Brief and Early Interventions

A single session intervention is a structured, goal-oriented program intentionally designed to deliver meaningful clinical benefit in one encounter with a practitioner, program, or digital platform. The core philosophy is that any session might be someone's last and that any session can yield real benefit if properly designed.

In the eating disorders field, SSIs have been most studied as waitlist interventions, offered to people recently referred to an eating disorder service while they wait to commence formal treatment. The foundational Australian research by Fursland and Byrne at the Centre for Clinical Interventions (CCI) in Perth demonstrated that a 75–90 minute psychoeducational SSI based on CBT-E principles delivered a median of 16 days after referral reduced waiting times, increased the likelihood of patients entering treatment, and facilitated early reductions in eating disorder symptoms across a sequential cohort of 448 referrals.

SSIs are also being explored as stand-alone digital interventions for sub-threshold presentations and for carers and families of people with eating disorders. The evidence base for eating disorder SSIs is emerging and promising, though further rigorous research is needed.

Examples of SSI in Australia

Clinic/Telehealth: Psychoeducation SSI (Fursland & Byrne)

A 75–90 minute face-to-face or telehealth session based on CBT-E principles. Covers eating disorder assessment, psychoeducation (including starvation syndrome), collaborative formulation of maintaining factors, and written summary. Designed for people who have been referred to a specialist service and are waiting to commence treatment. Has demonstrated reductions in ED symptoms, psychosocial impairment, and depression from SSI completion to first treatment session.

Developing skills in single session: The Bouverie Centre

The Bouverie Centre team provide training opportunities in Single Session Thinking and exploration of ideas for embedding SST into practice. You can reach out to their team for further information on upcoming events. Information here.

Peer led: Eating Disorders Victoria Hub SSI

EDV's Hub offers brief structured conversations with trained peer support workers and carer coaches that incorporate core SSI principles: assessment of need, psychoeducation, practical guidance, and supported navigation to appropriate services. Free for Victorians.

Public mental health: ACT Eating Disorders Hub

Most people referred to the ACT Eating Disorders Hub first receive a SSI. This supports more accurate triage and helps people to connect in with the service that is most appropriate to their needs.

AI: ED ESSI Chatbot

A chatbot-delivered SSI (ED ESSI) for people aged 16+ on waitlists for eating disorder treatment, developed and tested by Australian researchers. Delivered via a rule-based conversational agent, it incorporates CBT-E psychoeducation including starvation syndrome and maintaining factors. A 2025 RCT (n=60) found promising results for reducing eating disorder pathology and psychosocial impairment. Not yet in routine clinical use; represents the frontier of scalable digital SSI delivery.

Private practice: Eat Love Live SSI for Parents and Carers

In-clinic or telehealth consultation for carers and families with ELL's Family Therapist, Bliss Jackman. Each session is designed to be about what is happening right now, with the family able to explore the current challenges and practical steps to supporting their loved one. Find out more here.

Private practice: BodyMatters SSI for Parents and Carers

A 90-minute session (in-clinic or telehealth) with a psychologist, available to parents and carers of someone with an eating disorder who are on a waitlist for family-based treatment. Covers current symptoms, barriers to change, family dynamics, psychoeducation, recommendations for refeeding support, and containment strategies while awaiting treatment. Not available as a standalone — specifically for those on BodyMatters' FBT waitlist.

Smartphone App: NourishED Mind: Flinders University

NourishED Mind contains nine different single session interventions (SSI) placed on a smartphone application. Each SSI is designed to be brief, between 20 to 40 minutes on one occasion, and designed to decrease disordered eating, depression and anxiety in young people aged 14 to 25 years. Each SSI will contain a ‘Learn’ section with psychoeducation and a ‘Do’ section containing interactive activities. NourishED is being evaluated via an NHMRC Investigator Grant. Find out more here.

Have other suggestions for where SSI is being embedded in services? Please let our team know at nationalstrategy@nedc.com.au 

Guided self-help (CBT-GSH) is a lower-intensity, manualised approach in which a person works through a structured CBT-based self-help program, with brief support from a practitioner over approximately 6–8 sessions. Self-help can also be used independently without professional guidance.

CBT-GSH is recommended as a first-line intervention by NICE (UK) guidelines for Bulimia Nervosa and Binge Eating Disorder in adults, and is increasingly recommended in Australian guidelines including the ANZAED Practice Standards and ANZAED Credentialing system. Evidence supports moderate-sized reductions in core behavioural and cognitive symptoms, particularly for bulimia nervosa, binge eating disorder, and OSFED. It is appropriate for mild-to-moderate presentations and can be offered in primary care, community mental health, and digital settings. 

