne S. Juarascio, Rowan A. Hunt, Elin Lantz Lesser, Scott G. Engel, Emily M. Pisetsky, Carol B. Peterson, Stephen A. Wonderlich

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: Although current treatments are effective for some patients with eating disorders, a large number of patients remain partially or fully symptomatic post-treatment. This may be related to poor utilization of treatment skills outside of the therapy office. Smartphone applications that can detect and intervene during moments of need could facilitate such skill use between sessions. Method: Individuals (N = 16) participated in a small pilot open trial where they received 21 sessions of in-person Integrative Cognitive-Affective Therapy (ICAT) therapy an app (iCAT+) that delivers ecological momentary interventions (EMI) in response to user-entered data. Data were collected on the feasibility and acceptability of this treatment approach and on preliminary indicators of treatment outcomes. Results: Participants found iCAT+ as a treatment augmentation acceptable and indicated it had clinical utility as an adjunct to in-person therapy, although analyses indicated poor compliance with data entry needed to trigger EMI delivery. This suggests that long-term use of EMI requiring ongoing data entry is infeasible. Conclusions: We describe lessons learned from our initial pilot trial and future directions for the development of impactful EMI systems that can be used to augment in-person therapies.

Original languageEnglish (US)
Pages (from-to)152-158
Number of pages7
JournalEuropean Eating Disorders Review
Issue number1
StatePublished - Jan 2021

Bibliographical note

Funding Information:
Funding for this study was awarded to Adrienne S. Juarascio by the National Eating Disorders Association Feeding Hope Grant.

Publisher Copyright:
© 2020 Eating Disorders Association and John Wiley & Sons Ltd.

Copyright 2021 Elsevier B.V., All rights reserved.


  • binge eating disorder
  • bulimia nervosa
  • technology
  • treatment


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