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Completed

NCT Number: NCT06849830

Incorporating Narrative Into the Treatment of Youth With Anorexia Nervosa

The goal of this clinical trial is to evaluate whether a narrative medicine (NM) curriculum can enhance self-expression, reflection, and resilience in adolescents and young adults with anorexia nervosa.

The main questions it aims to answer are:

* Does participation in an NM curriculum improve self-expression and reflection in individuals with anorexia nervosa? * Does engaging in creative writing and group discussion promote resilience and emotional processing in this population?

Participants will be 16-25 years old, medically stable for outpatient eating disorder therapy, and actively engaged in treatment. Those with active suicidal ideation, recent non-suicidal self-injury, or a co-occurring personality disorder will not be eligible.

Participants will:

* Attend six weekly workshops (April-May 2025) focused on themes such as self-definition, kindness, resilience, and possibility * Engage in close reading of visual or written texts * Complete creative writing exercises in response to prompts * Participate in group discussions and sharing

An optional capstone reading event will provide a supportive space for participants to share their work with peers, loved ones, and providers, fostering connection and community.

This study aims to explore the role of narrative medicine in eating disorder treatment and assess its potential benefits for psychological well-being and self-expression.

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Key information

Conditions

Anorexia Nervosa Feeding and Eating Disorders Mental Disorders

Age range

16 year–25 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

UCSF Nancy Friend Pritzker Psychiatry Building

San Francisco, California, 94158, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 16-25 years old
  • have a DSM-5 diagnosis of AN (confirmed by the UCSF Eating Disorders Program clinical team),
  • currently engaged in outpatient eating disorder treatment, ensuring medical stability and capacity for a group-based intervention
  • English fluency to engage in reflective writing and discussions
  • Cognitive ability to meaningfully participate in narrative-based exercises

Exclusion criteria

  • Currently medically unstable or require inpatient hospitalization
  • History of psychosis, schizophrenia spectrum disorder, bipolar disorder, or personality disorder
  • Severe neurocognitive impairment that would prevent engagement with the intervention
  • Active suicidal ideation or non-suicidal self-injury within the past two months
  • Insufficient English proficiency to participate in group discussions and writing exercises

Treatment and study plan

Narrative Medicine (NM) Workshop Series

Behavioral

The Narrative Medicine (NM) Workshop Series is a structured six-week behavioral intervention designed to enhance self-expression, reflection, and resilience in adolescents and young adults recovering from eating disorders. This intervention differs from traditional psychotherapeutic or psychoeducational approaches by integrating literary analysis, creative writing, and guided discussion as therapeutic tools.

Each one-hour weekly workshop includes:

  • Close reading of visual or written texts related to themes such as self-definition, resilience, kindness, and possibility
  • Creative writing exercises in response to structured prompts that encourage self-reflection and personal storytelling
  • Facilitated group discussions to foster connection, self-expression, and emotional processing in a supportive environment

Primary outcomes

  1. Number of participants in each session

    Time frame: Immediately post-intervention (Week 6)

    Feasibility will be measured by participant retention in intervention.

  2. Satisfaction with intervention components using 5-point Likert scales and semi-structured individual interviews

    Time frame: Immediately post-intervention (Week 6)

    Acceptability will be measured by questionnaire including 5-point Likert scales and semi-structured individual interviews assessing content relevance, writing prompts, group discussions, and facilitation.

    Scale title: Intervention Satisfaction Questionnaire (ISQ) Minimum value: 1 (Strongly Disagree) Maximum value: 5 (Strongly Agree) Interpretation: Higher scores indicate greater satisfaction with the intervention (better outcome).

Secondary outcomes

  1. Identity Clarity

    Time frame: Pre- (Week 0) and immediately post-intervention (Week 6)

    Assessed using the Erikson Psychosocial Stage Inventory - Identity Subscale (EPS-Identity), which evaluates self-concept clarity and personal identity coherence.

    Scale title: Erikson Psychosocial Stage Inventory - Identity Subscale (EPS-Identity) Minimum value: 1 (Strongly Disagree) Maximum value: 5 (Strongly Agree) Interpretation: Higher scores indicate stronger identity development and consolidation (better outcome).

  2. Social Connectedness

    Time frame: Pre- (Week 0) and immediately post-intervention (Week 6)

    Measured using the Social Connectedness Scale (SCS), which assesses perceived closeness to others and sense of belonging.

    Scale title: Social Connectedness Scale (SCS) Minimum value: 1 (Strongly Disagree) Maximum value: 6 (Strongly Agree) Interpretation: Higher scores indicate greater feelings of social connectedness and belonging (better outcome).

  3. Depression Symptoms

    Time frame: Pre- (Week 0) and immediately post-intervention (Week 6)

    Measured using the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms.

    Scale title: Patient Health Questionnaire-9 (PHQ-9) Minimum value: 0 (Not at all) Maximum value: 3 (Nearly every day) Interpretation: Higher scores indicate greater severity of depressive symptoms (worse outcome).

  4. Anxiety Symptoms

    Time frame: Pre- (Week 0) and immediately post-intervention (Week 6)

    Measured using the Generalized Anxiety Disorder-7 (GAD-7) for anxiety.

    Scale title: Generalized Anxiety Disorder 7-item (GAD-7) Scale Minimum value: 0 (Not at all) Maximum value: 3 (Nearly every day) Interpretation: Higher scores indicate greater severity of anxiety symptoms (worse outcome).

  5. Eating Disorder Severity

    Time frame: Pre- (Week 0) and immediately post-intervention (Week 6)

    Measured using the Eating Disorder Examination Questionnaire (EDE-Q), which captures cognitive and behavioral symptoms of AN, and percent of expected body weight (EBW) at follow-up.

    Scale title: Eating Disorder Examination Questionnaire (EDE-Q) Minimum value: 0 (No days / Not at all) Maximum value: 6 (Every day / Extremely) Interpretation: Higher scores indicate greater severity of eating disorder psychopathology (worse outcome).

Sponsors and collaborators

Lead sponsor

University of California, San Francisco

Other

Registry information

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Feb 27, 2025
Registry last updated
Jul 4, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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