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Cognitive interpersonal maintenance model of eating disorders: intervention for carers

  • Elizabeth Goddard (a1), Pamela Macdonald (a1), Ana Rosa Sepulveda (a1), Ulrike Naumann (a2), Sabine Landau (a2), Ulrike Schmidt (a1) and Janet Treasure (a3)...
Abstract
Background

Carers of people with eating disorders report high levels of distress. In addition, carers' responses to the illness may perpetuate eating disorder symptoms. A cognitive interpersonal maintenance model of eating disorders is proposed and interventions for carers may improve well-being in both carers and patients.

Aims

To examine an interpersonal maintenance model of eating disorders, using a self-help intervention for carers.

Method

A pre-test–post-test design was used with carers randomised into self-help or guided self-help, which included the Expert Carers Helping Others (ECHO) intervention. Carers' distress, well-being, proposed maintenance factors, and carer reports on the status of the patient were measured.

Results

Carers' distress reduced and secondary outcomes improved. Improvement in carers' status and perceived improvements in patients were associated with reductions in expressed emotion and in accommodating and enabling behaviours. Self-help and guided self-help versions were comparable.

Conclusions

Changes in maintenance factors from the theoretical model were associated with a reduction in carers' distress and improvement in perceived patient functioning. Interventions which specifically target maintaining factors may be of benefit.

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Copyright
Corresponding author
Elizabeth Goddard, Department of Psychological Medicine, 5th Floor Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK. Email: Elizabeth.Goddard@kcl.ac.uk
Footnotes
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This work presents independent research commissioned by the National Institute for Health Research (NIHR) under Programme Grant for Applied Research (Reference number RP-PG-0606-1043). This work was also supported by the NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, Institute of Social Psychiatry and Institute of Psychiatry, King's College London. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Declaration of interest

J.T. is co-author of the book used in the ECHO intervention and was part of the team who developed the DVDs. P.M. was one of the telephone coaches in the project.

Footnotes
References
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Cognitive interpersonal maintenance model of eating disorders: intervention for carers

  • Elizabeth Goddard (a1), Pamela Macdonald (a1), Ana Rosa Sepulveda (a1), Ulrike Naumann (a2), Sabine Landau (a2), Ulrike Schmidt (a1) and Janet Treasure (a3)...
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