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Internet-based CBT Skills for Parents or Partners of Individuals with Anorexia Nervosa

Anorexia nervosa (AN) poses a major burden on families. Carers (e.g. parents or partners) of people with AN are often highly distressed and may inadvertently respond in ways that can contribute to the maintenance of the disorder, e.g. through high levels of over-involvement and criticism [also known as expressed emotion (EE)]. This study aimed to evaluate the efficacy of a novel web-based systemic cognitive-behavioral (CBT) intervention for carers of people with AN, designed to reduce carer distress and teach skills in how to offer effective support. Carers of people with AN (n=64) were randomly allocated to either the web-intervention, overcoming anorexia online, with limited clinician supportive guidance (by email or phone), or to ad-hoc usual support from the UK patient and carer organization Beat. Carer outcomes were assessed at post-treatment (4 months) and follow-up (6 months). Compared with the control intervention, web-based treatment significantly reduced carers’ anxiety and depression (primary outcome) at post-treatment, with a similar trend in carers’ EE. Other secondary outcomes did not favor the online intervention. Gains were maintained at follow-up. This is the first ever study to use an online CBT program to successfully reduce carer distress and improve carers’ ability to support the person with AN.

Grover, M., Naumann, U., Mohammad-Dar, L., Glennon, D., Ringwood, S., Eisler, I., Williams, C., … Schmidt, U. (December 01, 2011). A randomized controlled trial of an Internet-based cognitive-behavioural skills package for carers of people with anorexia nervosa. Psychological Medicine, 41(12), 2581-2591.

 

Anorexia Nervosa Relapse Prevention Benefited by CBT

NewStudy-Graphic-72x72_edited-3 A recent clinical study in the International Journal of Eating Disorders found preliminary evidence supporting the notion that Cognitive Behavioral Therapy (CBT) is beneficial to preventing relapse and improving outcomes in patients with weight-restored Anorexia Nervosa (AN). The aim of the present study was to compare the relapse prevention effectiveness of CBT versus maintenance treatment as usual (MTAU) for weight-restored AN.

Participants were patients suffering from AN who were part of the inpatient or day hospital program at the Toronto General Hospital Eating Disorders Program. After participants reached a body mass index (BMI) of at least 19.5 for 2-3 weeks, they were able to begin participation in the present study. About half of the participants chose to enter into the CBT treatment condition and the rest received MTAU. Participants in the CBT group focused on addressing thoughts and behaviors about eating and weight that increase the risk of relapse, and then changing those thoughts and behaviors to healthier strategies and skills. In addition cognitive strategies were taught for a broader range of issues, such as self-esteem, interpersonal problems, and developmental issues.

Results showed that participants in the CBT group had a significantly longer time to relapse than those in the MTAU group, with 65% of the CBT group and 34% of the MTAU not having relapsed after 1 year. The authors concluded that “the current findings provide preliminary evidence that CBT may be helpful in improving outcome and preventing relapse in weight-restored AN.”

Study authors: J. C. Carter, T. L. McFarlane, C. Bewell, M. P. Olmsted, D. B. Woodside, A. S. Kaplan, R. D. Crosby