General Introduction & Outline 15 1 In the last two decades, the development of virtual coaching has made considerable progress. It is not yet easy to give an unambiguous definition of what a virtual coach is. It is more important to look at the functional characteristics that make a virtual coach an effective coach and add value for the specific target group. A virtual coach can play a role in lifestyle and/or behaviour change [69-71]. Application areas of virtual coaching include supporting healthy lifestyle dealing with chronically illness, [72], coping with cardiovascular disease [73], handling andmonitoringDiabetes II [74-76], promoting adherence to self-isolation during the Covid pandemic [77], and coaching intended for specific groups such as people with low socioeconomic status [78], and indigenous people [79]. Virtual coaching is also applied in mental health and offers support and help with eating disorders, depression, and anxiety. Approaches used include ACT [80], Cognitive Behavioural Therapy [81-82], and Dialectical Behavioural Therapy [83-85]. From the reviews by Wilks et al, and Xie et al, as cited above, it appears that Dialectical Behaviour Therapy in virtual coaching is primarily used for Borderline Personality Disorder. The desire to use DBT in the capacity of virtual coaching is motivated by the same as with emotional eaters, according to Xie et al. “...access to traditional therapistdelivered psychotherapies such as DBT may be limited for many people due to costs, mental health stigma, and logistical barriers such as travel required to attend therapy appointments. For many, therapists trained in DBT are simply not accessible.” [85]. Literature also suggests that virtual coaching applications for DBT do not appear to be just online replicas of the face-to-face therapy. The application of DBT consists of “using DBT techniques”, “based on DBT”, “including DBT elements”, “inspired by DBT”, “DBT informed”, “internet based DBT (i-DBT)”, and “internet delivered DBT” [83, 85-86]. It is apparently feasible to help patients online with parts of the DBT therapy. Spurred by the recent Covid pandemic, there is a desire among DBT therapists ‘to move forward on telepsychology applications’ but there is an urgent need to compare standard DBT to online or blended DBT [87-88]. Although the internet has a great potential to deliver psychological interventions, smartphone-based interventions in the capacity of virtual coaching for emotional eaters remain scarce. Emotional eaters are a group of people who, for reasons mentioned above, keep their distance from care. Because emotional eating can be associated with obesity, it is even more important that this group also get the help and support it needs. Currently, the availability of suitable treatment or support is poor. DBT seems to be a promising way, but it is not yet available on a larger scale.
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