Early intervention in eating disorders: a parent group approach

Authors

  • Dasha E. Nicholls,

    Corresponding author
    1. Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust
    2. UCL Institute of Child Health, University College London, London
      Dr Dasha E. Nicholls, Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK. Email: d.nicholls@ich.ucl.ac.uk
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  • Irene Yi

    1. Surrey and Borders Partnership NHS Foundation Trust, Surrey, UK
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  • This paper was presented at the EDs Section Conference of the Royal College of Psychiatrists in September 2011.

Dr Dasha E. Nicholls, Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK. Email: d.nicholls@ich.ucl.ac.uk

Abstract

Aim: Early intervention in eating disorders (EDs) has been a neglected area. Peak onset is in adolescence, suggesting that early intervention should include parents. We synthesize findings from five key theoretical domains, and present pilot data from a phase-specific early intervention for new onset EDs in young people.

Methods: From literature searches, we reviewed current knowledge on risk factors for EDs; ED prevention in young people; the evidence base for treatment for young people with EDs; early intervention in other mental health fields; and parenting interventions. Based on these findings, we devised and piloted a parent group intervention.

Results: Presenting features are typically parental concern about changes in eating behaviour and/or weight loss. There is a delay between symptom onset and help seeking, by which time the illness is well established. Early intervention should therefore target parents and be delivered at secondary rather than primary care. Effective treatments favour family-focused interventions with parental responsibility for symptom management. We hypothesized that a parents' group might be effective for addressing the specific emotional experience of parents in the early stages and their relative lack of knowledge and understanding. Pilot data show significant improvements in knowledge, skills, confidence, understanding and their child's adherence to meal plans as a result of a 6-week parent group intervention.

Conclusion: A parent group intervention addressing themes identified from risk factor, prevention and treatment research is a potentially promising approach to early intervention for EDs. The impact of the intervention on patient outcome needs evaluation.

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