E-mail as a therapeutic adjunct in the outpatient treatment of anorexia nervosa: Illustrative case material and discussion of the issues

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Abstract
Objective To explore using adjunctive e‐mail in treating anorexia nervosa. Method Four treatment plans were supplemented by obligatory e‐mail emphasizing patients' reports of specific eating‐related behaviors. Office visits occurred weekly to once every few months. E‐mail contact occurred once to several times per week. Patients also saw other providers. Results All patients have shown good clinical improvement. Patients provided their assessments of contributions made by the use of e‐mail and generally found it to be helpful. Discussion E‐mail has had excellent patient acceptability and adherence. Benefits have been attributed to increased therapeutic contact, “talking” on demand, and having to frequently confront one's integrity, honesty, and eating behaviors. Little clinician time is needed for reading and responding to e‐mails. Informed consent and confidentiality issues must be carefully addressed. Controlled trials are warranted to further evaluate the roles that adjunctive e‐mail may play in clinical research and practice. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 29: 125–138, 2001.

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