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Individual Oral Paper

Eating Disorders

Along the Treatment Cascade of Eating Disorders

6 - (IOP 34) Acceptability and Feasibility of a Digital Mindfulness-based Intervention for Anorexia Nervosa and Bulimia Nervosa: A Pilot Trial

Sunday, November 23, 2025
11:15 AM - 11:30 AM CST
Location: Celestin G, Level 3
Keywords: Anorexia, Bulimia, Mindfulness
Recommended Readings: Sala, M., Shankar Ram, S., Vanzhula, I. A., & Levinson, C. A. (2020). Mindfulness and eating disorder psychopathology: A meta‐analysis. International Journal of Eating Disorders, 53(6), 834-851.,   Turgon, R., Ruffault, A., Juneau, C., Blatier, C., & Shankland, R. (2019). Eating disorder treatment: a systematic review and meta-analysis of the efficacy of mindfulness-based programs. Mindfulness, 10, 2225-2244.,   Sala, M., Levinson, C. A., Kober, H., & Roos, C. R. (2023). A pilot open trial of a digital mindfulness-based intervention for anorexia nervosa. Behavior Therapy, 54(4), 637-651.,   ,  

    Co-Author(s)

  • MS

    Margaret Sala, Ph.D.

    Assistant Professor
    Ferkauf Graduate School of Psychology
    Riverside, CT, United States

  • HK

    Hedy Kober, Ph.D.

    Professor
    University of California at Berkeley
    Berkeley, CA, United States

  • Cheri A. Levinson, Ph.D.

    Professor of Psychological and Brain Sciences
    University of Louisville
    Louisville, KY, United States

  • CR

    Corey R. Roos, Ph.D.

    Assistant Professor
    Yale University School of Medicine
    Branford, CT, United States

Background and

Objectives: There is a great need for the development of scalable treatments for anorexia nervosa (AN) and bulimia nervosa (BN), as most individuals with AN/BN are currently not able to access treatment. Mindfulness-based interventions (MBIs) may be promising for AN/BN and lend themselves well to digital delivery. We aimed to develop and test the initial acceptability and feasibility of Mindful Courage, a digital MBI for AN/BN.

Method: We evaluated an 8-week version of Mindful Courage including 32 modules (8 core multi-media lessons, 24 brief audio-guided mindfulness practices). Participants also received weekly phone coaching.

Results: Acceptability was demonstrated by relatively high ratings for perceived usability (81.34/100), understandability (4.6/5.0), engage-ability (4.1/5.0), visual appeal (4.1/5.0), helpfulness (4.2/5.0), skills acquisition (4.3/5.0), and confidence applying skills (4.2/5.0). Feasibility was demonstrated by high module completion (an average of 28 of 32 modules). Clinical promise was demonstrated by significant improvements, from baseline to post-intervention, in target mechanisms: mindfulness (d = .72), emotion regulation difficulties (d = .70), and savoring (d = .63). In addition, there were significant reductions, from baseline to post-intervention, in target outcomes: ED symptoms (d = .94), body dissatisfaction (d = .78), anxiety (d = .53), depression (d= .73), and clinical impairment (d = 1.00). Improvements in mechanisms and outcomes were sustained at the two-month post-intervention follow-up.

Conclusion: Mindful Courage is a viable and potentially effective intervention. A future randomized trial is warranted.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Understand the iterative development and user-testing process involved in digital intervention development.