Developing and evaluating a ‘low intensity’ psychological treatment for children and young people

Developing and evaluating a ‘low intensity’ psychological treatment for children and young people with eating disorders

Background:
Eating disorders have serious physical, psychological and social consequences and the Government has recognised ‘it is vital that children and young people with eating disorders and their families can access effective help quickly’1. It is recognised that offering evidence-based, high quality care can improve early detection, recovery rates, lead to fewer relapses and reduce the need for inpatient admissions and Government guidelines suggest that treatment should be received within a maximum of 4 weeks from first contact with a designated healthcare professional for routine cases and 1 week for urgent cases2. To meet this demand, a stepped care approach to treatment including guided self-help is required as is recommended for (a) related mental health disorders such as anxiety and depression in children3, (b) binge eating disorder in adolescents4 and (c) eating disorders in adults5. However, parent-delivered guided self-help interventions are not yet able to be recommended for children and young people with eating disorders because they have not been sufficiently researched.

Aims/Objectives:
This PhD project aims to (i) develop and (ii) evaluate parent-delivered guided self-help for impairing symptoms of eating disorders in children and young people for whom it is clinically appropriate.

Methods and Timeline:
1.  Systematic review and meta-analysis of guided self-help interventions for children and young people with eating disorders. (Months 1-6)
2.  Identification of appropriate self-help books or equivalent to be the basis of the guide for the range of eating disorders for which the systematic review has indicated that parent-delivered guided self-help would be suitable. (Months 6-9)
3.  Modification of self-help books to be used as parent-delivered guided self-help with guidance from a therapist; modifications would be made with input from focus groups of young people with eating disorders and their parents, charities and health professionals. (Months 9-18)
4.  Conducting a feasibility study for the delivery of parent-delivered guided self-help for children and young people with impairing symptoms of eating disorders using patients recruited from Great Ormond Street Hospital and local Child and Adolescent Mental Health and community services. (Months 18-30)
5.  Conducting a multiple baseline case series to establish the impact of the parent-delivered guided self-help for children and young people with impairing symptoms of eating disorders (Months 18-30)
6.  Writing up and disseminating findings (Months 31-36)

References:
1. NHS England » Children And Young People’S Eating Disorders Programme. [online] England.nhs.uk. Available at: https://www.england.nhs.uk/mental-health/cyp/eating-disorders/
2. Available at: www.england.nhs.uk/wp-content/uploads/2015/07/cyp-eating-disorders-access-waiting-time-standard-comm-guid.pdf
3. Bennett, S. D., Cuijpers, P., Ebert, D. D., McKenzie Smith, M., Coughtrey, A. E., Heyman, I., ... & Shafran, R. (2019). Practitioner Review: Unguided and guided self‐help interventions for common mental health disorders in children and adolescents: a systematic review and meta‐analysis. Journal of Child Psychology and Psychiatry, 60(8), 828-847.
4. Schmidt, U., Lee, S., Beecham, J., Perkins, S., Treasure, J., Yi, I., Winn, S. et al. "A randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders." American Journal of Psychiatry 164, no. 4 (2007): 591-598.
5. www.nice.org.uk/guidance/ng69/resources/eating-disorders-recognition-and-treatment-pdf-1837582159813