A Pilot, Multicentre Pragmatic Randomised Trial to Explore the Impact of Carer Skills Training on Carer and Patient Behaviours: Testing the Cognitive Interpersonal Model in Adolescent Anorexia Nervosa. (25th September 2017)

• Record Type: Journal Article
• Authors: Hodsoll, John; Rhind, Charlotte; Micali, Nadia; Hibbs, Rebecca; Goddard, Elizabeth; Nazar, Bruno Palazzo; Schmidt, Ulrike; Gowers, Simon; Macdonald, Pamela; Todd, Gillian; Landau, Sabine; Treasure, Janet
• Is Part Of: European eating disorders review. Volume 25:Number 6(2017)
• Page Start: 551
• Page End: 561
• Publication Date: 2017-09-25
• Subjects: anorexia nervosa -- eating disorders -- carers -- adolescent -- family intervention -- treatment -- pragmatic randomised controlled trial -- skills training -- motivational interviewing; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/erv.2540
• Languages: English
• ISSNs: 1072-4133

Abstract

Abstract: Aim: The aim of the study is to establish the acceptability, feasibility and approximate size of the effect of adding a carer intervention [Experienced Caregivers Helping Others (ECHO)] to treatment as usual (TAU) for adolescents with anorexia nervosa. Methods: The study is a pilot randomised trial comparing TAU ( n = 50) alone or TAU plus ECHO with ( n = 50) or without ( n = 49) telephone guidance. Effect sizes (ESs) were regression coefficients standardised by baseline standard deviations of measure. Results: Although engagement with ECHO was poor (only 36% of carers in the ECHO group read over 50% of the book), there were markers of intervention fidelity, in that caregivers in the ECHO group showed a moderate increase in carer skills (ES = 0.4) at 12 months and a reduction in accommodating and enabling behaviour at 6 months (ES = 0.17). In terms of efficacy, in the ECHO group, carers spent less time care giving (ES = 0.40, p = 0.04) at 1 year, and patients had a minor advantage in body mass index (ES = 0.17), fewer admissions, decreased peer problems (ES = −0.36) and more pro‐social behaviours (ES = 0.53). The addition of telephone guidance to ECHO produced little additional benefit. Conclusions: The provision of self‐management materials for carers to standard treatment for adolescent anorexia nervosa shows benefits for both carers and patients. This could be integrated as a form of early intervention in primary care. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.