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Psychological therapies in anorexia nervosa: on the wrongtrack?

Recently, in a randomised controlled trial, specialist supportive clinical management (SSCM) has proven to be more effective than the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA), a treatment specially designed to address the disorder according to a rather complex rationale in co...

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Bibliographic Details
Published in:British journal of psychiatry 2013-05, Vol.202 (5), p.384-384
Main Authors: Gutierrez, Emilio, Carrera Olaia
Format: Article
Language:English
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Summary:Recently, in a randomised controlled trial, specialist supportive clinical management (SSCM) has proven to be more effective than the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA), a treatment specially designed to address the disorder according to a rather complex rationale in comparison with SSCM. 1 Specialist supportive clinical management, originally ‘non-specific supportive clinical management’ administered to a control group in a previous randomised controlled trial, 2 was found to be more effective than two specialised treatments - cognitive-behavioural therapy and interpersonal therapy - and was as effective as these treatments at 5-year follow-up. 3 Specialist supportive clinical management was originally defined as clinical management and supportive psychotherapy, as revealed by its original definition: ‘Non-specific supportive clinical management was developed for the present study, and its aim was to mimic outpatient treatment that could be offered to individuals with anorexia nervosa in usual clinical practice. The abnormal nutritional status and dietary patterns typical of anorexia nervosa were central to non-specific supportive clinical management, which emphasised the resumption of normal eating and the restoration of weight and provided information on weight maintenance strategies, energy requirements and relearning to eat normally. (p. 742) 2 In contrast, MANTRA claims to be novel in several respects: (a) it is biologically informed and trait-focused, drawing on neuropsychological, social cognitive and personality trait research; (b) it includes both intra- and interpersonal maintaining factors and strategies to address these; and (c) it is modularised with a hierarchy of procedures tailored to the individuals (as described in the authors' online Table DS1).
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.202.5.384