Effectiveness of the ECHOs Approach for Patients With Eating Disorders and Their Carers

Not Applicable

Completed

• Conditions: Eating Disorders
• Interventions: Behavioral: Treatment as Usual; Behavioral: ECHOs plus TAU

• Registration Number: NCT01927042
• Lead Sponsor: Nova Scotia Health Authority

Brief Summary

Family therapy is considered an empirically supported treatment approach for adolescents and adults with eating disorders. One family based approach, Expert Carers Helping Others (ECHO) is based on evidence that suggests family environment, e.g., carer criticism, can influence an individual's eating disorder symptoms. ECHO aims to improve carer coping, reduce expressed emotion and manage eating disorder symptoms, and has been associated with reduced carer distress, caregiver burden, and an increase in general well being. The current pilot study seeks to evaluate a new condensed version of the ECHO intervention that is delivered entirely in a 2 ½ hour self-help DVD format (ECHOs). Sixty patients and their carers will be recruited from the Capital Health Eating Disorders Service and randomized into either a treatment as usual group (TAU) or a TAU+ECHOs group. Both carers and patients will be assessed along a variety of dimensions including psychiatric symptoms, family functioning, and carer and patient collaboration, at pre-intervention, four weeks later at post-intervention, and then three-months post-intervention. ANOVAs will be used to compare the primary outcomes between the two groups over time. This pilot study will be the first evaluation of ECHOs, which may ultimately boost the efficacy of current treatment for adults with eating disorders and reduce carer distress.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2013-08-15
• Study First Submitted QC: 2013-08-21
• Study First Posted: 2013-08-22
• Study Start: 2014-04
• Primary Completion: 2017-12
• Study Completion: 2017-12
• Status Verified: 2018-07
• Last Update Submitted: 2018-07-16
• Last Update Posted: 2018-07-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 58

Inclusion Criteria

• Patients with an ED (AN, BN, EDNOS) according to DSM-V criteria (American Psychiatric Association, 2013) as determined by standard clinical interview completed by team psychiatrist or clinical psychologist.
• Patients age of >17y.o.
• Carers can include parents/partners/siblings/extended family who provide unpaid help and support. Peers and roommates could also be included in circumstances within which they play a significant role in the person's life and meet the following criteria:
• Live with or have regular, current contact with the patient (at least 7 hours/week) throughout the duration of the trial (approximately 6months).
• Interact with the patient in some meaningful manner regarding their ED (e.g. provide support, eat meals together, discussions about behaviours).
• Consent from patient and at least one carer

Exclusion Criteria

• ED comorbid with severe psychiatric or physical comorbidity: e.g. current psychotic illness (inc. bipolar disorder), severe alcohol/drug abuse, significant metabolic or gastrointestinal problems (i.e. treatment interfering) as determined by standard clinical interview completed by team psychiatrist or clinical psychologist.
• Family in a concurrent treatment trial.
• Either patient or carer has insufficient knowledge of English.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Treatment as Usual	Treatment as Usual	Treatment as usual (TAU) consists of group psychotherapy and skills training, nutritional counselling, and meal support.
Expert Cares Helping Others plus Treatment as Usual	ECHOs plus TAU	The experimental treatment (ECHOs plus TAU) will consist of the standard treatment consisting of group psychotherapy and skills training, nutritional counselling, and meal support, PLUS self-help unguided DVD series for carers, providing education about eating disorders and coping strategies for supporting those living with eating disorders.

Primary Outcome Measures

Name	Time	Method
Changes in Carer and Patient Collaboration Scale (CPCS).	baseline, 4-weeks post-intervention, 3 months follow-up	A scale to assess self efficacy in caregiving, specifically tailored to measure the skills taught in the ECHOs intervention. This scale will assess changes from baseline to post-internvention in caregiver efficacy.
Changes in Short Evaluation of Eating Disorders (SEED)	baseline, 4-weeks post-intervention, 3 months follow-up	This measure will asssess changes in the severity of key anorexic and bulimic symptoms from baseline to post-treatment, and follow-up.

Secondary Outcome Measures

Name	Time	Method
Depression, Stress and Anxiety Scale (DASS-21)	baseline, 4-weeks post-intervention, 3 months follow-up	a measure of severity of anxiety, depression and stress pre- to post-treatment
The Family Questionnaire (FQ)	baseline, 4-weeks post-intervention, 3 months follow-up	20-item self report measure of expressed emotion in carers. Scores are given on a 4-point Likert scale and will measure the levels of expressed emotion from pre-intervention to post-intervention.

Trial Locations

Locations (1)

Capital Health District Health Authority; 🇨🇦 Halifax, Nova Scotia, Canada