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Background <p>Anorexia Nervosa (AN) can be a complex condition to treat, often complicated by high chronicity, complexity and comorbidity. Treatments for AN with comorbidity and complexity are limited, with carers having to take a large role in supporting these individuals. Carer distress can be high, impacting carer wellbeing and contributing to familial dynamics which can also perpetuate AN behaviours as a way of coping. This study evaluated a novel carers group, the CAREFREE programme, for the specific needs of carers of Moderate to Severe AN (MS-AN: adults with AN who have not responded to previous treatments, have a complex comorbidity, and/or complex aetiology), using schema therapy-focused coaching to improve carer distress and family functioning.</p> Methods <p>A non-concurrent group case series design was employed. Outcome measures included carer distress, expressed emotion, family functioning and communication, mood, and attachment-related anxiety and avoidance. Outcomes were analysed at 4-timepoints, (i.e. pre-intervention, mid-point [6 weeks], post-intervention [12-weeks] and 3-month follow-up), using multi-level modelling.</p> Results <p>53 carers commenced the programme in the study across 5 groups. Carer distress, expressed emotion, family functioning, mood and attachment-related avoidance significantly improved after the end of the group and remained significantly improved at follow-up. Attachment-anxiety did not lead to statistically significant changes, although a trend of improvement was seen.</p> Conclusions <p>Preliminary evidence suggests improvements in carer wellbeing and family functioning following participation in the CAREFREE programme for carers of MS-AN. Attachment outcome measures that did not lead to statistically significant change may be related to the time-limited nature of the intervention and the group intervention itself, with greater change in attachment outcomes often requiring individualised and more intensive interventions. Future research is required to explore what impact this has on patient outcomes.</p> <p><i>Trial registration</i> This study was registered with clinicaltrials.gov (ClinicalTrials.gov ID: NCT06624397).</p>

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A case series evaluation of a schema therapy-coaching programme for carers of patients with moderate to severe anorexia nervosa: the CAREFREE programme

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  • 发表日期：

    2026年7月16日

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  • Emma Mawdsley,
  • Stacey McNicol,
  • Alasdair C. Rutherford,
  • Lesley Symon,
  • Debbie Smith,
  • Hazel Elliott,
  • Susan Simpson

摘要

Background

Anorexia Nervosa (AN) can be a complex condition to treat, often complicated by high chronicity, complexity and comorbidity. Treatments for AN with comorbidity and complexity are limited, with carers having to take a large role in supporting these individuals. Carer distress can be high, impacting carer wellbeing and contributing to familial dynamics which can also perpetuate AN behaviours as a way of coping. This study evaluated a novel carers group, the CAREFREE programme, for the specific needs of carers of Moderate to Severe AN (MS-AN: adults with AN who have not responded to previous treatments, have a complex comorbidity, and/or complex aetiology), using schema therapy-focused coaching to improve carer distress and family functioning.

Methods

A non-concurrent group case series design was employed. Outcome measures included carer distress, expressed emotion, family functioning and communication, mood, and attachment-related anxiety and avoidance. Outcomes were analysed at 4-timepoints, (i.e. pre-intervention, mid-point [6 weeks], post-intervention [12-weeks] and 3-month follow-up), using multi-level modelling.

Results

53 carers commenced the programme in the study across 5 groups. Carer distress, expressed emotion, family functioning, mood and attachment-related avoidance significantly improved after the end of the group and remained significantly improved at follow-up. Attachment-anxiety did not lead to statistically significant changes, although a trend of improvement was seen.

Conclusions

Preliminary evidence suggests improvements in carer wellbeing and family functioning following participation in the CAREFREE programme for carers of MS-AN. Attachment outcome measures that did not lead to statistically significant change may be related to the time-limited nature of the intervention and the group intervention itself, with greater change in attachment outcomes often requiring individualised and more intensive interventions. Future research is required to explore what impact this has on patient outcomes.

Trial registration This study was registered with clinicaltrials.gov (ClinicalTrials.gov ID: NCT06624397).