Acta Psychopathologique Libre accès


A Qualitative Evaluation of Adolescent Patient’s and their Caregiver’s Perspectives following a Skills Intervention for Caregivers of People with Anorexia Nervosa

Pam Macdonald

Objective: Caregivers request information; guidance and support in helping their loved one recover from Anorexia Nervosa (AN). The question is whether skills training interventions are of help, both to them, and indirectly for the person with AN. The aim of this study is to examine feedback from adolescent patients and their caregivers about their experiences following a skills intervention which compared two forms of interventions for caregivers (skills training materials, with or without coaching {E}) with Treatment As Usual (TAU).

Method: Patients and caregivers from 38 eating disorder outpatient centers were randomized into one of three groups: a) skills training materials + TAU, b) skills training materials plus telephone coaching + TAU) or c) TAU alone. Feedback forms were sent to participants at 12 months and completed by 69 patients (n=26E; n=21 EC; n=21T) and 144 caregivers (n=50E; n=47EC; n=47T). Data were coded blind to treatment group by two researchers using thematic analysis.

Results: Caregivers and patients recognize more positive changes in their caregivers’ approach than those in TAU. The additional coaching element was associated with a greater level of perceived self-changes in carers, e.g. relationship improvements, reduced anxiety, anger and hostility, than self-help alone and this, in turn, was greater than in TAU.

Discussion: Qualitative feedback suggests that skills training materials may produce changes in caregiver behavior, noted by patients and caregivers, particularly in the more intensive intervention group. Statistical analyses should be employed to explore these results further. This approach is easily disseminated and may play an important role in breaking some of the barriers to early intervention in this patient group.