Abstract:
BACKGROUND: The leading evidence-based treatment for anorexia nervosa (AN) in adolescents is Family-based Treatment (FBT). However, due to the intensive training requirements and lack of practitioners, it is often difficult for families to access FBT. Thus, innovations that improve access to care are needed. A pilot randomized study of a guided self-help version of Family-based Treatment (GSH-FBT) that utilized approximately 1/4 the amount of therapist time compared to FBT found that the approach was acceptable and appeared to achieve similar outcomes. The study protocol detailed in this manuscript compares the efficiency (clinician time) of GSH-FBT to Family-based Treatment via Videoconferencing (FBT-V) in a fully powered study in achieving clinical outcomes through a multi-site randomized clinical trial across the US and Ontario, Canada.
METHODS: This study will randomize the families of adolescents ages 12-18 (n = 200) who meet DSM-5 criteria for AN to receive either GSH-FBT or FBT-V. Participants will be randomized to 15 sixty-minute sessions of FBT-V or to 10 twenty-minute sessions of online GSH-FBT. Major assessments will be conducted by a masked assessor at baseline, within treatment, at the end of treatment (EOT), and 6 and 12 months after the end of treatment (EOT). The primary outcomes of this study are changes to body weight and eating disorder cognitions relative to clinician time used (relative efficiency of treatment modality).
CONCLUSIONS: The findings of this study may help increase access to care by providing a time efficient, affordable, more scalable intervention for adolescent AN compared to standard FBT.
摘要:
背景:青少年神经性厌食症(AN)的主要循证治疗是基于家庭的治疗(FBT)。然而,由于严格的培训要求和缺乏从业人员,家庭通常很难获得FBT。因此,需要改善获得护理的创新。一项针对基于家庭的指导自助治疗(GSH-FBT)的试点随机研究发现,与FBT相比,该方法使用了约1/4的治疗师时间,该方法是可以接受的,并且似乎取得了类似的结果。本手稿中详细介绍的研究方案比较了GSH-FBT与通过视频会议(FBT-V)进行的基于家庭的治疗的效率(临床医师时间),这是一项完全有效的研究,通过美国和安大略省的多站点随机临床试验来实现临床结果。加拿大。
方法:本研究将对符合DSM-5标准的12-18岁(n=200)青少年家庭进行随机分组,以接受GSH-FBT或FBT-V。参与者将被随机分配到15个60分钟的FBT-V会议或10个20分钟的在线GSH-FBT会议。主要评估将由一名蒙面评估员在基线时进行,在治疗中,在治疗结束时(EOT),治疗结束后6个月和12个月(EOT)。这项研究的主要结果是体重和饮食失调认知相对于临床医生使用时间的变化(治疗方式的相对效率)。
结论:这项研究的结果可能有助于增加获得护理的机会,负担得起的,与标准FBT相比,对青少年AN的干预更具可扩展性。