Gina Dimitropoulos1, James D Lock2, William Stewart Agras2, Harry Brandt3, Katherine A Halmi4, Booil Jo2, Walter H Kaye5, Leora Pinhas6, Denise E Wilfley7, D Blake Woodside8. 1. Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada. 2. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA. 3. The Center for Eating Disorders, Sheppard Pratt Health System, Baltimore, MD. 4. Department of Psychiatry, Weill Medical College, Cornell University, New York, NY. 5. Centre for Eating Disorders, Department of Psychiatry, University of California, San Diego, CA. 6. Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada. 7. Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. 8. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: This exploratory study is the first to examine family-based treatment (FBT) adherence and association to treatment outcome in the context of a large-scale, multi-centre study for the treatment of adolescents with anorexia nervosa. METHOD: One hundred and ninety recorded FBT sessions from 68 adolescents with anorexia nervosa and their families were recruited across multiple sites (N = 6). Each site provided 1-4 tapes per family over four treatment time points, and each was independently rated for therapist adherence. RESULTS: There were differences in adherence scores within and between sites. ANOVA produced a main effect for site, F(5, 46) = 8.6, p < .001, and phase, F(3, 42) = 12.7, p < .001, with adherence decreasing in later phases. Adherence was not associated to end of treatment percent ideal body weight after controlling for baseline percent ideal body weight (r = .088, p = .48). CONCLUSIONS: Results suggest that FBT can be delivered with adherence in phase one of treatment. Adherence was not associated with treatment outcome as determined using percent ideal body weight.
OBJECTIVE: This exploratory study is the first to examine family-based treatment (FBT) adherence and association to treatment outcome in the context of a large-scale, multi-centre study for the treatment of adolescents with anorexia nervosa. METHOD: One hundred and ninety recorded FBT sessions from 68 adolescents with anorexia nervosa and their families were recruited across multiple sites (N = 6). Each site provided 1-4 tapes per family over four treatment time points, and each was independently rated for therapist adherence. RESULTS: There were differences in adherence scores within and between sites. ANOVA produced a main effect for site, F(5, 46) = 8.6, p < .001, and phase, F(3, 42) = 12.7, p < .001, with adherence decreasing in later phases. Adherence was not associated to end of treatment percent ideal body weight after controlling for baseline percent ideal body weight (r = .088, p = .48). CONCLUSIONS: Results suggest that FBT can be delivered with adherence in phase one of treatment. Adherence was not associated with treatment outcome as determined using percent ideal body weight.
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