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The relationship between working alliance with peer mentors and eating psychopathology in a digital 6-week guided self-help intervention for anorexia nervosa

Research output: Contribution to journalArticlepeer-review

Gaia Albano, Valentina Cardi, Dennis M. Kivlighan, Suman Ambwani, Janet Treasure, Gianluca Lo Coco

Original languageEnglish
Pages (from-to)1519-1526
Number of pages8
JournalInternational Journal of Eating Disorders
Volume54
Issue number8
DOIs
Accepted/In press2021
PublishedAug 2021

Bibliographical note

Funding Information: The authors are grateful to the recovered individuals who contributed to the video-clips used in the RecoveryMANTRA intervention and to Scarlet Park and Elise Pacquette, who contributed illustrations for the workbook. The authors acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN) and are very grateful to our participating clinical services and local collaborators for their help with participants? recruitment (participating centers: Avon and Wiltshire Mental Health NHS Trust, Barnet Enfield and Haringey Mental Health NHS Trust, Berkshire Healthcare NHS Foundation Trust, Cambridgeshire and Peterborough NHS Foundation Trust, Central and North West London NHS Foundation Trust, Coventry and Warwickshire Partnership NHS Trust, Cumbria Partnership NHS Foundation Trust, Derbyshire Healthcare Foundation Trust, Dorset Healthcare University NHS Foundation Trust, Kent and Medway NHS, Leicestershire Partnership NHS Trust, Lincolnshire Partnership NHS Foundation Trust, Northamptonshire Healthcare NHS Foundation Trust, North Essex Partnership NHS Foundation Trust, Nottinghamshire Healthcare NHS Foundation Trust, South London and Maudsley NHS Foundation Trust, South Staffordshire and Shropshire Healthcare NHS Foundation Trust, South Essex Partnership University NHS Foundation Trust, South West London and St George? s Mental Health NHS Trust, Surrey and Borders Partnership NHS Foundation Trust, Sussex Partnership NHS Foundation Trust, Worcestershire Health and Care NHS Trust. Local collaborators: Alysum Jones, Heather Tinkler, Lynsel Wilson, Katie Egan, Eric Johnson-Sabine, Karishma Jivraj, Ilyas Mirza, Elma Ramly, Emma Donaldson, Jessica Cox, Alice Wright, Amber Dickinson, Andy Foster, Jane Shapleske, Frances Connan, Matthew Pugh, Hayley Dunn, Naomi Bateman, Kay Wright, Anthony Winston, Aujla Manjit, James Tucker, Emily Benson, Liz Bolt, Miriam Naheed, Yumna Masood, Sarah Thornthwaite, Jose Schutter, P. Kendal, Audrey Williamson, Lisa Thompson, Rubina Reza, Joanna Miatt, Ciaran Newell, Jean Throughton, Hazel Eaton, Ramesh Muthuswamy, Alisha O? Connor, Hannah Herlihy, Jon Arcelus, Debbie Whight, Rebecca Cashmore, Thomas Hanly, P. Marshall, Rachael Lawrence, Anna Chafer, Helen Birchall, Sally Clarke, Michelle Chalke, Amy McConnell, Mhorag Brown, Lara Horrax, Ian Lea, Steph King, Neisha Rhule, Kim Moore, Andy Taylor, Tim Lewington, Jane Dalgleish, Sarah Thurlow, Jennifer Walker, Marissa Hodson, Vicky Fryer, Maxine Barnard, Sophia Ali, Irene Yi, Jack Holland, Ashley Chapman, Jane Gregg, Dorrie Mystris, Renate Pantke, Philippa Case, Charmaine Kohn, Kay Lobo, Angela Hoadley). The authors are grateful to all our study participants for their patience and perseverance. This manuscript presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0712-28041). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. This work was also supported by the Psychiatry Research Trust, the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London (VC and JT). VC is supported by a grant from MIUR (Dipartimenti di Eccellenza DM May 11, 2017 n. 262) to the Department of General Psychology at the University of Padova, Italy. The views expressed herein are not necessarily those of the NHS, NIHR, or the Department of Health. Funding Information: The authors are grateful to the recovered individuals who contributed to the video‐clips used in the RecoveryMANTRA intervention and to Scarlet Park and Elise Pacquette, who contributed illustrations for the workbook. The authors acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN) and are very grateful to our participating clinical services and local collaborators for their help with participants’ recruitment (participating centers: Avon and Wiltshire Mental Health NHS Trust, Barnet Enfield and Haringey Mental Health NHS Trust, Berkshire Healthcare NHS Foundation Trust, Cambridgeshire and Peterborough NHS Foundation