|dc.description.abstract||Numerous studies have reported psychological benefits associated with the practice of values-based selfaffirmation.
However, there is little evidence regarding their clinical applicability. Many of the
purported benefits of values-based self-affirmation are highly relevant to people with bulimia nervosa
(BN). This study used a multiple case study design in order to investigate the effectiveness, underlying
mechanisms and acceptability of a brief (three week) intervention focussing on the development and
practice of values-based self-affirmations with people who have BN. Two participants were recruited
from an Eating Disorders (ED) Service waiting list. They completed questionnaires measuring cognitions
associated with ED, attitude towards change, self-esteem, self-compassion, body image acceptance,
psychological flexibility, cognitive defusion, and SELF repertory grids over four time points. Following
appointments qualitative data was collected, and on completion of the intervention participants were
interviewed, regarding their experiences. Pre and post intervention behavioural measures of BN were
also collected. The use of a personal values-based self-affirmation intervention was associated with
reductions in behaviours associated with BN, enhanced attitude towards change and reduced discrepancy
between self and ideal self. There was little convincing evidence that the intervention was associated
with a reduction in cognitions associated with ED. A very small degree of change in a positive direction
was observed in relation to self-esteem, self-compassion, body image acceptance, psychological
flexibility and cognitive fusion. However, scores did not reflect Reliable Change in these processes.
Overall, results appeared to be slightly better explained by theory underpinning Personal Construct
Psychotherapy rather than Acceptance and Commitment Therapy. However, neither theoretical
explanation fully accounted for the data. Participants generally found the intervention to be acceptable.
The results add novel findings to the literature regarding the use of values-based self-affirmation within
the treatment of BN. They suggest that a brief values-based self-affirmation intervention might be a
useful adjunct to evidence based treatment of BN. However, the case study design that is utilised in this
study limits the degree to which these results may be generalised and future research should explore this