Chapter 5 110 practical suggestions and motivational messaging, but also by tracking and analyzing inadequate behaviour and the triggers prior to that behaviour (by self-monitoring), and by offering appropriate exercises [29-35]. Coaching is optimal in a face-to-face situation (“gold standard”): it creates a reciprocal bond between client and caregiver. This promotes mutual trust and achieves quality in the caregiver-client relationship. Recently it has been shown that coaching does not necessarily have to be face-to-face to create a therapeutic alliance, a bond between therapist and client, but that online coaching has also shown the ability to do so [36-39]. Not only the timing and the 24/7 availability of coaching are important, the essence of the message and the tone of voice demand a good fit, adapted to the situation at hand [40-43]. Successful therapies for treating emotional eating behaviour such as Cognitive Behaviour Therapy (CBT) [4, 41, 44-45] and Dialectical Behaviour Therapy (DBT) [20-21, 40, 46-47] employ a variety of communication strategies in the face-to-face treatment to put the client on the track to insight and the willingness to move to action. “DBT is an eclectic mix of concepts and techniques from a wide variety of psychological and philosophical approaches.” [42, p23]. It combines change-oriented interventions from cognitive behavioral therapy with acceptance techniques from Zen Buddhism [48]. The treatment program was adapted for Boulimia Nervosa and Binge Eating Disorder (BED) by Safer, Telch, & Chen, [40]. Since BED is closely related to emotional eating behaviour, this program is also tailored for emotional eaters [20-21]. Face-to-face therapy is a fast-paced interaction between therapist and coachee, in which the therapist not only anticipates the coachee's response, but can already predict, based on his facial expressions, tone of voice, and contextual information, what that response will be. Reality dictates that social intelligence and interaction at such a level are not (yet) possible for a personalized virtual coach [50]. As mentioned earlier a virtual coach can be experienced as impersonal [51]. The perceived interpersonal closeness is lacking, and the likelihood of dropout is greater than with face-to-face therapy [52], but on the positive side, a personalized virtual coach is always available. It is able to provide right-on-time coaching, exactly at the difficult moments while 'experiencing cravings' and 'after giving in to cravings' when the human therapist is not available. Virtual coaching based on DBT is still something of the future. Since the outbreak of COVID-19, therapists have begun to offer DBT online [53-54], but the present studies involved remote therapy with the intervention of a therapist (telehealth, tele-DBT), delivered by video link or telephone.
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