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A randomized controlled trial of an Internet-based cognitive-behavioural skills package for carers of people with anorexia nervosa

Published online by Cambridge University Press:  20 May 2011

M. Grover
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
U. Naumann
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
L. Mohammad-Dar
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
D. Glennon
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
S. Ringwood
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
I. Eisler
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
C. Williams
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
J. Treasure
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
U. Schmidt*
Affiliation:
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK
*
*Address for correspondence: U. Schmidt, M.D., Ph.D., FRCPsych, PO 59, Section of Eating Disorders, Institute of Psychiatry, 103, Denmark Hill, London SE5 8AF, UK. (Email: ulrike.schmidt@kcl.ac.uk)

Abstract

Background

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-behavioural (CBT) intervention for carers of people with AN, designed to reduce carer distress and teach skills in how to offer effective support.

Method

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).

Results

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 favour the online intervention. Gains were maintained at follow-up.

Conclusions

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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