An evaluation of the effectiveness and short‐term stability of an innovative Australian day patient programme for eating disorders

Abstract

There is a dearth of literature evaluating day patient treatment for eating disorders based upon the targeted goals of treatment, to conclude that day patient programmes are effective. This study aimed to explore the effectiveness of an innovative day patient programme by examining whether the seven key treatment goals improved across treatment and were maintained 3 months after discharge. Of the 58 participants who completed measures assessing BMI, eating disorder cognitions, behaviours, core beliefs, readiness to change, quality of life and perpetuating factors at admission, discharge and follow-up, 44 completed the day programme with 14 non-completers. The results demonstrated that all seven treatment goals improved across treatment and the improvements were maintained or further improved at 3 month follow-up. The results are discussed in context of the published day patient programme literature with implications for future research to maximise optimal treatment outcomes from day patient treatment.

Eating Disorders, Addictions and Substance Use Disorders

“…In the treatment of ED, MI has been used as both a stand-alone intervention (in conjunction with a self-help manual) (Cassin, von Ranson, Heng, Brar, & Wojtowicz, 2008;Dunn, Neighbors, & Larimer, 2006), and as a prelude or adjunct to another treatment, such as outpatient cognitive behavioral therapy (Gowers & Smyth, 2004;Katzman et al, 2010;Treasure et al, 1999) or intensive inpatient or day patient ED treatment (Dean, Touyz, Rieger, & Thornton, 2008;Feld, Woodside, Kaplan, Olmsted, & Carter, 2001;Geller, Brown, & Srikameswaran, 2011;George, Thornton, Touyz, Waller, & Beumont, 2004;Wade, Frayne, Edwards, Robertson, & Gilchrist, 2009;Willinge, Touyz, & Thornton, 2010). In the treatment of ED, MI has been used as both a stand-alone intervention (in conjunction with a self-help manual) (Cassin, von Ranson, Heng, Brar, & Wojtowicz, 2008;Dunn, Neighbors, & Larimer, 2006), and as a prelude or adjunct to another treatment, such as outpatient cognitive behavioral therapy (Gowers & Smyth, 2004;Katzman et al, 2010;Treasure et al, 1999) or intensive inpatient or day patient ED treatment (Dean, Touyz, Rieger, & Thornton, 2008;Feld, Woodside, Kaplan, Olmsted, & Carter, 2001;Geller, Brown, & Srikameswaran, 2011;George, Thornton, Touyz, Waller, & Beumont, 2004;Wade, Frayne, Edwards, Robertson, & Gilchrist, 2009;Willinge, Touyz, & Thornton, 2010).…”

Efficacy and intensity of day hospital treatment for eating disorders

“…Similarly, in studies based on two separate cohorts of mixed diagnosis eating disorder patients treated in the Freiburg Day Clinic in Germany, there were very significant reductions in symptoms and improvements in psychological functioning. Remission rates at the end of treatment were 28% and 18% in the two studies, while 41% and 50% of the patients continued to meet diagnostic criteria (Zeeck et al, 2009;Zeeck, Herzog, & Hartmann, 2004). The Day Patient Program in Sydney, Australia, reported significant improvements in psychological functioning and noted that 61% of patients were abstinent from bingeing and vomiting after approximately 6 weeks of attendance 5 days weekly followed by about 6 weeks of attendance 3 days weekly (Willinge et al, 2010).…”

“…Remission rates at the end of treatment were 28% and 18% in the two studies, while 41% and 50% of the patients continued to meet diagnostic criteria (Zeeck et al, 2009;Zeeck, Herzog, & Hartmann, 2004). The Day Patient Program in Sydney, Australia, reported significant improvements in psychological functioning and noted that 61% of patients were abstinent from bingeing and vomiting after approximately 6 weeks of attendance 5 days weekly followed by about 6 weeks of attendance 3 days weekly (Willinge et al, 2010). The Partial Hospitalization Program in Cleveland, Ohio, consists of 30 hours of treatment spread over 5 days weekly and incorporates a dialectical behavior therapy approach.…”

“…There are currently descriptions of at least ten different DH programs in the literature and several of these have published uncontrolled effectiveness data (Ben-Porath, Wisniewski, & Warren, 2010;Goldstein et al, 2011;Lammers, Exterkate, & De Jong, 2007;Willinge, Touyz, & Thornton, 2010;Zipfel et al, 2002). In addition, two small randomized trials have been conducted demonstrating that DH treatment is more effective than multi-modal outpatient treatment for a mixed sample of eating disorder patients (Kong, 2005) and not significantly different from inpatient treatment for severe bulimia nervosa (BN; Zeeck et al, 2009).…”

Systematic review of evidence for different treatment settings in anorexia nervosa

“…Treatment settings for AN include inpatient, partial hospitalization (also known as day hospital care) and outpatient. Inpatient treatment programs are usually multidisciplinary and treatment focuses on weight restoration, normalizing eating behavior and facilitating psychological change through nutritional education, supervised meals and individual and group psychotherapy [18,19] . In published trials admissions have been prolonged with a length of stay ranging from several months to 15.2 wk [22][23][24] .…”