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.

Stefanie Truttmann,Hartmut Imgart,Andreas F K Karwautz,Julia Philipp,Janet Treasure,Ellen Auer-Welsbach,Elisabeth Merl,Doris Koubek,Clarissa Laczkovics,Tanja Wittek,Claudia Franta,Annika Zanko,Michael Zeiler,Gabriele Schöfbeck,Gudrun Wagner

doi:10.3390/jcm9061912

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.

Highlights

The National Institute for Health and Care Excellence (NICE) Guidelines recommend involving carers in the treatment of adolescent patients with anorexia nervosa (AN) [1]
Two participants were excluded post-randomisation because they were not willing to participate in the group they were randomised to, and they were not considered in the subsequent analyses
The only exception was that the AN duration was slightly longer in patients of carers assigned to the online group compared to the workshop group (p = 0.041)

Summary

Introduction

The National Institute for Health and Care Excellence (NICE) Guidelines recommend involving carers in the treatment of adolescent patients with anorexia nervosa (AN) [1]. As AN tends to develop during adolescence, parents usually function as main carers. AN is often associated with lack of insight and low motivation to change in patients. The illness can have a serious emotional impact on the whole family, especially the main carer, who usually is a parent. This can cause severe parental distress and lead to enormous burden and relationship problems within the whole family [3,4,5,6]

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Discussion

Conclusion