ABSTRACT
OBJECTIVE: We tested the feasibility, acceptability, and preliminary effect sizes on outcome measures of Reconnecting for Recovery (R4R) Multifamily Therapy Group for young adults with anorexia nervosa (AN). METHOD: Ten participants (mean age = 23 years, SD = 3.6) meeting Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria for a restrictive eating disorder (AN or other specified feeding and eating disorder) and 14 family members received 16 R4R outpatient sessions over 26 weeks. Feasibility and acceptability were evaluated by recruitment and retention rates and patient/family member suitability scores. Outcomes were determined utilizing the Eating Disorder Examination (EDE), weight (body mass index), and Difficulties in Emotion Regulation Scale. RESULTS: All participants and 12 family members were retained, and the majority found R4R acceptable. EDE global score and lack of emotional awareness improved significantly from baseline (BL) to end-of-treatment (EOT) and BL to 6-month follow-up (6MFU) with moderate to large effect sizes (0.47-1.41). Limited access to emotion regulation strategies (LAERS) improved significantly from BL to 6MFU (moderate effect size; 0.57). Improvements in LAERS from BL to EOT (0.32) and weight from BL to EOT and BL to 6MFU were not significant (effect sizes 0.16-0.22). DISCUSSION: Findings provide preliminary evidence that R4R is feasible, acceptable, and produces clinically significant changes in targeted outcomes.
Subject(s)
Anorexia Nervosa/therapy , Family Therapy/methods , Patient Acceptance of Health Care/psychology , Adult , Anorexia Nervosa/psychology , Awareness , Body Mass Index , Body Weight , Emotions , Feasibility Studies , Female , Humans , Male , Outpatients/psychology , Pilot Projects , Treatment Outcome , Young AdultABSTRACT
A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6 month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6 month SDT-based intervention to 12 months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12 month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30 day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others.
