© 2025 SURF
Presentation at eHealth consultation northern Netherlands, organized by Rob Giel Research Centre (UMCG), held in October 2013.Presentation on obesity issues and use of online Dialectical Behavioral Therapy to launch a research proposal.
DOCUMENT
Which components are essential for developing the online version of the DBT intervention to be an effective equivalent of the existing face-to-face DBT?Presentation, held during the Symposium Emotional Eating, 14th European Congress of Psychology in Milan, Italy, 7-10 July 2015.
DOCUMENT
Which components are essential for developing the online version of the DBT intervention to be an effective equivalent of the existing face-to-face DBT?Presentation, held during the New Year Conference KCO-January 2014.
DOCUMENT
There is a growing number of eHealth interventionsaiming at enhancing lifestyle to address obesity. However, theexisting interventions do not take the emotional aspects ofobesity into account. Forty percent of the overweight populationis an emotional eater. Emotional eaters gain weight because ofpoor emotion regulation, not just due to bad eating habits. Weaim at developing a personalised virtual coach ‘Denk je zèlf!’providing support for self-regulation of emotions for obeseemotional eaters. This paper presents a research study protocolon validating persuasive coaching strategies in emotionregulation, based on Dialectical Behaviour Therapy, ultimatelytargeting behaviour change. Our goal is to design a personalisedeCoaching framework, allowing us to optimally translatesuccessful behaviour change mechanisms and techniques, suchas dialectical strategies, into personalised persuasive coachingstrategies.
LINK
Background. Violent criminal offenders with personality disorders (PD’s) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. Methods. We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. Results. Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*- time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*- time: t(1387) = −2.85, p = 0.005). Conclusions. These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community
DOCUMENT
Obesity has become a major societal problem worldwide [1][2]. The main reason for severe overweight is excessive intake of energy, in relation to the individual needs of a human body. Obesity is associated with poor eating habits and/or a sedentary lifestyle. A significant part of the obese population (40%) belongs to a vulnerable target group of emotional eaters, who overeat due to negative emotions [3]. There is a need for self-management support and personalized coaching to enhance emotional eaters in recognising and self-regulating their emotions.Over the last years, coaching systems have been developed for behavior change support, healthy lifestyle, and physical activity support [4]-[9]. Existing virtual coach applications lack systematic evaluation of coaching strategies and usually function as (tele-)monitoring systems. They are limited to giving general feedback to the user on achieved goals and/or accomplished (online) assignments.Dialectical Behavior Therapy (DBT) focuses on getting more control over one’s ownemotions by reinforcing skills in mindfulness, emotion regulation, and stress tolerance [10]. Emotion regulation is about recognizing and acknowledging emotions and accepting the fact that they come and go. The behavior change strategies within DBT are based on validation and dialectics [11]. Dialectics changes the users’ attitude and behavior by creating incongruence between an attitude and behavior since stimuli or the given information contradict with each other.The ultimate goal of the virtual coach is to raise awareness of emotional eaters on their own emotions, and to enhance a positive change of attitude towards accepting the negative emotions they experience. This should result in a decrease of overeating and giving in to binges. We believe that the integration of the dialectical behavior change strategies and persuasive features from the Persuasive System Design Model by Kukkonen and Harjumaa [12] will enhance the personalization of the virtual coach for this vulnerable group. We aim at developing a personalized virtual coach ‘Denk je zèlf!’ (Dutch for ‘Develop a wise mind and counsel yourself’) providing support for self-regulation of emotions for young obese emotional eaters. This poster presents an eCoaching model and a research study protocol aiming at the validation of persuasive coaching strategies based on behavior change techniques using dialectical strategies. Based on the context (e.g., location), emotional state of the user, and natural language processing, the virtual coach application enables tailoring of the real-time feedback to the individual user. Virtual coach application communicates with the user over a chat timeline and provides personal feedback.The research protocol decribes the two weeks field study on validating persuasive coaching strategies for emotional eaters. Participants (N=30), recruited via a Dutch franchise organization of dietitian nutritionists, specialized in treating emotional eating behaviors, will voluntarily participate in this research study. Participants will be presented with short dialogues (existing questions and answers) and will be asked to select the preferred coaching strategy (validating or a dialectical), according to their (current) emotions. To trigger a certain emotion (e.g., the affect that fits best with the chosen coaching strategy), a set of pictures will be shown to the user that evoke respectively sadness, anger, fear, and disgust [13].Participants will be asked to fill out the demographics data ((nick) name, age, gender, weight, length, place of residence) and three questionnaires: • Dutch Eating Behavior Questionnaire (DEBQ) [14],• Five Factor Personality Inventory (FFPI) [15], • Quality of Life Index Questionnaire [16].This research study aims at answering the following research questions: “Which coaching strategies do users with a specific type of emotional eating behavior benefit most from while consulting their personalized virtual coach?; “Which coaching strategies are optimal for which emotions?” and “Which coaching approach do users prefer in which context, e.g. time of the day, before/after a craving?”
LINK
Background: Around 13% of the world’s population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to moreeffective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one – the latter being a synthesis of the first two strategies. Methods: A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies. Participants: 71 adult women (Mage 44.4/years, range 19–70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69–4.92, SD = .69) with mean BMI 30.1 (range 18–46, SD = 6.53). They were recruited via dieticians’ practices, were randomly assigned to the conditions and asked how they would face and react to thepresented coaching strategies. Data were transcribed and a thematic analysis was conducted. Results: Qualitative results showed that participants valued both the validating coaching strategy and the focus-onchange strategy, but indicated that a combination of validation and focus-on-change provides both mental supportand practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills. Conclusion: The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.
DOCUMENT
Het pakket bestaat uit twee delen: Deel A: Het achtergronddocument: hierin worden u allerlei theoretische en procedurele gegevens aangereikt die van belang zijn om goed met het interventiepakket te kunnen werken. Deel B: Het werkboek: dit werkboek biedt u praktische ondersteuning om in samenwerking met de patiënt effectief met het zelfverwondende gedrag om te gaan. Het werkboek kan als WORD-document digitaal worden opgeslagen. Denkt u hierbij vanzelfsprekend aan de privacybescherming van de patiënt. Bij het werkboek behoren een aantal bijlagen.
MULTIFILE
Obesity is a fast growing societal threat, causing chronic conditions, physical and psychological health problems, as well as absenteeism and large healthcare costs. Despite numerous attempts to promote physical activity and healthy diet, existing interventions do not focus on often occurring emotional causes of obesity. There is a need for self-management support of this vulnerable target group: emotional eaters. This paper presents the results of the design case study focusing on a holistic development of a personalised virtual mHealth coach that provides self-management training ‘Denk je zèlf!’ (Dutch for ‘Develop a wise mind and counsel yourself’). Target group are young adults with emotional eating disorder and obesity. The contextual inquiry study was conducted to get insights into the needs and experiences of the target users, including interviews and questionnaires with emotional eaters, obesity treatment patients and healthcare practitioners. Personas and user stories were derived from these results and translated into a new ‘Denk je zèlf!’ virtual coach, based on Dialectical Behaviour Therapy and experience sampling measures to capture user experience and emotional state. This paper makes two main contributions: (a) combining holistic design with behaviour therapy in one virtual mHealth coaching application for emotional eaters; (b) applying Personas to guide the design. Preliminary results suggest that an online self-management training might be useful for the target group. Future research will be aimed at iterative evaluation and further development of the dialectical dialogues for the virtual coach and content for the education and instruction modules.
DOCUMENT
