Adele Lafrance Robinson

‘I Know I Can Help You’: Parental Self‐efficacy Predicts Adolescent Outcomes in Family‐based Therapy for Eating Disorders

Family-based therapy is regarded as best practice for the treatment of eating disorders in adolescents. In family-based therapy, parents play a vital role in bringing their child or adolescent to health; however, little is known about the parent-related mechanisms of change throughout treatment. The present study examines parent and adolescent outcomes of family-based therapy as well as the role of parental self-efficacy in relation to adolescent eating disorder, depressed mood and anxiety symptoms. Forty-nine adolescents and their parents completed a series of measures at assessment, at 3-month post-assessment and at 6-month follow-up. Results indicate that, throughout treatment, parents experienced an increase in self-efficacy and adolescents experienced a reduction in symptoms. Maternal and paternal self-efficacy scores also predicted adolescent outcomes throughout treatment. These results are consistent with the philosophy of the family-based therapy model and add to the literature on possible mechanisms of change in the context of family-based therapy.

Adapting family‐based therapy to a day hospital programme for adolescents with eating disorders: preliminary outcomes and trajectories of change

Adolescent eating disorder symptoms, depression and anxiety, the impact of their symptoms on their parents, and parental self-efficacy were assessed before beginning family-based day hospital treatment, and at 3 and 6 months post-assessment. Parents’ self-efficacy increased during the first 3 months of treatment, and their knowledge and confidence in their effectiveness against the eating disorder continued to increase between 3 and 6 months post-assessment. Adolescent eating disorder symptoms, depression and anxiety, and the impact of the symptoms on their parents decreased between 3 and 6 months post-assessment. The results suggest that family-based treatment can be adapted to day hospital programmes for adolescents. The results also provide preliminary support for a treatment duration of at least 6 months.

Is the Next Generation of Physicians Adequately Prepared to Diagnose and Treat Eating Disorders in Children and Adolescents

This study examined medical residents’ comfort with and knowledge of eating disorder assessment and treatment practices for children and adolescents. Since entering medical school, the majority of respondents reported receiving fewer than 5 hours of training in this area. Participants reported feeling more comfortable with the assessment of eating disorders than with their medical management and treatment. Questions testing participants’ knowledge in these domains reflected this finding; participants did well on the assessment questions, but quite poorly on the treatment questions. Intensity of training and self-reported comfort with these skills predicted residents’ knowledge, suggesting that additional training opportunities are warranted.

“That chair work thing was great”: a pilot study of group-based emotion-focused therapy for anxiety and depression

Emotion-focused therapy (EFT) is an evidence-based treatment for depression and it has shown promise for the treatment of anxiety. Only one other published study has examined EFT in a group therapy setting. Using mixed-methods, the current study explored the feasibility and outcomes of an EFT group with adults referred for anxiety and depression. Pre-, post-, and 12-month follow-up measures of depression, anxiety, and difficulties in emotion regulation were administered in addition to a semi-structured interview at one-year follow-up. The analysis of individual interviews suggested improvements in various areas of functioning and quantitative data revealed a significant decrease in emotion regulation difficulties. The results of this study provide preliminary support for the application and further study of group-based EFT for clinical presentations of anxiety and depression.

The influence of carer fear and self-blame when supporting a loved one with an eating disorder

ABSTRACT Carers often feel disempowered and engage in behaviours that inadvertently enable their loved one’s ED symptoms and yet little is known regarding these processes. This study examined the relationships among fear, self-blame, self-efficacy, and accommodating and enabling behaviours in 137 carers of adolescents and adults with ED. The results revealed that fear and self-blame predicted low carer self-efficacy in supporting their loved one’s recovery as well as the extent to which carers reported engaging in recovery-interfering behaviours. The relevance of these findings are discussed in the context of family-oriented ED therapies and highlight the importance for clinicians to attend to and help to process strong emotions in carers, in order to improve their supportive efforts and, ultimately, ED outcomes.

The Influence of Clinician Emotion on Decisions in Child and Adolescent Eating Disorder Treatment: A Survey of Self and Others

Eating disorder clinicians from various disciplines participated in one of two surveys: the “self” group (n = 143) completed a survey assessing the negative influence of emotions on their own clinical decisions, while the “other” group (n = 145) completed a parallel version of the survey that assessed their perceptions of the negative influence of emotion in their colleagues. Both groups endorsed this phenomenon to some degree, although differences in reporting were noted between groups. The perceived negative influence of emotion with regards to specific treatment decisions fell within three categories: decisions regarding food and weight, decisions regarding the involvement of the family in treatment, and decisions related to autonomy and control. Decisions regarding the involvement of the family were perceived to be the most emotionally charged, in particular the involvement of a critical or dismissive parent.

The effect of academic stress and attachment stress on stress-eaters and stress-undereaters.

It is well established that stress is related to changes in eating patterns. Some individuals are more likely to increase their overall food intake under conditions of stress, whereas others are more likely to consume less food when stressed. Attachment style has been linked to disordered eating and eating disorders; however, comparisons of eating behaviors under attachment versus other types of stress have yet to be explored. The present laboratory study examined the eating patterns in self-identified stress-undereaters and stress-eaters under various types of stress. More specifically, the study examined the effects of academic and attachment stress on calorie, carbohydrate and sugar consumption within these two groups. Under the guise of critiquing student films, university students viewed either one of two stress-inducing videos (academic stress or attachment stress, both designed to be emotionally arousing) or a control video (designed to be emotionally neutral), and their food intake was recorded. Results demonstrated that the video manipulations were effective in inducing stress. Differential patterns of eating were noted based on group and stress condition. Specifically, stress-undereaters ate fewer calories, carbohydrates and sugars than stress-eaters in the academic stress condition, but not in the attachment stress or control condition. Findings suggest that specific types of stressors may influence eating behaviors differently.