Supporting Individuals on Eating Disorder Waitlists Through App-Based Motivational Interviewing - A Qualitative Evaluation of a Program-Led Pilot Intervention

Sep 29, 2026

Individuals with eating disorders often endure prolonged wait times before formal treatment, intensifying distress and weakening recovery motivation. Few structured options exist to help during the pretreatment period. This qualitative study evaluates MI-Coach: ED, a structured, program-led mobile app grounded in motivational interviewing, designed to support people while waitlisted. Semi-structured interviews assess feasibility, acceptability, and perceived utility across interest-holder groups.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Background on treatment delays and motivation

Methods

Semi-structured interviews and analysis approach

Results

Feasibility, acceptability, and perceived clinical utility

Discussion

Implications for refinement and future trials

Public Significance Statement

International Journal of Eating Disorders ORIGINAL ARTICLE OPEN ACCESS Supporting Individuals on Eating Disorder Waitlists Through App-Based Motivational Interviewing: A Qualitative Evaluation of a Program-Led Pilot Intervention Amané Halicki-Asakawa | Jill Gerlof | Emily Mayzes-Kotulla | Maya Libben Department of Psychology, UBC Okanagan Campus, Kelowna, British Columbia, Canada Correspondence: Maya Libben ([maya.libben@ubc.ca](maya.libben@ubc.ca)) Received: 30 July 2025 | Revised: 9 September 2025 | Accepted: 17 September 2025 Action Editor: Tracey Wade Funding: Amané Halicki-Asakawa was supported by a Canada Graduate Scholarships–Masters award from the Canadian Institute for Health Research (CIHR) . Keywords: digital mental health | eating disorders | interest-holder feedback | motivational interviewing | program-led intervention | qualitative research | waitlist intervention ABSTRACT Objective: Individuals with eating disorders (EDs) often face long wait times before receiving formal treatment, which can exacerbate distress and undermine motivation for recovery. Despite this risk, few structured interventions are available to support individuals during the pretreatment period. This qualitative study examined the feasibility, acceptability, and perceived utility of motivational interviewing (MI)-Coach: ED, a structured and focused program-led mobile app intervention grounded in MI, designed to support individuals with EDs while waitlisted for treatment. Methods: Semi-structured interviews were conducted with two interest-holder groups: individuals with lived ED experience (n = 14) who completed a 4-week pilot study and clinicians (n = 5) in ED treatment settings. Data were analyzed using framework analysis to integrate themes across groups. Results: Both groups described MI-Coach: ED as accessible, flexible, and relevant to recovery. Preliminary indications of clinical benefit in the lived-experience group were observed, including clarity surrounding reasons for change, more manageable near-term goals, and renewed motivation. Clinicians described similar motivational benefits for clients facing lengthy treatment delays. Both groups emphasized the importance of a supportive digital relationship and suggested accessibility improvements. Discussion: Findings support the feasibility and acceptability of MI-Coach: ED as a program-led digital tool for individuals awaiting ED treatment. The framework approach integrated cross-group themes and informed ongoing refinements to strengthen emotional safety, accessibility, and equitable use and will guide a future randomized controlled trial evaluating clinical impact and implementation. Public Significance Statement: People with eating disorders often wait a long time for treatment, leaving them feeling isolated and unmotivated. This study conducted interviews with people with eating disorders and clinicians to explore the value of MICoach: ED, a guided mobile app designed to support people during this waiting period. Feedback from both groups showed that the app was helpful, and suggestions are now shaping future improvements and research. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2025 The Author(s). International Journal of Eating Disorders published by Wiley Periodicals LLC. International Journal of Eating Disorders, 2026; 59:111–121 111 [https://doi.org/10.1002/eat.24561](https://doi.org/10.1002/eat.24561) 1 | Introduction Eating disorders (EDs) involve a complex treatment-seeking process marked by emotional, interpersonal, and motivational challenges (Lubieniecki et al. 2024; Treasure et al. 2024) . Delays between symptom onset and treatment often span years (Austin et al. 2021), and individuals

FAQs

What problem does MI-Coach: ED target?

It targets the long wait times individuals with eating disorders face before receiving formal treatment, aiming to support motivation and coping during the pretreatment period.

How was the pilot evaluated in the study?

Researchers conducted semi-structured interviews with two interest-holder groups, including individuals with lived experience and clinicians, and analyzed data using framework analysis to integrate themes across groups.

What benefits were reported by participants?

Both interest-holder groups described the app as accessible, flexible, and relevant to recovery, with preliminary indications such as clearer reasons for change, more manageable near-term goals, and renewed motivation.

Sep 29, 2026

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