Examples of CBT-GSH

Guided self-help booklet: Break Free from ED (CCI)

Developed by the Centre for Clinical Interventions (CCI),this transdiagnostic CBT-ED self-help workbook can be used independently or guided by a clinician. It covers regular eating, self-monitoring, tackling restriction, binge eating and purging, behavioural experiments, and body image. Freely available via the CCI website. 

Self-help guide: Break Binge Eating

A self-help e-book, outlining 5 steps to support people to overcome binge eating based on the principles, techniques and assumptions of cognitive-behavioural therapy.

Access here.

Digital Guided Self-Help: IOI eClinic Brief BEeT

The InsideOut Institute's eClinic platform provides immediate access to evidence-based digital interventions including Brief BEeT which is a 4-session online CBT-based guided self-help therapy for bulimia nervosa, binge eating disorder, and sub-threshold presentations, with 4 supporting clinician sessions. Available for people 16+. Piloted with headspace and Head to Health nationally; demonstrated high feasibility and significant reductions in eating disorder psychopathology. Has a Health Professional Portal for clinician-guided support.

CBT-GSH Manuals

Practitioners and people seeking treatment can access the following CBT-GSH manuals:

• Overcoming Bulimia Nervosa and Binge-Eating: A self-help practical manual by Peter Cooper
• Overcoming Binge Eating by Christopher Fairburn

CBT-GSH factsheet

Further information on this treatment approach can be found on NEDC's Cognitive Behavioural Therapy Guided Self Help (CBT-GSH) factsheet.

Ten-session Cognitive Behavioural Therapy for Eating Disorders (CBT-T), developed by Waller, Turner, Tatham, Mountford, and Wade, is a transdiagnostic, manualised outpatient therapy for people with a non-underweight eating disorder (BMI above 17.5). It incorporates all key elements of full CBT-E, including in-session weighing, psychoeducation, regular eating, exposure, behavioural experiments, cognitive restructuring, body image work, and relapse prevention, in a structured 10-session format.

A key feature is that CBT-T is designed to be delivered by novice therapists under supervision (including trainee psychologists), enabling deployment in primary care and community settings. Australian research (Pellizzer, Waller & Wade, 2019) has demonstrated outcomes comparable to 20-session CBT-E delivered by experienced therapists. This makes CBT-T a particularly important model for services seeking to expand capacity without requiring a large specialist workforce.

The treatment manual (Waller, Turner, Tatham, Mountford, Wade, 2019) is commercially available.

Training in CBT-T

CBT-T is an approved training under the ANZAED Eating Disorder Credential. Details of approved training providers can be found here.

CBT-T in Primary Care

A 2024 Australian feasibility study (Hart, Hirneth et al. 2024) evaluated CBT-T delivered to 13–25 year olds attending an early intervention mental health service. Of 63 participants commencing, 60% completed 10 sessions; 94% reported high satisfaction. Significant reductions in eating pathology, depression, and stress were found, with large-to-very-large effect sizes. Results suggest CBT-T is feasible and acceptable for young people in primary care, regardless of age group.

FREED (First Episode Rapid Early Intervention for Eating Disorders) is a service model and care pathway developed at King's College London and South London & Maudsley NHS Foundation Trust for emerging adults (16–25 years) with a recent onset eating disorder of up to three years' duration. It addresses the duration of untreated eating disorder (DUED) by prioritising rapid access, reducing waiting times, and providing developmentally-tailored, evidence-based, stepped-care treatment.

FREED is not a single brief therapy but a service framework that ensures that all components of good care (psychoeducation, nutritional management, evidence-based psychological therapy, family involvement, proactive outreach) are coordinated, monitored, and delivered consistently. FREED has been scaled across NHS England with strong outcomes data and is being adapted for Australian contexts. This includes , the Queensland Eating Disorders Service (QuEDS), SEED at Marymead Catholic Care ACT, and EmergED in South Australia.

FREED - First Episode Rapid Early Interventions for Eating Disorders

A transdiagnostic service model for 16–25 year olds with ED onset <3 years. Core principles: rapid access, early nutritional focus, evidence-based stepped care, family involvement, and transition management. The FREED-Up multi-centre study (n=278 across 4 UK services) found that 53% of FREED patients with AN reached healthy weight at 12 months vs 18% of treatment-as-usual patients. Fewer FREED patients required inpatient treatment (6.6% vs 12.4%). Free online training and implementation toolkit available at freedfromed.co.uk.

