Feedback versus no feedback in improving patient outcome in group psychotherapy for eating disorders (F-EAT): protocol for a randomized clinical trial

Abstract

BackgroundContinuous feedback on patient improvement and the therapeutic alliance may reduce the number of dropouts and increase patient outcome. There are, however, only three published randomized trials on the effect of feedback on the treatment of eating disorders, showing inconclusive results, and there are no randomized trials on the effect of feedback in group therapy. Accordingly the current randomized clinical trial, initiated in September 2012 at the outpatient clinic for eating disorders at Stolpegaard Psychotherapy Centre, aims to investigate the impact of continuous feedback on attendance and outcome in group psychotherapy.Methods/designThe hypothesis is that continuous feedback to both patient and therapist on treatment progress and alliance will increase attendance and treatment outcome. The trial is set up using a randomized design with a minimum of 128 patients allocated to either an experimental or control group at a ratio of 1:1. The experimental group will receive standard treatment (systemic and narrative group psychotherapy) with feedback intervention, whereas the control group will receive standard treatment only. The participants are diagnosed with bulimia nervosa, binge eating disorder, or an eating disorder not otherwise specified, according to the DSM-IV. In the experimental group feedback to the participants, based on the Outcome Rating Scale (ORS) and the Group Session Rating Scale (GSRS), is actively added to standard treatment. The ORS assesses areas of life functioning known to change as a result of therapeutic intervention. The GSRS assesses key dimensions of effective therapeutic relationships. In the control group, the patients fill out the Outcome Rating Scale only, and feedback is not provided.The primary outcome is the rate of attendance to treatment sessions. The secondary outcome is the severity of eating disorder symptoms. Exploratory outcomes are the level of psychological and social functioning, and suicide or self-harm. This is measured with the ORS, Symptom Check List, WHO-Five Wellbeing Index, Sheehan Disability Scale and a modified version of the Self-Harm Inventory.DiscussionIf the results will confirm the hypothesis, this trial will support feedback as a way to improve group treatment attendance for outpatients with eating disorders.Trial registrationClinicalTrials.gov identifier: NCT01693237

Feedback in group psychotherapy for eating disorders: A randomized clinical trial.

“…The F-EAT trial is an investigator-initiated randomized, clinical superiority trial using a parallel group design with a 1:1 allocation ratio and blinded outcome assessments for outcomes, analyses, and drawing of conclusions. The design and methods have been described in detail in a previous publication (Davidsen, Poulsen, Waaddegaard, Lindschou, & Lau, 2014).…”

“…A detailed description of the outcome and assessment measures is published elsewhere (Davidsen et al, 2014). We will briefly summarize the measures in the following.…”

Guided self‐help to manage binge eating in a dietetic‐led community weight management service

“…Previous research has indicated that feedback has a promising effect on maximizing the benefits of outcomes in psychological interventions [29]. However, the benefits of session by session feedback are still inconclusive for patients, as research studies tend to lack homogeneity in outcome, feedback measures and methodology [30].…”