Long-Term Efficacy of the Workshop Vs. Online SUCCEAT (Supporting Carers of Children and Adolescents with Eating Disorders) Intervention for Parents: A Quasi-Randomised Feasibility Trial

Abstract

Interventions for main carers of adult patients with anorexia nervosa (AN) can reduce the caregiving burden and increase caregiver skills. However, the effectiveness and feasibility for carers of adolescent patients, the optimal form of the intervention and long-term outcomes are largely unknown. We evaluated the efficacy and feasibility of the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) workshop vs. online intervention. Main caregivers (parents) of adolescent patients with AN were randomly allocated to a workshop (n = 50) or online version (n = 50). Participants were compared to a non-randomised comparison group (n = 49) receiving multi-family or systemic family therapy. Primary (General Health Questionnaire) and secondary outcomes were obtained at baseline, three-month and 12-month follow-up. Adherence was high for workshop and online participants (6.2 and 6.7 sessions completed out of 8). Intention-to-treat analyses revealed significant pre–post reductions in the primary outcome for the workshop (d = 0.87 (95%conficence interval (CI): 0.48; 1.26)) and online (d = 0.65 (95%CI: 0.31; 0.98)) intervention that were sustained at the 12-month follow-up. There was no significant group difference (p = 0.473). Parental psychopathology and burden decreased and caregiver skills increased in all groups; the improvement of caregiver skills was significantly higher in SUCCEAT participants than in the comparison group. Online interventions for parents of adolescents with AN were equally effective as workshops. The improvements remained stable over time.

Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa—Caregivers’ and Adolescents’ Perspective

“…However, there were no systematic differences between the WS and ONL groups at the baseline. Details on the randomization procedure are reported elsewhere [26].…”

“…Caregivers received weekly handouts, a manual to read more about the topics addressed [30], and a DVD [31] with case examples of unhelpful and helpful communication. A detailed description of the interventions is provided by Franta et al [28] and Truttmann, Philipp et al [26].…”

“…SUCCEAT (Supporting Carers of Children and Adolescents with Eating Disorders in Austria) is an intervention for caregivers of adolescents with AN based on the interpersonal maintenance model [14][15][16] that has already been shown to effectively reduce caregiving burden and increase caregiver skills [26]. This paper presents secondary analyses of the SUCCEAT study, focusing on various aspects of high EE.…”

Advances in Eating Disorders

“…On the other hand, Philipp et al [ 27 ] demonstrated that parental expressed emotion (associated with higher distress and a lack of skills) was reduced after interventions for caregivers (namely the SUCCEAT program), and that this reduction positively influenced patients’ outcomes. Likewise, the results from the study of Truttmann et al [ 26 ] provide support for the efficacy of the same interventions for caregivers (i.e., SUCCEAT) reducing parental burden, distress and psychopathology. Last but not least, Treasure et al [ 23 ] reviewed the underpinnings of the Cognitive Interpersonal Model for AN and how this can be targeted to treatment.…”

“…To address this important health issue, the current Special Issue collected 21 articles examining the most recent and relevant scientific findings regarding advances in ED. The published articles comprised three reviews and 18 research articles focusing on different aspects, such as genetic [ 7 ] and epigenetic factors [ 8 ], biomarkers [ 9 ], comorbidity [ 10 , 11 , 12 , 13 , 14 ], clinical phenotypes [ 15 , 16 ], neurocognition [ 12 , 17 , 18 , 19 , 20 , 21 ], treatment predictors [ 22 ], and treatment models and therapeutic targets [ 19 , 23 , 24 , 25 , 26 , 27 ]. Altogether, these studies may provide increased knowledge about the pathogenesis, the risk factors, the maintenance factors, and the most appropriate treatments tools for ED.…”