EmerED (South Australia)

One Australian adaptation of the FREED model, operating under the name EmergED, is in the South Australian eating disorder service (SEDS). Follows the same principles of rapid access, early intervention, and developmentally-tailored care for emerging adults with recent-onset eating disorders. Work is ongoing nationally to support broader adoption in line with the National Strategy.

Emerging evidence supports the potential of virtual and digital delivery for brief eating disorder interventions, with some studies suggesting comparable efficacy to in-person equivalents. Digital modalities significantly expand geographic access, particularly for regional and rural populations, and can reduce barriers related to stigma and cost. The National Strategy specifically notes "emerging evidence that virtual treatment may be as effective as in-person treatment."

Key digital approaches include: digital guided self-help platforms (such as the IOI eClinic), online SSIs, chatbot-delivered interventions (ED ESSI), app-based monitoring and support tools, and telehealth-delivered CBT-T and CBT-GSH. Attrition in digital interventions remains higher than in-person equivalents and is an active research focus.

IOI eClinic

InsideOut Institute's eClinic provides immediate access to evidence-based online interventions and self-monitoring tools at any point in the recovery journey. Includes a Health Professional Portal enabling clinician-guided support. Research is establishing a comprehensive outcomes database. Currently includes Brief BEeT (4 online sessions + 4 telehealth sessions) for BN/BED in people 16+. 

Current evidence reviews

Anderson C, Soliman OM, Moffitt RL, et al. Acute, Longer-Term, and Transdiagnostic Outcomes After Digital Interventions for Eating Disorders: A Meta-Analysis. JAMA Psychiatry. Published online May 13, 2026. doi:10.1001/jamapsychiatry.2026.0668

Liu C., Anderson C., Messer M., Linardon J. Associations Between Baseline Severity and Treatment Effects in Digital Interventions for Eating Disorders: A Meta-Regression. European Eating Disorders Review. Published April 10, 2026. https://doi.org/10.1002/erv.70113.

Fursland, Erceg-Hurn, Byrne & McEvoy (2018) — A single session assessment and psychoeducational intervention for eating disorders: Impact on treatment waitlists and eating disorder symptoms. Available here.

Foundational Australian study of 448 sequential referrals examining a 75–90 minute psychoeducational SSI based on CBT-E principles. Found reductions in ED symptoms, psychosocial impairment, and depression, along with reduced waitlist length and improved treatment uptake. The primary Australian evidence base for the clinical SSI model.

Schleider, Smith & Ahuvia (2023). Realizing the Untapped Promise of Single-Session Interventions for Eating Disorders. International Journal of Eating Disorders. Available here.

Forum paper defining SSI's, with evidence from 60+ clinical trials of SSIs across mental health conditions supporting the utility for earing disorder symptoms. Proposes a framework for developing eating disorder-focused SSIs and outlines priorities for future research including targeting modifiable risk factors, diverse implementation pathways, and transdiagnostic utility.

Pellizzer, Waller & Wade (2019). A pragmatic effectiveness study of 10-session cognitive behavioural therapy (CBT-T) for eating disorders: Targeting barriers to treatment provision. European Eating Disorders Review. Access here.

Effectiveness study of CBT-T delivered by trainee psychologists at a Flinders University training clinic (n=52). Found outcomes comparable to full CBT-E delivered by specialist therapists, with the intervention explicitly designed to reduce cost, therapist expertise requirements, and wait times. Key Australian validation of the CBT-T model.

Austin et al. (2021). The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes. Early Intervention in Psychiatry. Access here.

Multi-centre quasi-experimental study of FREED across 4 NHS services (n=278). Found 53% of FREED patients with AN reached healthy weight at 12 months vs 18% of TAU, fewer needed inpatient treatment (6.6% vs 12.4%), and a trend toward cost savings. Demonstrates scalability of the model across differing service contexts.

Allen et al. — A framework for conceptualising early intervention for eating disorders. European Eating Disorders Review. Access here.

Comprehensive framework paper providing a global overview of early intervention for eating disorders across different regions and settings, including the Australian context. Outlines policy, service, and clinician-level recommendations. Covers FREED, SSI, GSH, and the Australian landscape including CCI's SSI work and calls for youth-focused research agendas.

