First episode rapid early intervention for eating disorders: A two‐year follow‐up

Fukutomi, Akira; Austin, Amelia; McClelland, Jessica; Brown, Amy L.; Glennon, Danielle; Mountford, Victoria; Grant, Nina; Allen, Karina L.; Schmidt, Ulrike

doi:10.1111/eip.12881

Cited by 53 publications

(79 citation statements)

References 13 publications

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“…Therefore, it appears to be feasible to offer the majority of adult patients with eating disorders (i.e., non-underweight cases - Fairburn & Harrison, 2003) a treatment that is more time-limited and efficient than current evidence-based options, without loss of effectiveness. To have such briefer therapies available means that patient turnover can be improved, allowing services to reduce waiting times while continuing to deliver effective, manualised and evidence-based therapy (Fukutomi et al, 2019). Furthermore, the cost savings afforded by a shorter therapy that can be delivered by supervised assistants (rather than more expensive qualified therapists) allows more patients to be offered effective treatment.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of brief and enhanced cognitive‐behavioural therapy for adults with non‐underweight eating disorders: A non‐randomized comparison

Tatham¹,

Hewitt²,

Waller

2020

Euro Eating Disorders Rev

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Objective: Cognitive-behavioural therapy (CBT) is an efficacious and effective treatment for eating disorders, and is particularly valuable in the treatment of non-underweight cases (e.g., bulimia nervosa; binge eating-disorders). However, its recommended length for such cases (up to 20 sessions) makes it a relatively costly therapy. It has been suggested that a 10-session version (CBT-T) can also be effective, but there has been no direct comparison between the two forms (10 vs. 20 sessions). Method: This study reports the outcomes of brief and standard-length CBT for non-underweight eating disorders, comparing two cohorts of patients from the same clinic (N = 55 and 138, respectively). Results: The two therapies had very similar results in terms of eating pathology, remission rate, and improved quality of life. Each showed substantial change by the mid-point of therapy and up to 6-month follow-up. Conclusion: It appears that brief CBT (CBT-T) is as effective as existing 20-session CBT, and is less demanding of time and resource. The findings need to be replicated in a randomized control trial before this conclusion can be made definitive.

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Section: Discussionmentioning

confidence: 99%

Outcomes of brief and enhanced cognitive‐behavioural therapy for adults with non‐underweight eating disorders: A non‐randomized comparison

Tatham¹,

Hewitt²,

Waller

2020

Euro Eating Disorders Rev

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“…Given the evidence for intensive interventions at the early stages of an ED (Currin & Schmidt, 2005;Fukutomi et al, 2020), it is unsurprising that all participants felt face-to-face contact was crucial at the beginning of treatment. Staff felt that virtual appointments were inappropriate for high risk patients given the di culty of adequately assessing physical and mental health risks remotely (Keshen et al, 2020).…”

Section: Timing Is Everythingmentioning

confidence: 99%

What was the Impact of a Global Pandemic (COVID-19) Lockdown Period on Experiences within an Eating Disorder Service? A Service Evaluation of the Views of Patients, Parents/Carers and Staff.

Shaw

Robertson

Ranceva

2020

Preprint

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Background: The World Health Organization declared the outbreak of COVID-19 as a global pandemic on the 11th March 2020. As a result, the UK Government imposed severe restrictions on working and social contact as part of “lockdown.” Whilst the full extent of the pandemic’s impact on eating disorder patients is unknown, the literature suggests that patients with pre-existing mental illness may be more vulnerable to the mental health impacts. In addition, the restrictions greatly reduced the access to mental health services and presented new challenges to service delivery. A service evaluation was carried out to explore how the COVID-19 global pandemic changed service provision in a young person’s eating disorder service and how this affected patients, family and staff experiences. Methods: Quantitative data was collected in an online survey and qualitative data was collected in two formats: open ended answers as part of the online survey and open-ended focus groups, structured using narrative enquiry. The 43 participants consisted of 12 patients, 19 parents/carers, and 12 staff members. Patients were under the age of 18 and had a diagnosis of an eating disorder. Results: COVID-19 and lockdown increased the pressure on the service and changed service provision significantly. This has impacted the relational experiences for patients and their carers and staff have been faced with new challenges. Patients, parents/carers and staff all preferred face-to-face appointments over virtual options. There was no difference in service satisfaction before and during COVID-19. Conclusions: It is possible to provide a high-quality eating disorder service in lockdown restrictions. Providing face-to-face appointments at the beginning of treatment and including families in the planning should be prioritised. Staff support is crucial to be able to continue delivering high quality services. The key themes are identified, and clinical recommendations are made to guide service delivery.

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“…FREED aims to reduce waiting time between treatment-seeking and start of specialist evidence-based treatment, whilst also adapting said treatment to the specific developmental needs of emerging adults [9]. FREED has been shown to reduce duration of untreated ED and improve clinical outcomes compared to treatment as usual [8,[10][11][12]. However, whilst initiatives like FREED address service-related delays in ED treatment, duration of untreated ED also encompasses patientrelated delays in treatment-seeking [13].…”

Section: Introductionmentioning

confidence: 99%

“I’m not a teenager, I’m 22. Why can’t I snap out of it?”: a qualitative exploration of seeking help for a first-episode eating disorder during emerging adulthood

et al. 2020

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Background: Eating disorders (EDs) typically have their onset during adolescence or the transition to adulthood. Emerging adulthood (~18-25 years) is a developmental phase which conceptually overlaps with adolescence but also has unique characteristics (e.g. increased independence). Emerging adults tend to come to ED services later in illness than adolescents, and emerging adulthood's unique characteristics may contribute to such delays. Objective: This study aimed to explore attitudes towards ED symptoms, and their implications for help-seeking, amongst emerging adults receiving ED treatment through FREED, an early intervention care pathway. Method: Participants were 14 emerging adults (mean age 20.9 years; SD = 2.0), all currently receiving specialist treatment for a first-episode, recent-onset (< 3 years) ED. Semi-structured interviews relating to experiences of helpseeking were conducted, and data were analysed thematically. Results: Symptom egosyntonicity, gradual reappraisal and feelings of exclusion from ED discourse were key attitudinal phases prior to help-seeking, each of which had distinct implications for help-seeking. Conclusions: Emerging adults with first-episode EDs show a distinct set of help-seeking-related challenges and opportunities (e.g. help-seeking for others; help-seeking at transitions; self-sufficiency). This research might be used to inform the development and evaluation of interventions which aim to facilitate help-seeking amongst emerging adults with first-episode recent-onset EDs.

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First episode rapid early intervention for eating disorders: A two‐year follow‐up

Cited by 53 publications

References 13 publications

Outcomes of brief and enhanced cognitive‐behavioural therapy for adults with non‐underweight eating disorders: A non‐randomized comparison

Outcomes of brief and enhanced cognitive‐behavioural therapy for adults with non‐underweight eating disorders: A non‐randomized comparison

What was the Impact of a Global Pandemic (COVID-19) Lockdown Period on Experiences within an Eating Disorder Service? A Service Evaluation of the Views of Patients, Parents/Carers and Staff.

“I’m not a teenager, I’m 22. Why can’t I snap out of it?”: a qualitative exploration of seeking help for a first-episode eating disorder during emerging adulthood

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