Body Project and Healthy Weight programme

Domain II · Behavioural & cognitive · Eric Stice, Katherine Presnell, Heather Shaw

What it is

The Body Project (also called the dissonance intervention) is a brief, scripted, group-based selective prevention programme developed by Eric Stice, Katherine Presnell, Heather Shaw, Paul Rohde and colleagues for adolescent girls and young women (roughly 14 to 24) who have body image concerns but…

Format

• Format. Closed group of about 5 to 10 participants (NEDA script recommends about 6 to 8), led by one or two facilitators working from a script. Standard delivery is four weekly 1-hour sessions; alternatives are two 2-hour sessions, or six 45- to 50-minute sessions when groups run over time. Needs a…
• Original vs enhanced: since about 2011 the "enhanced" version stresses voluntary participation (reminders each session; homework described as not required), accountability (participants sign homework; sessions video-recorded) and effort (harder homework, two role-plays each).

Who practises it, and how they are trained or regulated

• Clinician-led: facilitators with graduate mental health training; less-trained staff (teachers, students) should deliver only under supervision of a qualified professional.
• Training and fidelity. Clinician training is a 4-hour workshop; a 6-hour implementation workshop is recommended for peer educators; an 8-hour train-the-trainer option exists. Training covers group leadership, talkative and quiet members, reluctance to discuss costs, maximising homework and attendance, make-up sessions and responding to eating disorder disclosures. Fidelity checklists and competence ratings are…

Evidence status, as the guide reports it

• Version followed: the 4-session Body Project script as distributed by the National Eating Disorders Association (NEDA, peer-leader edition, dated Nov 2016, which uses the term "appearance ideal"), cross-checked against the clinician-led "enhanced dissonance" version described by Stice, Butryn,…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Repeated absences (see Section 5).
• Patterns of non-completion (Section 5).
• Leader summarising instead of participants.
• Grief or regret surfacing; validate briefly.
• Pressure on unwilling participants; keep it optional.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.