Brief early adolescent multi-family therapy (BEAM) trial for anorexia nervosa: a feasibility randomized controlled trial protocol

Julian Baudinet; Ivan Eisler; Mima Simic; Ulrike Schmidt

doi:10.1186/s40337-021-00426-4

Brief early adolescent multi-family therapy (BEAM) trial for anorexia nervosa: a feasibility randomized controlled trial protocol

Julian Baudinet^*, Ivan Eisler, Mima Simic, Ulrike Schmidt

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

Introduction: Multi-family therapy (MFT) is a recommended treatment for adolescent anorexia nervosa internationally. Despite recent significant advances in single-family therapy, the evidence base for MFT remains relatively small. Several individual and family factors have been associated with poorer outcomes in single-family therapy, many of which may be addressed or ameliorated by MFT if delivered early in treatment. This trial aims to determine the feasibility and acceptability of adding a five-day multi-family therapy group to the early stages of family therapy for anorexia nervosa. Secondary objectives are to explore effect size changes in key individual and family factors across treatment. Methods: This feasibility trial will use a randomised controlled design. Sixty adolescents (age 10–17 inclusive) with anorexia nervosa or atypical anorexia nervosa and their parents will be recruited from a community-based specialist eating disorder service in London, UK. Participants will be randomly allocated to receive six months of eating disorder focussed family therapy with a five-day MFT group (experimental group) or without (control group). Block randomisation will be conducted by the King’s Clinical Trials Unit and researchers will be blind to participants’ intervention allocation. Feasibility, acceptability and secondary outcomes measures will be collected at baseline, post-MFT, end of treatment, six-month and 12-month follow-up. Feasibility and acceptability will be assessed according to trial sign-up rates, retention, measure completion rates and satisfaction. Secondary outcomes include physical health improvements, changes in psychiatric symptoms, emotion regulation and reflective function capacity, expressed emotion, parental difficulties and therapeutic alliance. Descriptive data and exploration analysis of trends and effect sizes will be reported upon at trial completion. Discussion: The five-day MFT program developed for this study is novel, brief and more accessible than previous MFT models. The inclusion of a data collection point during treatment and follow-up will allow for an investigation of trends during and after treatment. This will allow exploration and comparison of future potential mediators and moderators of MFT and FT-AN outcomes and how these may differ between treatments. Trial registration: ISRCTN registry; ISRCTN93437752, on 27 January 2021.

Original language	English
Article number	71
Journal	Journal of Eating Disorders
Volume	9
Issue number	1
DOIs	https://doi.org/10.1186/s40337-021-00426-4
Publication status	Published - Dec 2021

Keywords

Adolescents
Anorexia nervosa
Family based treatment (FBT)
Family therapy
Feasibility
Group
Maudsley family therapy
Multi-family therapy (MFT)
Protocol
Randomized controlled trial

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s40337-021-00426-4

Cite this

@article{cdf2ebb64c7c42048a932b8ca1b169b3,

title = "Brief early adolescent multi-family therapy (BEAM) trial for anorexia nervosa: a feasibility randomized controlled trial protocol",

abstract = "Introduction: Multi-family therapy (MFT) is a recommended treatment for adolescent anorexia nervosa internationally. Despite recent significant advances in single-family therapy, the evidence base for MFT remains relatively small. Several individual and family factors have been associated with poorer outcomes in single-family therapy, many of which may be addressed or ameliorated by MFT if delivered early in treatment. This trial aims to determine the feasibility and acceptability of adding a five-day multi-family therapy group to the early stages of family therapy for anorexia nervosa. Secondary objectives are to explore effect size changes in key individual and family factors across treatment. Methods: This feasibility trial will use a randomised controlled design. Sixty adolescents (age 10–17 inclusive) with anorexia nervosa or atypical anorexia nervosa and their parents will be recruited from a community-based specialist eating disorder service in London, UK. Participants will be randomly allocated to receive six months of eating disorder focussed family therapy with a five-day MFT group (experimental group) or without (control group). Block randomisation will be conducted by the King{\textquoteright}s Clinical Trials Unit and researchers will be blind to participants{\textquoteright} intervention allocation. Feasibility, acceptability and secondary outcomes measures will be collected at baseline, post-MFT, end of treatment, six-month and 12-month follow-up. Feasibility and acceptability will be assessed according to trial sign-up rates, retention, measure completion rates and satisfaction. Secondary outcomes include physical health improvements, changes in psychiatric symptoms, emotion regulation and reflective function capacity, expressed emotion, parental difficulties and therapeutic alliance. Descriptive data and exploration analysis of trends and effect sizes will be reported upon at trial completion. Discussion: The five-day MFT program developed for this study is novel, brief and more accessible than previous MFT models. The inclusion of a data collection point during treatment and follow-up will allow for an investigation of trends during and after treatment. This will allow exploration and comparison of future potential mediators and moderators of MFT and FT-AN outcomes and how these may differ between treatments. Trial registration: ISRCTN registry; ISRCTN93437752, on 27 January 2021.",

keywords = "Adolescents, Anorexia nervosa, Family based treatment (FBT), Family therapy, Feasibility, Group, Maudsley family therapy, Multi-family therapy (MFT), Protocol, Randomized controlled trial",

author = "Julian Baudinet and Ivan Eisler and Mima Simic and Ulrike Schmidt",

note = "Funding Information: Ulrike Schmidt is supported by a National Institute of Health Research (NIHR) Senior Investigator Award and receives salary support from the NIHR Mental Health Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London. Funding Information: This trial is being funded by the Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED). No external funding has been provided. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = dec,

doi = "10.1186/s40337-021-00426-4",

language = "English",

volume = "9",

journal = "Journal of Eating Disorders",

issn = "2050-2974",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Brief early adolescent multi-family therapy (BEAM) trial for anorexia nervosa

