Implementing and evaluating the uptake of family inclusive practice in adult eating disorders: A stepped care approach to working with families of adults affected by eating disorders.

Family-based treatment and active carer involvement are common in the treatment of child and adolescent eating disorders but little is known about the preferences for family involvement in treatment seeking adults with eating disorders. The current study examined patient demographic characteristics and clinical features associated with a preference for family involvement as well as the impact of a brief family consultation adjunct to treatment as usual in a sample of adult outpatients. Utilising an observational design, 12 months of service delivery in a cohort of adult referrals to an EDs outpatient service was analysed in a prospective investigation into uptake of treatment as usual supplemented with a proactive carer engagement strategy. Following a routine offer to involve family members or other supports, patients who chose to involve their carers were compared to those who did not. 35 consecutive referrals to a typical adult outpatient treatment service aged 18 to 56 years were examined. 69% of adult patients chose to involve their carers in treatment. Patient illness severity, psychosocial impairment, and readiness to change were unrelated to the uptake of family inclusive treatment. The family consultation had an impact on the frequency of, disturbance from and confidence regarding the problems participants identified. A range of adults at varying stages of illness want family members involved during outpatient treatment and will take this up if proactively offered.