Dr Katherine Wakelin

A higher proportion of children and young people (CYP) with type 1 diabetes (T1D) present with disordered eating compared to CYP without T1D. Due to the complexities of T1D management in addition to eating disorder treatment, it is essential to discuss T1DE with families to screen early and frequently. This enables those most vulnerable to be identified and treated early. The aim of this paper was to (1) identify the barriers for health care professionals (HCPs) communicating with families about T1D and Disordered Eating (T1DE) and (2) identify practical ways to overcome these barriers. This paper discusses qualitative data from interviews with ten parents about how they would like conversations about T1DE to be facilitated by HCPs. All parents had a child aged 11-14 with T1D and were recruited through the PRIORITY trial. Four main barriers to communicating about T1DE were identified. These were: (1) parents fearing that conversation about T1DE will increase the likelihood of T1DE developing, (2) psychology not being integrated into routine care, (3) concerns about sensitive communication around the topic of weight and (4) parents feeling overwhelmed. Practical suggestions for ways HCPs can overcome these barriers are discussed. The paper provides a practical guide for HCPs to help them facilitate conversations about T1DE with families in order to allow earlier detection, prevention and intervention of disordered eating within this population.

Veterinarians report high levels of psychological distress and self-criticism. Evidence suggests that compassion-focused therapy is effective at reducing distress in those with high self-criticism. Therefore, Wakelin et al.’s (2022) feasibility study investigated the feasibility and preliminary effectiveness of a two-week online compassion focused therapy intervention using a sample of 128 veterinarians. The study found the intervention to be acceptable, feasible and show preliminary effectiveness. Following the successful feasibility research, a randomised control trial was delivered to investigate the effectiveness of a modified version of the intervention, relative to a wait-list control, using a sample of 162 veterinarians (Corthorne, 2024). The intervention significantly improved a range of outcomes including resilience, self-reassurance, self-compassion, work-related rumination and self-criticism, relative to the control. These findings were sustained at follow-up and were associated with small-to-medium and medium-to-large effect sizes. Overall, the research provides a strong rationale for developing and delivering compassion-based interventions to veterinarians in the workplace and in training. Therefore, the fourteen videos making up the intervention are freely accessible through the University of Surrey repository for veterinarians wanting to improve their psychological wellbeing. Each video is around 10-15 minutes in length and designed to be watched in order, one a day, over a two-week period. The videos teach psychoeducation and compassion focused skills and imagery exercises. Anonymous data is being collected to monitor the continual use and impact of the course within the veterinary community in a service evaluation. Therefore veterinarians accessing the intervention are asked to complete a short questionnaire before starting the course (pre questionnaire: https://surreyfahs.eu.qualtrics.com/jfe/form/SV_0uE1bmDsvPZ6H30) and upon finishing the course (post questionnaire: https://surreyfahs.eu.qualtrics.com/jfe/form/SV_77XintCeaEIGFQW).

Aims: Children and young people (CYP) with type 1 diabetes (T1D) are at increased risk of disordered eating. This study aimed to determine the feasibility and acceptability of a novel, theoretically informed, two-session psychoeducational intervention for parents to prevent disordered eating in CYP with T1D.Methods: Parents of CYP aged 11-14 years with T1D were randomly allocated to the intervention or wait-list control group. Self-reported measures including the Diabetes Eating Problem Survey-Revised (DEPS-R), Problem Areas in Diabetes Parent Revised (PAID-PR), Child Eating Behaviour Questionnaire subscales (CEBQ), Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), clinical outcomes (e.g. HbA1c, BMI, medication and healthcare utilisation) and process variables, were collected at baseline, 1-and 3-month assessments. Acceptability data were collected from intervention participants via questionnaire.Results: Eighty-nine parents were recruited, which exceeded recruitment targets, with high intervention engagement and acceptability (

Background Veterinarians report high levels of psychological distress and self-criticism. However, there is minimal research investigating psychological interventions for veterinarians. Evidence suggests that compassion-focused therapy is effective at reducing distress in those with high self-criticism. This study aimed to investigate the feasibility and preliminary effectiveness of a 2-week online compassionate imagery intervention for veterinarians. Methods A one-group repeated measures design was used with 128 veterinarians. Participants completed measures of perfectionism, self-criticism, self-reassurance and fears of compassion four times, at 2-week intervals (at baseline, pre-intervention, post-intervention and 2-week follow-up). Participants answered written questions about their intervention experience post-intervention. Results Content analysis of the qualitative data found the intervention to be acceptable and beneficial to participants. Overall, study attrition was 50.8%, which is reasonable for a low-cost intervention. Minimal differences were found between participants who dropped out compared to those who completed the intervention. Perfectionism, work-related rumination and self-criticism were significantly reduced post-intervention, and these effects were maintained at follow-up. Resilience and self-reassurance remained unchanged. Fears of compassion reduced over the baseline period and pre-post intervention, questioning the validity of the measure. Conclusion Overall, in the context COVID-19, the intervention showed impressive feasibility and preliminary effectiveness. Randomised control trials are recommended as the next step for research to establish the intervention's effectiveness.

Self-criticism is the process of negative self-evaluation. High levels are associated with psychopathology and poorer therapeutic outcomes. Self-compassion interventions were developed to explicitly target self-criticism. The aim of this review was to estimate the overall effect of self-compassion-related interventions on self-criticism outcomes and investigate potential moderating variables. A systematic search of the literature identified 20 randomized controlled trials (RCTs) that met the inclusion criteria. Nineteen papers, involving 1350 participants, had sufficient data to be included in the meta-analysis. Pre- and post-data points were extracted for the compassion and control groups. Study quality was assessed using an adapted version of the Cochrane Collaboration's risk of bias tool, which concluded that studies were of moderate quality. Meta-analysis findings indicated that self-compassion-related interventions produce a significant, medium reduction in self-criticism in comparison with control groups (Hedges' g = 0.51, 95% CI [0.33-0.69]). Moderator analysis found greater reductions in self-criticism when self-compassion-related interventions were longer and compared with passive controls rather than active. The remaining moderators of forms of self-criticism, sample type, intervention delivery, intervention setting and risk of bias ratings were insignificant. Overall, the review provides promising evidence of the effectiveness of self-compassion-related interventions for reducing self-criticism. However, results are limited by moderate quality studies with high heterogeneity. Directions for future research indicate that more RCTs with active controls, follow-ups, consistent use and reporting of measures and diverse samples are needed.

Abstract Background There is a high prevalence and complex overlap between type 1 diabetes (T1D) and disordered eating. However, screening for disordered eating in children and young people (CYP) with T1D is not routinely conducted, with reluctance reported by both professionals and parents. This study aimed to validate a parent‐reported version of a validated disordered eating screening tool for CYP with T1D (the Diabetes Eating Problems Survey‐Revised; DEPS‐R). Methods The existing DEPS‐R was adapted for parent use. 89 parents of CYP with T1D aged 11‐14 years completed the parent‐reported DEPS‐R and other questionnaires related to demographics, child eating behaviours and parental wellbeing. CYP of parents were invited to participate with 51 CYP completing the validated CYP‐reported DEPS‐R for comparison. Results The parent‐reported DEPS‐R demonstrated good internal consistency (Cronbach's α = 0.89). Moderate to good inter‐rater reliability was found between the parent‐reported DEPS‐R and CYP‐reported DEPS‐R (ICC 0.746, 95% CI = 0.554‐0.855, p