Guided Self Help for Anorexia Nervosa

(GSHimplement Trial)

Overseen By Jennifer Couturier, MSc, MD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: McMaster University

Disqualifiers: Hospitalization, Drug dependence, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 10 weeks

90 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Guided Self Help Family Based Therapy (GSH FBT) for anorexia nervosa?

Research shows that guided self-help approaches, like GSH FBT, can help patients stay engaged in their treatment and improve the wellbeing of their caregivers. This suggests that GSH FBT might be effective in supporting recovery from anorexia nervosa. ^{1 2 3 4 5}

Is guided self-help family-based therapy safe for humans?

The studies on guided self-help family-based therapy for anorexia nervosa focus on feasibility and acceptability, but they do not report any specific safety concerns, suggesting it is generally safe for use in humans. ^{1 4 6 7 8}

What makes Guided Self Help Family Based Therapy (GSH FBT) unique for treating anorexia nervosa?

Guided Self Help Family Based Therapy (GSH FBT) is unique because it allows parents to play an active role in their child's treatment for anorexia nervosa through a self-help format, making it more accessible for families who cannot attend traditional therapy sessions. This approach can be delivered online, providing flexibility and support even for those on waitlists for face-to-face therapy. ^{1 4 6 7 8}

What is the purpose of this trial?

Eating disorders are amongst the most understudied illnesses affecting young women in Canada. Further, mortality rates are amongst the highest of all psychiatric illnesses. Despite their high prevalence and mortality rates, research into adolescent eating disorders is underfunded in Canada. In addition to the problem of research underfunding, healthcare system underfunding exists - creating long waiting lists and fragmented care for children and youth with eating disorders. More efficient treatments are urgently needed to reduce wait times and provide expedited care to adolescents on eating disorder waitlists. The current study aims to assess whether implementing a virtual parent-lead therapy, Guided Self Help Family-Based Therapy (GSH FBT) might alleviate wait times for eating disorder services and also reduce eating disorder symptomatology in young people with anorexia nervosa. This study also aims to determine the experiences of both families and medical teams of GSH FBT implementation as an intervention.

Eligibility Criteria

This trial is for young individuals in Canada with anorexia nervosa or other eating disorders. It's designed to help those facing long wait times for treatment by testing a virtual parent-led therapy called Guided Self Help Family-Based Therapy (GSH FBT).

Inclusion Criteria

Access to computer and internet connection

My family has a teenager diagnosed with Anorexia nervosa.

Capacity to speak, write, and understand English

Exclusion Criteria

Adolescent has a current physical condition known to influence weight or eating (pregnancy, diabetes mellitus)

My body weight is expected to be less than 75% of the ideal for my age.

Does not have the capacity to speak, write, and understand English

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Guided Self Help Family-Based Therapy (GSH FBT) for eating disorders, involving pre-recorded videos, an electric scale, and a therapy manual

10 weeks

Virtual sessions with therapist 'coach'

Follow-up

Participants are monitored for changes in eating disorder symptoms, depressive symptoms, anxiety symptoms, and parental self-efficacy

14 weeks

Implementation Evaluation

Evaluation of implementation success, including fidelity assessments and qualitative measures of experiences from families and providers

Throughout the trial

Treatment Details

Interventions

• Guided Self Help Family Based Therapy (GSH FBT)

Trial Overview The study tests the effectiveness of GSH FBT, a virtual therapy led by parents to treat adolescents with eating disorders. The goal is to see if this method can reduce waiting periods and improve symptoms more efficiently.

Participant Groups

Group I: Parents who have a child with anorexia nervosa Experimental Treatment 1 Intervention

Each participant will receive a series of pre-recorded videos, an electric scale, and a therapy manual ("Help Your Teen Beat an Eating Disorder"). This will include content on empowering parents to renourish their child and interrupt binge/purge behaviors.

Who Is Running the Clinical Trial?

McMaster University

Lead Sponsor

Trials

936

Recruited

2,630,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Findings from Research

A pilot study involving 40 adolescents with anorexia nervosa showed that both the online guided self-help program for parents (GSH-FBT) and videoconferencing family-based treatment (FBT-V) were similarly acceptable and effective in improving weight and parental self-efficacy, with significant improvements maintained at a 3-month follow-up.

GSH-FBT demonstrated a greater efficiency in achieving treatment outcomes compared to FBT-V, suggesting that online interventions may be a more time-effective option for families dealing with anorexia nervosa.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of conducting a randomized controlled trial comparing family-based treatment via videoconferencing and online guided self-help family-based treatment for adolescent anorexia nervosa. Lock, J., Couturier, J., Matheson, BE., et al.[2021]

The online guided self-help family-based treatment (GSH-FBT) for families waiting for face-to-face treatment showed promising results, with participating children gaining an average of 6 kg and experiencing a significant decrease in eating disorder behaviors.

Parents reported enhanced knowledge, skills, and confidence in managing their child's anorexia nervosa, indicating that GSH-FBT can be a valuable interim support, although strategies to improve initial recruitment are necessary.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is guided self-help family-based treatment for parents of adolescents with anorexia nervosa on treatment waitlists feasible? A pilot trial. Wade, T., Byrne, S., Fursland, A., et al.[2022]

A parental guided self-help version of family-based treatment (FBT) for adolescent anorexia nervosa was found to be feasible and acceptable, with 19 families participating in the study over 6 months.

Participants showed significant improvements in weight, with median BMI increasing from 85.01% to 97.31%, and reductions in eating-related psychopathology, indicating potential effectiveness of this self-help approach, although further evaluation is needed due to a high dropout rate.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parental guided self-help family based treatment for adolescents with anorexia nervosa: A feasibility study. Lock, J., Darcy, A., Fitzpatrick, KK., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Feasibility of conducting a randomized controlled trial comparing family-based treatment via videoconferencing and online guided self-help family-based treatment for adolescent anorexia nervosa. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

A pilot study of multifamily therapy group for young adults with anorexia nervosa: Reconnecting for recovery. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Task-sharing interventions for patients with anorexia nervosa or their carers: a systematic evaluation of the literature and meta-analysis of outcomes. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

Comparison of long-term outcomes in adolescents with anorexia nervosa treated with family therapy. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Ten session body image therapy: efficacy of a manualised body image therapy. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Is guided self-help family-based treatment for parents of adolescents with anorexia nervosa on treatment waitlists feasible? A pilot trial. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Parental guided self-help family based treatment for adolescents with anorexia nervosa: A feasibility study. [2018]

8. England pubmed.ncbi.nlm.nih.gov

An evaluation of family-based treatment for restrictive-type eating disorders, delivered as standard care in a public mental health service. [2021]