T2 - a feasibility randomized controlled trial protocol

AU - Baudinet, Julian

AU - Eisler, Ivan

AU - Simic, Mima

AU - Schmidt, Ulrike

N1 - Funding Information: Ulrike Schmidt is supported by a National Institute of Health Research (NIHR) Senior Investigator Award and receives salary support from the NIHR Mental Health Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King’s College London. Funding Information: This trial is being funded by the Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED). No external funding has been provided. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/12

Y1 - 2021/12

N2 - Introduction: Multi-family therapy (MFT) is a recommended treatment for adolescent anorexia nervosa internationally. Despite recent significant advances in single-family therapy, the evidence base for MFT remains relatively small. Several individual and family factors have been associated with poorer outcomes in single-family therapy, many of which may be addressed or ameliorated by MFT if delivered early in treatment. This trial aims to determine the feasibility and acceptability of adding a five-day multi-family therapy group to the early stages of family therapy for anorexia nervosa. Secondary objectives are to explore effect size changes in key individual and family factors across treatment. Methods: This feasibility trial will use a randomised controlled design. Sixty adolescents (age 10–17 inclusive) with anorexia nervosa or atypical anorexia nervosa and their parents will be recruited from a community-based specialist eating disorder service in London, UK. Participants will be randomly allocated to receive six months of eating disorder focussed family therapy with a five-day MFT group (experimental group) or without (control group). Block randomisation will be conducted by the King’s Clinical Trials Unit and researchers will be blind to participants’ intervention allocation. Feasibility, acceptability and secondary outcomes measures will be collected at baseline, post-MFT, end of treatment, six-month and 12-month follow-up. Feasibility and acceptability will be assessed according to trial sign-up rates, retention, measure completion rates and satisfaction. Secondary outcomes include physical health improvements, changes in psychiatric symptoms, emotion regulation and reflective function capacity, expressed emotion, parental difficulties and therapeutic alliance. Descriptive data and exploration analysis of trends and effect sizes will be reported upon at trial completion. Discussion: The five-day MFT program developed for this study is novel, brief and more accessible than previous MFT models. The inclusion of a data collection point during treatment and follow-up will allow for an investigation of trends during and after treatment. This will allow exploration and comparison of future potential mediators and moderators of MFT and FT-AN outcomes and how these may differ between treatments. Trial registration: ISRCTN registry; ISRCTN93437752, on 27 January 2021.

AB - Introduction: Multi-family therapy (MFT) is a recommended treatment for adolescent anorexia nervosa internationally. Despite recent significant advances in single-family therapy, the evidence base for MFT remains relatively small. Several individual and family factors have been associated with poorer outcomes in single-family therapy, many of which may be addressed or ameliorated by MFT if delivered early in treatment. This trial aims to determine the feasibility and acceptability of adding a five-day multi-family therapy group to the early stages of family therapy for anorexia nervosa. Secondary objectives are to explore effect size changes in key individual and family factors across treatment. Methods: This feasibility trial will use a randomised controlled design. Sixty adolescents (age 10–17 inclusive) with anorexia nervosa or atypical anorexia nervosa and their parents will be recruited from a community-based specialist eating disorder service in London, UK. Participants will be randomly allocated to receive six months of eating disorder focussed family therapy with a five-day MFT group (experimental group) or without (control group). Block randomisation will be conducted by the King’s Clinical Trials Unit and researchers will be blind to participants’ intervention allocation. Feasibility, acceptability and secondary outcomes measures will be collected at baseline, post-MFT, end of treatment, six-month and 12-month follow-up. Feasibility and acceptability will be assessed according to trial sign-up rates, retention, measure completion rates and satisfaction. Secondary outcomes include physical health improvements, changes in psychiatric symptoms, emotion regulation and reflective function capacity, expressed emotion, parental difficulties and therapeutic alliance. Descriptive data and exploration analysis of trends and effect sizes will be reported upon at trial completion. Discussion: The five-day MFT program developed for this study is novel, brief and more accessible than previous MFT models. The inclusion of a data collection point during treatment and follow-up will allow for an investigation of trends during and after treatment. This will allow exploration and comparison of future potential mediators and moderators of MFT and FT-AN outcomes and how these may differ between treatments. Trial registration: ISRCTN registry; ISRCTN93437752, on 27 January 2021.

KW - Adolescents

KW - Anorexia nervosa

KW - Family based treatment (FBT)

KW - Family therapy

KW - Feasibility

KW - Group

KW - Maudsley family therapy

KW - Multi-family therapy (MFT)

KW - Protocol

KW - Randomized controlled trial

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U2 - 10.1186/s40337-021-00426-4

DO - 10.1186/s40337-021-00426-4

M3 - Article

AN - SCOPUS:85108160477

SN - 2050-2974

VL - 9

JO - Journal of Eating Disorders

JF - Journal of Eating Disorders

IS - 1

M1 - 71

ER -

Brief early adolescent multi-family therapy (BEAM) trial for anorexia nervosa: a feasibility randomized controlled trial protocol

Abstract

Keywords

UN SDGs

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