Therapist written goodbye letters: evidence for therapeutic benefits in the treatment of anorexia nervosa.


Journal

Behavioural and cognitive psychotherapy
ISSN: 1469-1833
Titre abrégé: Behav Cogn Psychother
Pays: United States
ID NLM: 9418292

Informations de publication

Date de publication:
Jul 2020
Historique:
pubmed: 18 3 2020
medline: 21 11 2020
entrez: 18 3 2020
Statut: ppublish

Résumé

Despite their use in clinical practice, there is little evidence to support the use of therapist written goodbye letters as therapeutic tools. However, preliminary evidence suggests that goodbye letters may have benefits in the treatment of anorexia nervosa (AN). This study aimed to examine whether therapist written goodbye letters were associated with improvements in body mass index (BMI) and eating disorder symptomology in patients with AN after treatment. Participants were adults with AN (n = 41) who received The Maudsley Model of Anorexia Treatment for Adults (MANTRA) in a clinical trial evaluating two AN out-patient treatments. As part of MANTRA, therapists wrote goodbye letters to patients. A rating scheme was developed to rate letters for structure and quality. Linear regression analyses were used to examine associations between goodbye letter scores and outcomes after treatment. Higher quality letters and letters that adopted a more affirming stance were associated with greater improvements in BMI at 12 months. Neither the overall quality nor the style of goodbye letters were associated with improvements in BMI at 24 months or reductions in eating disorder symptomology at either 12 or 24 months. The results highlight the potential importance of paying attention to the overall quality of therapist written goodbye letters in the treatment of AN, and adopting an affirming stance.

Sections du résumé

BACKGROUND BACKGROUND
Despite their use in clinical practice, there is little evidence to support the use of therapist written goodbye letters as therapeutic tools. However, preliminary evidence suggests that goodbye letters may have benefits in the treatment of anorexia nervosa (AN).
AIMS OBJECTIVE
This study aimed to examine whether therapist written goodbye letters were associated with improvements in body mass index (BMI) and eating disorder symptomology in patients with AN after treatment.
METHOD METHODS
Participants were adults with AN (n = 41) who received The Maudsley Model of Anorexia Treatment for Adults (MANTRA) in a clinical trial evaluating two AN out-patient treatments. As part of MANTRA, therapists wrote goodbye letters to patients. A rating scheme was developed to rate letters for structure and quality. Linear regression analyses were used to examine associations between goodbye letter scores and outcomes after treatment.
RESULTS RESULTS
Higher quality letters and letters that adopted a more affirming stance were associated with greater improvements in BMI at 12 months. Neither the overall quality nor the style of goodbye letters were associated with improvements in BMI at 24 months or reductions in eating disorder symptomology at either 12 or 24 months.
CONCLUSIONS CONCLUSIONS
The results highlight the potential importance of paying attention to the overall quality of therapist written goodbye letters in the treatment of AN, and adopting an affirming stance.

Identifiants

pubmed: 32178754
pii: S1352465820000089
doi: 10.1017/S1352465820000089
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

419-431

Auteurs

Jess Simmonds (J)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Karina L Allen (KL)

Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
School of Psychology, University of Western Australia, Perth, Australia.

Caitlin B O'Hara (CB)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Savani Bartholdy (S)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Beth Renwick (B)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Alexandra Keyes (A)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Anna Lose (A)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Martha Kenyon (M)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Hannah DeJong (H)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Hannah Broadbent (H)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Rachel Loomes (R)

Oxford Adult Eating Disorder Service, Warneford Hospital, Oxford, UK.

Jessica McClelland (J)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Lucy Serpell (L)

Hope Wing, Porters Avenue Health Centre, Dagenham, Essex, UK.

Lorna Richards (L)

The Phoenix Wing, St Ann's Hospital, Tottenham, London, UK.

Eric Johnson-Sabine (E)

The Phoenix Wing, St Ann's Hospital, Tottenham, London, UK.

Nicky Boughton (N)

Oxford Adult Eating Disorder Service, Warneford Hospital, Oxford, UK.

Linette Whitehead (L)

Oxford Adult Eating Disorder Service, Warneford Hospital, Oxford, UK.

Janet Treasure (J)

Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Tracey Wade (T)

School of Psychology, Flinders University, Adelaide, Australia.

Ulrike Schmidt (U)

Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

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Classifications MeSH