Wade (2023). Developing the "single-session mindset" in eating disorder research: Commentary on Schleider et al., 2023 "Realizing the untapped promise of single-session interventions for eating disorders. International Journal of Eating Disorders. Access here.

Commentary from  Australian researcher Prof Tracey Wade in response to Schleider et al., articulating how the "single-session mindset" could reshape eating disorder research and practice. Also see Wade & Waller (2025) on transdiagnostic SSIs identifying rapid vs gradual responders to personalise subsequent therapy.

Thompson, Radunz, Wade & Balzan (2024). Can SSIs Bridge Gaps in Youth Mental Health Delivery? Australia and New Zealand Journal of Psychiatry. Access here.

Australian paper examining the role of SSIs specifically in enhancing mental health treatment delivery for young people in Australia, with implications for eating disorder services. Contextualises SSI research within the Australian youth mental health system, including headspace and Head to Health (now Medicare Mental Health) settings

Hart et al. (2014). Brief cognitive behavioural therapy for eating disorders symptomatology among a mixed sample of adolescents and young adults in primary care: A non-randomised feasibility and pilot study. European Eating Disorders Review. Access here.

Australian feasibility and pilot study of CBT-T for 13–25 year olds in an early intervention primary care mental health service (n=63). Found high treatment satisfaction (94%), significant reductions in eating pathology, depression and stress, with large effect sizes. No age group differences. Provides preliminary support for CBT-T in Australian primary care settings for young people.

Barakat et al (2023). A randomised controlled trial of clinician supported vs self-help delivery of online cognitive behaviour therapy for Bulimia Nervosa. Psychiatry Research. Access here.

Explored clinician support for a ten-session online CBT self-intervention program compared to self-help. The results demonstrate that good clinical outcomes can be achieved with a relatively brief online CBT-based program even in the absence of structured clinical support, indicating a possible overreliance upon clinician support as a primary adherence-facilitating mechanism.

Brief and early interventions are relevant to the following National Strategy Priority Actions:

• Initial Response Priority Action 4.2 Eating disorder service development and lived experience organisations to disseminate information to health and mental health services about brief interventions such as single session interventions, self-help and guided self-help.
• Initial Response Priority Action 4.3 Tertiary and vocational health/mental health education providers to ensure that curricula routinely include/provide access to information about eating disorder assessment tools and treatment including brief interventions such as single session interventions, self-help and guided self-help.
• Initial Response Standard 5: Health professionals, mental health professionals and the community can easily access information about the treatment and support options available face-to-face, through telehealth, and online for their region, including brief treatment interventions and peer support programs, to assist referrals during the initial response stage
• Treatment Priority Action 1.6 Researchers and service providers to conduct further research into brief and/or digital interventions and innovative solutions to meet needs.
• Treatment Standard 7: Eating disorder treatment is provided by a multidisciplinary team, with a mental health professional and medical practitioner as a minimum. Dietitians, psychiatrists and paediatricians can often be an integral part of the multidisciplinary team, with other professionals as needed (e.g., peer support workers, exercise physiologists). In the case of self-help or brief digital therapies, the person may not have a multidisciplinary team, but should be connected to medical care to ensure safety.
• Treatment (Community-Based) Standard 1: Community-based public mental health services (including child and adolescent/youth mental health services, adult mental health services, headspace, Head to Health, Aboriginal Community Controlled Health Services) provide evidence-based treatment ranging from guided self-help and brief interventions, to longer courses of treatment as clinically indicated,
  for binge-eating disorder, bulimia nervosa, OSFED (excluding atypical anorexia nervosa), UFED, and sub-threshold eating disorders, and provide or refer to treatment for anorexia nervosa, atypical anorexia nervosa, ARFID, pica, and rumination disorder
• Treatment (Community-Based) Standard 2: Treatment services routinely offer or refer to early and brief community interventions for people with binge-eating disorder, bulimia nervosa, OSFED (excluding atypical anorexia nervosa), UFED, and sub-threshold eating disorders where clinically indicated
• Treatment Priority Action 2.1 Treatment providers to be trained and supported to provide early and/or brief interventions for people with binge-eating disorder, bulimia nervosa, OSFED (excluding atypical anorexia nervosa), UFED, and sub-threshold eating disorders where clinically indicated.
• Treatment Priority Action 2.2: Services providing eating disorder treatment to ensure staff have capacity to offer, or refer to, early and brief interventions (online or face-to-face) such as single session interventions, guided self-help or other brief manualised interventions where clinically indicated