Skills Sharing Interventions for Caregivers: Addressing the Interpersonal Aspect of the Cognitive Interpersonal Model

The aim of this chapter is to consider task sharing interventions designed to share professional expertise with supporters. Community supporters (e.g., families and friends) of people with eating disorders are motivated to help but uncertain about how to do it. The cognitive interpersonal model of eating disorders provides a structure. The model describes bidirectional social interactions that can act as perpetuating factors. These are the targets of skills sharing interventions such as New Maudsley Collaborative care and derivatives such as Experienced Carers Helping Others (ECHO) and Supporting Carers of Children and Adolescents with Eating Disorders (SUCCEAT). Starvation impairs aspects of social cognition, and this can disrupt relationships. In addition, the visible starvation consequences of the eating disorder cause supporters to become distressed and anxious and either accommodate to the eating disorder or resist with frustration and criticism. Providing supporters with skills to manage their own reactions to these secondary manifestations of severe underweight produces positive benefits for themselves and those they care for and can reduce the need for high intensity services. Skills sharing interventions can be delivered as an independent resource for supporters or as a form of augmentation to individual therapy.