Eating disorders - anorexia Mental and Behavioural Disorders
Conditions
Interventions
The intervention will be guided by the protocol and consist of a maximum of 24 weekly sessions of individual Relating Therapy. The therapy protocol consists of three phases:
Phase 1 - socialization to
Sponsors
Sussex Partnership NHS Foundation Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Aged 18 years or older 2. Receiving care from a specialised eating disorder service (outpatients) 3. Following permission gained from the participant, a clinician-reported primary diagnosis of anorexia nervosa 4. BMI of 18.5 or less 5. Currently having experiences of the Anorexic Voice (AV); this will be operationalized by participants self-reporting at least one experience of voice-hearing within the previous week using an adapted item from the Hamilton Program for Voices Questionnaire (HPSVQ) 6. Self-reported distress by AV; this will be operationalized by participants scoring greater than or equal to 5 on the personal analogue measure of distress caused by the AV. 7. Be willing and have the capacity to provide written, informed consent
Exclusion criteria
Exclusion criteria: 1. Following permission gained from the participant, a clinician-reported active diagnosis for an eating disorder other than anorexia nervosa 2. Following permission gained from the participant, a clinician-reported active diagnosis of psychosis 3. Non-English speaking to the degree that the participant is unable to fully understand and answer assessment questions or give informed consent* 4. Immediate and serious risk to self or others where alternative interventions would take priority over participating in the research study (e.g being detained under the mental health act, requiring admission to hospital for refeeding) * Funding for translation services is not available but efforts will be made where possible to use translation services from clinical resources available at the participating NHS trust services.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The feasibility and acceptability of Relating Therapy to clinicians and clients will be assessed using the following outcomes at the end of the study: 1. The number of clients referred 2. The proportion of referred clients found to be eligible 3. The proportion of consenting participants who are retained within the study and offer full datasets 4. The proportion of non-missing items for each variable 5. The proportion of consenting participants who reach the point of therapy ‘exposure’ (attend at least 16 therapy sessions) | — |
Secondary
| Measure | Time frame |
|---|---|
| Measures (quantitative): During the baseline phase, assessment data will be collected weekly and consist of three timepoints. During the intervention phase, the personal analogue measures and weight will continue to be collected weekly, and the remaining outcome measures will be collected at 4-week intervals. All assessment data will then be collected at the post-intervention timepoint and a further 4-week interval for the follow-up timepoint. 1. Disordered eating over a period of 28 days measured using the Eating Disorder Examination Questionnaire Short (EDE-QS) 2. Weight and BMI measured using calibrated weighing scales at the start of appointments. Participants' weight (kg) and height (cm) will be used to calculate Body Mass Index (BMI) 3. Hamilton Program for Voices Questionnaire (HPSVQ) - 1 item will be used from the 4-item ‘negative impact of voices’ subscale during the screening meeting 4. Frequency of depression symptoms measured using the Patient Health Questionnaire (PHQ-9) 5. Frequency of generalized anxiety symptoms measured using Generalised Anxiety Disorder Questionnaire (GAD-7) 6. Relationship between the AV and the self, measured using the Experience of an Anorexic VoicE Questionnaire (EAVE-Q) 7. Assertive and non-assertive (passive and aggressive) relating to voices and other people; named Approve-Voices and Approve-Social respectively, measured using The Approve Questionnaires 8. Power differential that exists between the client and the voice(s) they hear, measured using the Voice Power Differential Scale 9. Personal analogue measure of distress caused by the AV, measured using a Personalised Analogue Measures Likert scale weekly during baseline and intervention phases. 10. A personal analogue measure of achievement of an identified personal goal of therapy, measured using the CHOICE questionnaire Measures (qualitative): Qualitative data will be generated using the Change Interview to guide discussions at the exit interview at the end of treat | — |
Countries
England, United Kingdom
Outcome results
None listed