A systematic review of the impact of carer interventions on outcomes for patients with eating disorders

Abstract

Purpose Eating disorder (ED) prevalence and illness severity is rapidly increasing. The complicated interplay of factors contributing to the maintenance of EDs, including family/carer influences, highlights the importance of carer interventions within ED treatment. Carer interventions demonstrate positive outcomes for carers themselves, though are also hypothesised to benefit the patient indirectly. A systematic review was conducted to greater understand the impact of carer interventions on ED patient outcomes. Methods Eight databases, including CINAHL, MEDLINE and PsychINFO, were systematically searched. Intervention studies for parent(s)/carer(s) of a patient with an ED were included, provided they reported outcomes for the patient. No publication date restrictions were set. Included studies were quality appraised. Results Twenty-eight studies met inclusion for the review; all of which varied in intervention type, duration, content and setting. Patient diagnosis and treatment setting were mixed across studies, though the majority focused on Anorexia Nervosa within outpatient settings. Intervention content broadly included consideration of relationship issues and interactional patterns, psychoeducation, skill development, behavioural management, and peer support. Therapeutic models utilised were diverse, including but not limited to: family, interpersonal, cognitive, and psychodynamic approaches. Conclusion Several carer interventions showed positive outcomes for patients with EDs, with small group treatment formats being commonly used and proving effective through intervention content alongside a peer support element. Separate family therapy was suggested to be of equal efficacy, if not better, than family therapy alongside the patient. Recommendations for clinical practice and future research are considered. Level of evidence 1. Systematic review, evidence mostly obtained from randomised controlled trials. Supplementary Information The online version contains supplementary material available at 10.1007/s40519-021-01338-7.

A description of virtual skills workshops for supporters of loved ones with eating disorders: Indicators of benefit and acceptability, clinical reflections and consideration of neurodiversity

“…Similar to the majority of supporters in Hannah et al.’s (2021) review, most supporters who opted into our workshops and completed the outcome measures were white British, female parents. Next time, we could work more closely with individual therapists within the service to identify more cases where it might be useful to involve more males, friends, siblings, children and partners.…”

“…A systematic review and synthesis of 28 studies on the impact of interventions for supporters of loved ones with EDs found supporters benefited from working with peers in a group setting and felt more equipped to help manage the disorder (Hannah et al., 2021). This has led to many services, including our own, delivering skills‐based workshops for supporters as part of usual care (Pépin & King, 2013).…”

“I’m not alone”: a qualitative report of experiences among parents of children with eating disorders attending virtual parent-led peer support groups

“…The majority of parents believed that these vPLPSGs should be widely available, indicating that they are a pivotal part of the continuum of care in pediatric EDs. Currently, there is a lack of support for parents despite a stated need for more peer support, as it assists them in being able to manage their child’s ED [ 36 ]. Parents are also burdened by long waiting lists at various stages of pediatric ED care and face challenges in accessing ED services, harbouring emotions of guilt and self-blame [ 37 ].…”

Conductas alimentarias de riesgo y satisfacción corporal en estudiantes universitarios mexicanos

“…Research on eating disorders and risky eating behaviors (REB) have increased over time, due to their prevalence and health consequences, mainly in the young population 1,17 . According to the National Health and Nutrition Survey concerns about gaining weight, losing control over eating and overeating were the most frequent REB in the Mexican adolescent population.…”