Early intervention in eating disorders: A parent group approach

Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust UCL Institute of Child Health, University College London, London Surrey and Borders Partnership NHS Foundation Trust, Surrey, UK.
Early Intervention in Psychiatry (Impact Factor: 1.95). 07/2012; 6(4). DOI: 10.1111/j.1751-7893.2012.00373.x
Source: PubMed


Early intervention in eating disorders (EDs) has been a neglected area. Peak onset is in adolescence, suggesting that early intervention should include parents. We synthesize findings from five key theoretical domains, and present pilot data from a phase-specific early intervention for new onset EDs in young people.

From literature searches, we reviewed current knowledge on risk factors for EDs; ED prevention in young people; the evidence base for treatment for young people with EDs; early intervention in other mental health fields; and parenting interventions. Based on these findings, we devised and piloted a parent group intervention.

Presenting features are typically parental concern about changes in eating behaviour and/or weight loss. There is a delay between symptom onset and help seeking, by which time the illness is well established. Early intervention should therefore target parents and be delivered at secondary rather than primary care. Effective treatments favour family-focused interventions with parental responsibility for symptom management. We hypothesized that a parents' group might be effective for addressing the specific emotional experience of parents in the early stages and their relative lack of knowledge and understanding. Pilot data show significant improvements in knowledge, skills, confidence, understanding and their child's adherence to meal plans as a result of a 6-week parent group intervention.

A parent group intervention addressing themes identified from risk factor, prevention and treatment research is a potentially promising approach to early intervention for EDs. The impact of the intervention on patient outcome needs evaluation.

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Available from: Dasha Nicholls, Nov 04, 2014
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    ABSTRACT: Eating disorders (ED) and non-suicidal self-injury (NSSI) are serious, impairing, and potentially life-threatening conditions that typically require care across the continuum, from primary care to inpatient care. Primary care practitioners (PCPs) are critical to the treatment of ED and NSSI, playing important roles in identification and assessment. Numerous tools have been developed to facilitate PCPs' involvement in the continuum of care for ED. Although similar tools have not been fully developed or evaluated for NSSI, promising practices are available for PCPs to address NSSI. Recommendations are also available for determining the best level of care for ED and NSSI, including when to refer for inpatient treatment. Inpatient treatment for ED and NSSI is a critical part of the continuum of care for these conditions, especially in establishing safety, stabilizing symptoms, and beginning the process of recovery. Increased attention by researchers and providers to the role of PCPs and inpatient levels of care in the continuum of care for ED and NSSI will go far to improving our treatment of these complex conditions.
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