A case series evaluation of the Maudsley Model for Treatment of Adults with Anorexia nervosa (MANTRA)

Eligibility criteria for the study included meeting the diagnostic criteria for anorexia nervosa (AN) with the exception that body mass index (BMI) was less than 19 as previously adopted in other treatment studies and amenorrhea was not required. Additional eligibility criteria required that person was medically stable as assessed by their general practitioner, and was aged 16 years and over. There was no exclusion based on BMI or comorbidity in order to make the study as inclusive as possible. The study was advertised to eating disorder service providers in South Australia, as well as the consumer support organisation and people were entered into the trial between 2005 and 2007. Data were collected at baseline, sessions 5 and 10, and at post-treatment, 3-month and 12-month follow-up. The outpatient therapy for AN was based on MANTRA, the treatment developed by Professors Ulrike Schmidt and Janet Treasure, designed specifically to treat AN and formulated from the cognitive-interpersonal maintenance model. MANTRA aims to tackle maintaining factors related to perfectionism and obsessive-compulsive personality traits, avoidance, pro-anorectic beliefs, and the responses of close others. The modularised treatment that has resulted from this model maintains a focus on specific changes required in eating and weight within a motivational interviewing and cognitive behavioural therapy framework, including individualised case conceptualisation, in addition to summary letters from the therapist to the patient. Due to its modularized nature, it results in a targeted treatment of AN that is matched to the clinical symptoms, personality traits and neuropsychological profile of participants, an approach that has been successfully used in people with addictions.