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Acceptability and feasibility of a gamified digital eating disorder early-intervention program (AcceptME) based on Acceptance and Commitment Therapy (ACT) (Pages 26-34)

Journal of Contextual Behavioral Science (JCBS)

Volume 25, July 2022, Pages 26-34


Patrisia Nicolaou, Rhonda M. Merwin, Maria Karekla



Digital early-intervention programs for a variety of psychological conditions, including eating disorders (EDs) are increasing. Yet, none to date have leveraged gamification and vicarious learning components grounded in empirically-supported therapeutic approaches to engage young people at risk for developing EDs in behaviour change.


The current paper describes the development and preliminary acceptability and feasibility testing of AcceptME, a novel self-directed, gamified digital ED early-intervention program based on Acceptance and Commitment Therapy (ACT). AcceptME helps women and girls identified at risk for an ED relate differently to their thoughts and feelings, such that these experiences do not have undue influence over their behaviour and actions can instead be guided by personal values.


Users learned skills of psychological flexibility by helping a third-person avatar (a main character in a storyline) navigate situations that elicit distressing thoughts/feelings, and via interactive exercises, practiced applying these skills to their own experiences. Young women and girls in the Republic of Cyprus with high weight concern scores (N = 58, Mage = 15.27, SD = 2.25) completed six 30-min digital sessions and reported on session and intervention acceptability.


Attrition was 46.55%. Of those who completed treatment, the majority of participants were either “Very” (40%) or “Mostly” (57%) Satisfied with the program. Fifty-two percent reported that the program “Helped a lot,” and 48% said it “Helped a bit.” Conclusion: Digital technology and gamification have advantages for engagement and delivery. The current study suggests a promising direction for early ED interventions to reach at risk youth and preliminary data to guide development.

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