Sarah L. Hersey is a 2014 graduate of the PsyD Program in Clinical Psychology at Antioch University, New England.


anorexia nervosa, recovery, websites, online forums, discussion boards, thematic analysis

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Anorexia Nervosa (AN) is a mental illness with serious physical, psychological, interpersonal, social, and economic consequences. AN is difficult to treat, with affected individuals experiencing symptoms after treatment completion. Recovery-oriented AN discussion boards are online forums on which individuals with AN can communicate with the goal of promoting their recovery. Using inclusion criteria, the author selected Mirasol, Something Fishy, Anorexia Nervosa and Associated Disorders (ANAD), and PsychForums. The research questions asked were: (a) What are the themes of recovery-oriented AN Internet discussion boards? (b) What types of support can be found on the boards? (c) How frequently are potentially 'triggering' materials posted on websites? and (d) What are the responses of site moderators to potentially triggering materials posted on the websites? Through the qualitative method of thematic analysis, themes and subthemes emerged from the exchanges among website users. The 10 themes were: Symptom Severity and Eating Disorder Thoughts; Advice and Suggestions; Forum Support; Unpleasant Emotions; Recovery, Improvement, and Motivation; Treatment; Requests; Interpersonal Issues; Insights; and Benefits of the Website and Gratitude. Other themes of support included Challenges/Confrontations and Information. Something Fishy and ANAD contained high levels of support and relatively few potentially triggering statements. Mirasol and PsychForums indicated high frequencies of potentially triggering posts. The presence of forum moderators did not substantially influence the frequency with which triggering material was posted. The interpretation of the themes and subthemes indicated that clients in treatment for AN may benefit from participating in select websites by becoming more motivated in treatment and maintaining treatment gains between sessions. Careful selection of websites, with the guidance of therapists, could help AN individuals reduce their reliance on defense mechanisms, provide a facilitative environment of peers, generate some of the therapeutic factors of group therapy, and challenge the distorted thinking of availability heuristics. Limitations included absence of diagnostic homogeneity among participants; a small time-limited sample of comments; and lack of representation of individuals who do not have Internet access, such as, those who are rural, poor, uneducated, and some racial and ethnic minorities. Future research could address client utilization of recovery-oriented websites as an adjunct to effective psychotherapy treatment.