A randomised clinical trial to evaluate the acceptability and efficacy of an early phase, online, guided augmentation of outpatient care for adults with anorexia nervosa

Outpatient interventions for adult anorexia nervosa typically have a modest impact on weight and eating disorder symptomatology. This study examined whether adding a brief online intervention focused on enhancing motivation to change and the development of a recovery identity (RecoveryMANTRA) would...

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Bibliographic Details
Published in:Psychological medicine 2020-11, Vol.50 (15), p.2610-2621
Main Authors: Cardi, Valentina, Albano, Gaia, Ambwani, Suman, Cao, Li, Crosby, Ross D., Macdonald, Pamela, Schmidt, Ulrike, Treasure, Janet
Format: Article
Language:English
Subjects:
Adjustment
Adults
Anorexia
Anxiety
Augmentation
Body mass index
Brief interventions
Clinical outcomes
Clinical research
Clinical trials
Eating disorders
Efficacy
Empowerment
Intervention
Mental disorders
Mentors
Motivation
Original Articles
Outpatient treatment
Patients
Psychological well being
Questionnaires
R&D
Recovery
Recovery (Medical)
Research & development
Social interactions
Therapeutic alliances
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Summary:Outpatient interventions for adult anorexia nervosa typically have a modest impact on weight and eating disorder symptomatology. This study examined whether adding a brief online intervention focused on enhancing motivation to change and the development of a recovery identity (RecoveryMANTRA) would improve outcomes in adults with anorexia nervosa. Participants with anorexia nervosa (n = 187) were recruited from 22 eating disorder outpatient services throughout the UK. They were randomised to receiving RecoveryMANTRA in addition to treatment as usual (TAU) (n = 99; experimental group) or TAU only (n = 88; control group). Outcomes were measured at end-of-intervention (6 weeks), 6 and 12 months. Adherence rates to RecoveryMANTRA were 83% for the online guidance sessions and 77% for the use of self-help materials (workbook and/or short video clips). Group differences in body mass index at 6 weeks (primary outcome) were not significant. Group differences in eating disorder symptoms, psychological wellbeing and work and social adjustment (at 6 weeks and at follow-up) were not significant, except for a trend-level greater reduction in anxiety at 6 weeks in the RecoveryMANTRA group (p = 0.06). However, the RecoveryMANTRA group had significantly higher levels of confidence in own ability to change (p = 0.02) and alliance with the therapist at the outpatient service (p = 0.005) compared to the control group at 6 weeks. Augmenting outpatient treatment for adult anorexia nervosa with a focus on recovery and motivation produced short-term reductions in anxiety and increased confidence to change and therapeutic alliance.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291719002824