SPEAKS Therapy - An Emotion Focused intervention for anorexia and restrictive eating difficulties

SPEAKS developed out of a recognition in the field of eating disorders that difficulties with emotion and emotion processing may underpin and maintain anorexia nervosa and thus emotion focused interventions may be beneficial (Oldershaw et al., 2015; Sala et al., 2016). In a 5 year research program funded by the National Institute for Health and Care Research (UK Department of Health), we developed an emotion focused intervention for adults with anorexia (SPEAKS).
Using these research findings, we ‘mapped out’ a hypothesised sequential emotion change process to help support people to find and connect with “The Real Me”, drawing on emotion change theory developed in the field of Emotion Focused Therapy. This was translated into practice to develop the SPEAKS therapy which predominantly draws on Emotion Focused Therapy and Schema Therapy across five phases of treatment. SPEAKS is feasible to deliver in practice and has good clinical outcomes (Oldershaw et al., 2023), as well as being viewed as acceptable to both clients and therapists (Rennick et al., 2024).

Introduction to SPEAKS
Attendees will learn about:
- The clinical and research program to develop SPEAKS
- The SPEAKS change, including the sequential model of emotional change and the 5 phases of SPEAKS therapy
- Outcome research data from our feasibility trail run in the NHS supporting the use of SPEAKS in clinical practice

Formulation and working with ‘stuck presentations’ (SPEAKS therapy phases 1 & 2)
Attendees will be introduced to:
- Formulation in the SPEAKS model using dynamic and interactive approaches such as toys and objects to ‘map’ the self and all its parts
- Using the map to guide therapy
- Unique tasks to improve stuckness and ambivalence towards change, such as the ‘Focusing for feeling stuck’ task

Facilitating the change process (SPEAKS therapy phases 3 & 4)
Once 'stuckness' has been recognised and understood, attendees will further consider how to facilitate (emotional) change across the SPEAKS therapy. This will include working to connect with and resolve core pain using traditional EFT tasks and other tasks adapted from different therapies such as Schema Therapy.

Consolidating the “Real Me” (SPEAKS therapy phase 5)
The final phase of therapy considers how to consolidate the changes made by maintaining self-efficacy and self-agency using a range of tasks. It will also cover the ending of therapy and ending tasks, including letters, reformulation and transitional objects.