Trust, Central and North West London NHS Foundation Trust, Coventry and Warwickshire Partnership NHS Trust, Cumbria Partnership NHS Foundation Trust, Derbyshire Healthcare Foundation Trust, Dorset Healthcare University NHS Foundation Trust, Kent and Medway NHS, Leicestershire Partnership NHS Trust, Lincolnshire Partnership NHS Foundation Trust, Northamptonshire Healthcare NHS Foundation Trust, North Essex Partnership NHS Foundation Trust, Nottinghamshire Healthcare NHS Foundation Trust, South London and Maudsley NHS Foundation Trust, South Staffordshire and Shropshire Healthcare NHS Foundation Trust, South Essex Partnership University NHS Foundation Trust, South West London and St George’ s Mental Health NHS Trust, Surrey and Borders Partnership NHS Foundation Trust, Sussex Partnership NHS Foundation Trust, Worcestershire Health and Care NHS Trust. Local collaborators: Alysum Jones, Heather Tinkler, Lynsel Wilson, Katie Egan, Eric Johnson‐Sabine, Karishma Jivraj, Ilyas Mirza, Elma Ramly, Emma Donaldson, Jessica Cox, Alice Wright, Amber Dickinson, Andy Foster, Jane Shapleske, Frances Connan, Matthew Pugh, Hayley Dunn, Naomi Bateman, Kay Wright, Anthony Winston, Aujla Manjit, James Tucker, Emily Benson, Liz Bolt, Miriam Naheed, Yumna Masood, Sarah Thornthwaite, Jose Schutter, P. Kendal, Audrey Williamson, Lisa Thompson, Rubina Reza, Joanna Miatt, Ciaran Newell, Jean Throughton, Hazel Eaton, Ramesh Muthuswamy, Alisha O′ Connor, Hannah Herlihy, Jon Arcelus, Debbie Whight, Rebecca Cashmore, Thomas Hanly, P. Marshall, Rachael Lawrence, Anna Chafer, Helen Birchall, Sally Clarke, Michelle Chalke, Amy McConnell, Mhorag Brown, Lara Horrax, Ian Lea, Steph King, Neisha Rhule, Kim Moore, Andy Taylor, Tim Lewington, Jane Dalgleish, Sarah Thurlow, Jennifer Walker, Marissa Hodson, Vicky Fryer, Maxine Barnard, Sophia Ali, Irene Yi, Jack Holland, Ashley Chapman, Jane Gregg, Dorrie Mystris, Renate Pantke, Philippa Case, Charmaine Kohn, Kay Lobo, Angela Hoadley). The authors are grateful to all our study participants for their patience and perseverance. This manuscript presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB‐PG‐0712‐28041). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. This work was also supported by the Psychiatry Research Trust, the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London (VC and JT). VC is supported by a grant from MIUR (Dipartimenti di Eccellenza DM May 11, 2017 n. 262) to the Department of General Psychology at the University of Padova, Italy. The views expressed herein are not necessarily those of the NHS, NIHR, or the Department of Health. Publisher Copyright: © 2021 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Objective: The quality of working alliance (WA) is associated with treatment outcomes across several types of psychiatric disorders and psychological interventions. This study examined the role of WA with peer mentors (people with lived experience of illness) and student mentors (graduated psychology students) in a 6-week, digital, guided self-help (GSH) intervention for anorexia nervosa. Method: Ninety-nine patients rated weekly, for 6 weeks: (a) eating psychopathology using the short version of the Eating Disorder Examination Questionnaire (EDE-QS) and (b) WA with a student mentor (n = 14) or a peer mentor (n = 10). WA was assessed by asking patients the extent to which they felt comfortable working with their mentor and the extent to which they agreed with them on the goals for support. WA with mentors and the association with eating psychopathology change were measured on a session-by-session basis. The analysis involved a random intercepts cross-lagged panel model. Results: WA with peer mentors was slightly higher than WA with students (ES = 0.3). Peer mentors' WA in the previous session was significantly associated with eating psychopathology ratings in the next session. No significant relationship was found between the previous session's EDE-QS scores and peer mentor alliance in the following session. In the student mentor group, there were no session-by-session associations between WA and eating psychopathology. However, greater WA with the student mentor across sessions was associated with less eating psychopathology. Discussion: These findings suggest that clinical outcomes are in part associated with the characteristics of the mentor delivering guidance in an online GSH for eating disorders.

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