Jenna Whitney

Can cognitive exercises help treat anorexia nervosa

Cognitive remediation therapy (CRT) is used as an intervention for people with brain lesions and psychosis. This case report demonstrates the possible benefits of introducing CRT into treatment packages for anorexia nervosa (AN). In our previous work, we reported that people with AN demonstrate inflexibility in cognitive set-shifting tasks. Weight gain alone does not improve the neuropsychological profile in set-shifting tasks. This case report illustrates how training programmes can address problems in cognitive rigidity. We acknowledge the limitations of case studies, however, this is a starting point in exploring the possibilities of introducing CRT as part of the treatment of AN.

A description of multiple family workshops for carers of people with anorexia nervosa

Carers of people with eating disorders are uncertain about how best to help and express the need for information. Fifty per cent of carers (usually parents) exhibit clinically significant anxiety and/or depression. This may result from a difficulty coping with the manifestations of anorexia nervosa (AN) in the sufferer. In turn, eating disorder symptoms can be maintained by family reactions to the illness. Thus, carers own symptoms, plus their uncertainty about how to help, impinge upon the AN sufferer, exacerbating their symptoms and behaviours. In this paper, we describe an intervention which uses cognitive behavioural therapy principles to alleviate carers depression and anxiety and motivational interviewing to target behaviours that maintain eating disorder symptoms, for example high expressed emotion and poor communication. This is given in the form of an educational workshop for two families.

Family work in anorexia nervosa: a qualitative study of carers' experiences of two methods of family intervention.

BACKGROUND Qualitative methods can aid in the development of complex interventions. AIMS Qualitative methodology was used to examine treatment efficacy, carer satisfaction and process of change in carers of people with anorexia nervosa who participated in a randomised controlled trial (RCT) comparing individual family work (IFW) and multi-(dual) family workshops. METHOD Twenty-three carers were interviewed. Themes were developed using Interpretive Phenomenological Analysis (IPA). RESULTS Carers who worked with another family described this as beneficial. There was dissatisfaction about a lack of structure perceived in the IFW. Most carers felt the interventions helped them communicate, understand the illness and gain personal and familial insight. Although there was lack of consensus on the most helpful techniques, carers felt sessions should focus on individual relationships and practical guidance for challenging behaviour. CONCLUSIONS Carers valued structured, skills-based interventions. The inclusion of multiple families may reduce carer blame and isolation and facilitate skills-based learning.