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 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.
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
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
Single group
Narrative Medicine (NM) Workshop Series
BehavioralThe 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
Number of participants in each session
Feasibility will be measured by participant retention in intervention.
Satisfaction with intervention components using 5-point Likert scales and semi-structured individual interviews
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).
Illness-Identity Centrality
Assessed using the Illness Identity Questionnaire, which evaluates self-concept clarity and personal identity coherence. Scale title: Illness Identity Questionnaire (IIQ) Minimum value: 1 (Strongly Disagree) Maximum value: 5 (Strongly Agree) Interpretation: Subscale scores reflect distinct illness identity states; higher scores indicate greater endorsement of that identity orientation
Social Connectedness
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).
Depression Symptoms
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).
Anxiety Symptoms
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).
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