Table 17 Cognitive-behavioural programs (without discussion groups) for children and adolescents (< 18 years)

Karekla et al. [78]

RCT

High school and university female students showing signs and symptoms of an ED and at high-risk for an ED (> 52 score on WCS)

n = 62 AcceptME intervention

n = 30 waitlist control

AcceptME: digital gamified Acceptance and Commitment Therapy (ACT; based in CBT that targets ineffective internal control strategies and inflexibility) early-intervention program consisting of 6 sessions (30 min each). AcceptME portrayed the story of a young girl contemplating whether to enter a reality television fashion contest. Participants followed the main character through making the decision and faced situations eliciting common challenging situations, thoughts, and emotions related to body image. Participants completed exercises in the program aiming to teach and apply ACT skills (e.g., acceptance, present moment awareness, values-consistent living)

WCS, EDDS, EDE-Q, YQOL-SF, BSQ-8C, BI-AAQ, BIAQ

Users of AcceptME had significantly lower EDE-Q weight and shape concerns at end-of-intervention vs. waitlist controls, with large effects; effects appeared to be maintained at 1-month follow-up. Most participants scored below the at-risk cut-off (WCS score < 52) in the AcceptME group at end-of-intervention (57.1%) vs. controls (7.1%), with odds of falling into the at-risk group being 14.5 times higher for controls. At 1-month follow-up, 72% of completers reported scores below the at-risk cut-off in AcceptME. The main effect of time was statistically significant for BSQ-8C (body dissatisfaction) and BI-AAQ and BIAQ (body image) between baseline, end-of-intervention, and/or 1-month follow-up scores. There was no significant time effect for quality of life