Effectiveness of the ECHOs Approach for Patients With Eating Disorders and Their Carers
Family therapy is considered an empirically supported treatment approach for adolescents and adults with eating disorders. One family based approach, Expert Carers Helping Others (ECHO) is based on evidence that suggests family environment, e.g., carer criticism, can influence an individual's eating disorder symptoms. ECHO aims to improve carer coping, reduce expressed emotion and manage eating disorder symptoms, and has been associated with reduced carer distress, caregiver burden, and an increase in general well being. The current pilot study seeks to evaluate a new condensed version of the ECHO intervention that is delivered entirely in a 2 ½ hour self-help DVD format (ECHOs). Sixty patients and their carers will be recruited from the Capital Health Eating Disorders Service and randomized into either a treatment as usual group (TAU) or a TAU+ECHOs group. Both carers and patients will be assessed along a variety of dimensions including psychiatric symptoms, family functioning, and carer and patient collaboration, at pre-intervention, four weeks later at post-intervention, and then three-months post-intervention. ANOVAs will be used to compare the primary outcomes between the two groups over time. This pilot study will be the first evaluation of ECHOs, which may ultimately boost the efficacy of current treatment for adults with eating disorders and reduce carer distress.
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Effectiveness of the Expert Carers Helping Others (ECHOs) Approach for Patients With Eating Disorders and Their Carers|
- Changes in Carer and Patient Collaboration Scale (CPCS). [ Time Frame: baseline, 4-weeks post-intervention, 3 months follow-up ] [ Designated as safety issue: No ]A scale to assess self efficacy in caregiving, specifically tailored to measure the skills taught in the ECHOs intervention. This scale will assess changes from baseline to post-internvention in caregiver efficacy.
- Changes in Short Evaluation of Eating Disorders (SEED) [ Time Frame: baseline, 4-weeks post-intervention, 3 months follow-up ] [ Designated as safety issue: No ]This measure will asssess changes in the severity of key anorexic and bulimic symptoms from baseline to post-treatment, and follow-up.
- Depression, Stress and Anxiety Scale (DASS-21) [ Time Frame: baseline, 4-weeks post-intervention, 3 months follow-up ] [ Designated as safety issue: No ]a measure of severity of anxiety, depression and stress pre- to post-treatment
- The Family Questionnaire (FQ) [ Time Frame: baseline, 4-weeks post-intervention, 3 months follow-up ] [ Designated as safety issue: No ]20-item self report measure of expressed emotion in carers. Scores are given on a 4-point Likert scale and will measure the levels of expressed emotion from pre-intervention to post-intervention.
|Study Start Date:||October 2013|
|Estimated Study Completion Date:||August 2016|
|Estimated Primary Completion Date:||August 2016 (Final data collection date for primary outcome measure)|
Experimental: Expert Cares Helping Others plus Treatment as Usual
The experimental treatment (ECHOs plus TAU) will consist of the standard treatment consisting of group psychotherapy and skills training, nutritional counselling, and meal support, PLUS self-help unguided DVD series for carers, providing education about eating disorders and coping strategies for supporting those living with eating disorders.
Behavioral: ECHOs plus TAU
A self-help DVD that provides information for carers on eating disorders and teaches coping strategies to carers.
Other Name: Expert Carers Helping Others plus Treatment as Usual
Active Comparator: Treatment as Usual
Treatment as usual (TAU) consists of group psychotherapy and skills training, nutritional counselling, and meal support.
Behavioral: Treatment as Usual
Treatment as Usual at the Eating Disorder Services includes group psychotherapy and skills training, nutritional counselling, and meal support.
Other Name: TAU
|Canada, Nova Scotia|
|Capital Health District Health Authority||Not yet recruiting|
|Halifax, Nova Scotia, Canada, B3H2E2|
|Contact: Aaron Keshen, MD, FRCPC 473-2577 firstname.lastname@example.org|
|Contact: Iryna V Ivanova, PhD 902-473-1560 email@example.com|
|Principal Investigator: Aaron Keshen, MD, FRCPC|
|Sub-Investigator: Iryna V Ivanova, PhD|
|Sub-Investigator: Phil Masson, PhD|
|Sub-Investigator: Joel Town, PhD|
|Sub-Investigator: Yvette Scattolon, PhD|
|Sub-Investigator: Cheryl Aubie, PhD|