In my recent talk for ANZAED, I spoke about the need for clinicians to study what they do. To measure our clinical outcomes to see if what we do, whatever that is, is helpful.
A recent paper published in IJED did a little bit of that and more. The paper by The Redleaf Practice's Director of Family Therapy, Dr Stuart Murray, and The Redleaf Practice's Research Fellow, Scott Griffiths (and some other guy named le Grange) looked at the importance of collegial alliance when working in FBT. This is something that we have written about before in a somewhat provocative way.
In looking at the article a few things jump out at me. One of the most important things to me is that
1) patients gained weight significantly in the 15 sessions the study covered
2) patients achieved significant thinking change in 15 sessions.
As Director of The Redleaf Practice, I am really pleased of these results (that were not really the point of the study).
3) Most change was achieved early. Those early sessions need to focus on behaviour change.
4) Neither Body Weight or EDE-Q score (which measures the thinking component of the eating disorder) predicted drop out. To me this indicates that "severity" of the eating disorder should not be a factor in offering FBT or not.
5) The alliance between clinicians was pretty stable. Either the team members were collaborating at the beginning or they never did. FBT still polarises.
6)Collegial alliance was correlated with drop out. If you want families to stay in a treatment program you need a unified team from the get go.
7)Collegial alliance was correlated with cognitive change (but not weight change). That is an interesting finding. The paper hypothesises that having a united therapy team, as well as united parenting team may help the patient feel more secure and this is helpful in changing cognitions. The teams, parenting and clinical need to be seen to be bigger than the eating disorder.
Why is alliance not correlated to weight change. Maybe because parents are not distracted by ideology that can divides teams (my way is the right way etc) because they simply focus on getting their child well. Maybe clinicians should just focus on that.
CT
A recent paper published in IJED did a little bit of that and more. The paper by The Redleaf Practice's Director of Family Therapy, Dr Stuart Murray, and The Redleaf Practice's Research Fellow, Scott Griffiths (and some other guy named le Grange) looked at the importance of collegial alliance when working in FBT. This is something that we have written about before in a somewhat provocative way.
In looking at the article a few things jump out at me. One of the most important things to me is that
1) patients gained weight significantly in the 15 sessions the study covered
2) patients achieved significant thinking change in 15 sessions.
As Director of The Redleaf Practice, I am really pleased of these results (that were not really the point of the study).
3) Most change was achieved early. Those early sessions need to focus on behaviour change.
4) Neither Body Weight or EDE-Q score (which measures the thinking component of the eating disorder) predicted drop out. To me this indicates that "severity" of the eating disorder should not be a factor in offering FBT or not.
5) The alliance between clinicians was pretty stable. Either the team members were collaborating at the beginning or they never did. FBT still polarises.
6)Collegial alliance was correlated with drop out. If you want families to stay in a treatment program you need a unified team from the get go.
7)Collegial alliance was correlated with cognitive change (but not weight change). That is an interesting finding. The paper hypothesises that having a united therapy team, as well as united parenting team may help the patient feel more secure and this is helpful in changing cognitions. The teams, parenting and clinical need to be seen to be bigger than the eating disorder.
Why is alliance not correlated to weight change. Maybe because parents are not distracted by ideology that can divides teams (my way is the right way etc) because they simply focus on getting their child well. Maybe clinicians should just focus on that.
CT
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