Relapse Prevention via Videoconference for Anorexia Nervosa - Findings from the RESTART Pilot Study

Giel, Katrin Elisabeth; Leehr, Elisabeth J.; Becker, Sandra; Herzog, Wolfgang; Junne, Florian; Schmidt, Ulrike; Zipfel, Stephan

doi:10.1159/000431044

Cited by 27 publications

(42 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Treatment augmentation, perhaps through individual visits, asynchronous email communication [36], text messages with therapists [37], and video conferencing [38], or intermittent face-to-face contact for on-line participants [16] may engage and retain patients for longer. More frequently scheduled groups and greater homework may also yield greater success [39].…”

Section: Resultsmentioning

confidence: 99%

CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa

Zerwas¹,

Watson

Hofmeier³

et al. 2016

Psychother Psychosom

103

View full text Add to dashboard Cite

Objective: Although cognitive-behavioral therapy (CBT) represents the first-line evidence-based psychotherapy for bulimia nervosa (BN), most individuals seeking treatment do not have access to this specialized intervention. We compared an Internet-based manualized version of CBT group therapy for BN conducted via a therapeutic chat group (CBT4BN) to the same treatment conducted via a traditional face-to-face group therapy (CBTF2F). Method: In a two-site, randomized, controlled noninferiority trial, we tested the hypothesis that CBT4BN would not be inferior to CBTF2F. A total of 179 adult patients with BN (2.6% males) received up to 16 sessions of group CBT over 20 weeks in either CBT4BN or CBTF2F, and outcomes were compared at the end of treatment and at the 12-month follow-up. Results: At the end of treatment, CBT4BN was inferior to CBTF2F in producing abstinence from binge eating and purging. However, by the 12-month follow-up, CBT4BN was mostly not inferior to CBTF2F. Participants in the CBT4BN condition, but not CBTF2F, continued to reduce their binge-eating and purging frequency from the end of treatment to the 12-month follow-up. Conclusions: CBT delivered online in a group chat format appears to be an efficacious treatment for BN, although the trajectory of recovery may be slower than face-to-face group therapy. Online chat groups may increase accessibility of treatment and represent a cost-effective approach to service delivery. However, barriers in service delivery such as state-specific license and ethical guidelines for online therapists need to be addressed.

show abstract

Section: Resultsmentioning

confidence: 99%

CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa

Zerwas¹,

Watson

Hofmeier³

et al. 2016

Psychother Psychosom

103

View full text Add to dashboard Cite

show abstract

“…In an uncontrolled pilot study, this intervention showed promise. 297 In terms of the specific feasibility objectives, the study ascertained that this intervention is not for everyone, as only 19.5% of inpatients screened for the study were found eligible and agreed to participate (feasibility objective a). This raises the question as to how representative of the typical inpatient population in the UK participants was.…”

Section: Discussionmentioning

confidence: 99%

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Schmidt

Sharpe

Bartholdy

et al. 2017

Programme Grants Appl Res

Self Cite

View full text Add to dashboard Cite

BackgroundAnorexia nervosa (AN) is a severe psychiatric condition and evidence on how to best treat it is limited.ObjectivesThis programme consists of seven integrated work packages (WPs) and aims to develop and test disseminable and cost-effective treatments to optimise management for people with AN across all stages of illness.MethodsWP1a used surveys, focus groups and a pre–post trial to develop and evaluate a training programme for school staff on eating disorders (EDs). WP1b used a randomised controlled trial (RCT) [International Standard Randomised Controlled Trial Number (ISRCTN) 42594993] to evaluate a prevention programme for EDs in schools. WP2a evaluated an inpatient treatment for AN using case reports, interviews and a quasi-experimental trial. WP2b used a RCT (ISRCTN67720902) to evaluate two outpatient psychological therapies for AN. WP3 used a RCT (ISRCTN06149665) to evaluate an intervention for carers of inpatients with AN. WP4 used actimetry, self-report and endocrine assessment to examine physical activity (PA) in AN. WP5 conducted a RCT (ISRCTN18274621) of an e-mail-guided relapse prevention programme for inpatients with AN. WP6 analysed cohort data to examine the effects of maternal EDs on fertility and their children’s diet and growth. WP7a examined clinical case notes to explore how access to specialist ED services affects care pathways and user experiences. Finally, WP7b used data from this programme and the British Cohort Study (1970) to identify the costs of services used by people with AN and to estimate annual costs of AN for England.ResultsWP1a: a brief training programme improved knowledge, attitudes and confidence of school staff in managing EDs in school. WP1b: a teacher-delivered intervention was feasible and improved risk factors for EDs in adolescent girls. WP2a: both psychological therapies improved outcomes in outpatients with AN similarly, but patients preferred one of the treatments. WP2b: the inpatient treatment (Cognitive Remediation and Emotional Skills Training) was acceptable with perceived benefits by patients, but showed no benefits compared with treatment as usual (TAU). WP3: compared with TAU, the carer intervention improved a range of patient and carer outcomes, including carer burden and patient ED symptomatology. WP4: drive to exercise is tied to ED pathology and a desire to improve mood in AN patients. PA was not increased in these patients. WP5: compared with TAU, the e-mail-guided relapse prevention programme resulted in higher body mass index and lower distress in patients at 12 months after discharge. WP6: women with an ED had impaired fertility and their children had altered dietary and growth patterns compared with the children of women without an ED. WP7a: direct access to specialist ED services was associated with higher referral rates, lower admission rates, greater consistency of care and user satisfaction. WP7b: the annual costs of AN in England are estimated at between £45M and £230M for 2011.ConclusionsThis programme has produced evidence to inform future intervention development and has developed interventions that can be disseminated to improve outcomes for individuals with AN. Directions for future research include RCTs with longer-term outcomes and sufficient power to examine mediators and moderators of change.Trial registrationCurrent Controlled Trials ISRCTN42594993, ISRCTN67720902, ISRCTN06149665 and ISRCTN18274621.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 16. See the NIHR Journals Library website for further project information.

show abstract

“…Most of these multisite RCTs were designed, implemented, and evaluated according to stringent and robust regulatory rules conforming to good clinical practice. In recent years, the psychotherapy community has worked to modernize web-based health treatments by developing and testing approaches that apply digital media (Interbed, Base, Restart [33,34,35]). …”

Section: Psychosomatic Medicine In Academic Teaching and Researchmentioning

confidence: 99%

Psychosomatic Medicine in Germany: More Timely than Ever

Zipfel¹,

Herzog

Kruse

et al. 2016

Psychother Psychosom

Self Cite

1,622

View full text Add to dashboard Cite

Relapse Prevention via Videoconference for Anorexia Nervosa - Findings from the RESTART Pilot Study

Cited by 27 publications

References 12 publications

CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa

CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Psychosomatic Medicine in Germany: More Timely than Ever

Contact Info

Product

Resources

About