Does collaborative case conceptualisation enhance engagement and outcome in the treatment of anorexia nervosa?

Collaborative Case Conceptualisation (CCC) is designed as a prelude to traditional treatment with the aim of improving treatment motivation and engagement and therefore treatment outcome. It targets proposed anorexia nervosa (restricting type) maintaining factors namely obsessive-compulsive and perfectionistic behaviours and cognitions, avoidant behaviours and cognitions, positive beliefs about anorexia nervosa and responses of close others. CCC is done jointly with the patient and uses motivational techniques and an understanding of learning principles with a focus on the maintaining factors of AN. The collaborative assessment is conducted across 3 sessions (one session per week, each lasting approximately 1 hour) by psychology interns (post-graduate provisional psychologists). The assessments are largely focussed on identifying biopsychosocial maintaining factors for the disorder and during the assessment the therapist is constantly listening for examples of these factors. Using psychoeducation and socratic questioning, a shared understanding is developed in regards to the eating disorder and what keeps it going. This process then informs with the development of collaborative treatment goals. At completion patients will be provided with a formulation letter summarising the joint understanding of the maintaining factors of the disorder. A log of attendance at sessions will be used to monitor adherence.