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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
Author(s) -
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
Publication year - 2017
Publication title -
european eating disorders review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.511
H-Index - 67
eISSN - 1099-0968
pISSN - 1072-4133
DOI - 10.1002/erv.2540
Subject(s) - anorexia nervosa , eating disorders , intervention (counseling) , randomized controlled trial , psychology , social skills , medicine , clinical psychology , physical therapy , psychiatry , surgery
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.