Are Huddles the Missing PEACE of the Puzzle in Implementing Clinical Innovation for the Eating Disorder and Autism Comorbidity?

Abstract

Huddles are brief, time-limited, focused meetings to help organize and support clinical teams. Huddles have demonstrated their value and transferable benefits across a range of settings. Based on their transferable nature, their potential could be unacknowledged as a clinical implementation technique, particularly in specific subgroups of patients with anorexia who need a higher level of care. An innovative clinical pathway aimed at supporting autistic patients with eating disorders (PEACE Pathway) evaluated the use of weekly PEACE huddles for the multidisciplinary team as part of the implementation process across a 12-months period. A total of 283 responses evaluated the huddle as useful on average 84/100. Using content analysis, several perceived benefits were found of the huddles which were in line with the underpinnings of traditional huddles, suggesting that huddles are transferable as implementation techniques, as evidence by a team providing higher-level care for eating disorders.

Autistic characteristics in eating disorders: Treatment adaptations and impact on clinical outcomes

“…The second article (Smith & Tchanturia, 2020) focussed on one part of the implementation of the PEACE pathway: the PEACE huddles, which are brief, weekly meetings of the clinical teams to share feedback on PEACE patients and updates on the pathway implementation. The article included a study which aimed to evaluate clinicians' opinions on the benefits of the huddles in ED treatment settings in providing a higher level of care for patients with comorbid ASC.…”

“…Out of the 2,037 records screened, 20 articles were identified as potentially meeting inclusion criteria for Review 1 and subject to full text review. Of these, three articles met the inclusion criteria (Smith & Tchanturia, 2020; Tchanturia, Smith, Glennon, & Burhouse, 2020; Tchanturia et al., 2021), all published by the same research group and either described or evaluated the Pathway for Eating disorders and Autism developed from Clinical Experience (PEACE pathway).…”

“…Overall, the number of studies identified in Review 1 (description or evaluation of treatments or adaptations for comorbid ASC) was low and all related to the same intervention – the PEACE pathway. The PEACE Pathway was the only intervention for patients with ED and comorbid ASC that has been described and evaluated in published manuscripts (Smith & Tchanturia, 2020; Tchanturia et al., 2021; Tchanturia, Smith, Glennon, & Burhouse, 2020), despite the broad search strategy, indicating that few such treatments have been developed and few adaptations have been carried out. No RCTs of treatments or adaptations were identified, and the partial economic evaluation of the PEACE pathway (Tchanturia et al., 2021) explored cost‐savings only and so does not provide any evidence of either effectiveness or cost‐effectiveness.…”

Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes

“…Thus far, few treatment adaptations have been introduced to better serve autistic ED patients ( 55 – 57 ). A recent review synthesized findings from nine studies exploring various ways to adapt interventions based on cognitive remediation therapy (CRT), emotion skills training and cognitive behavioral therapy (CBT) to better suit the needs of autistic ED patients ( 58 ).…”

Autism and anorexia nervosa: longitudinal prediction of eating disorder outcomes

“…Thus far, few treatment adaptations have been introduced to better serve autistic ED patients (45)(46)(47). A recent review synthesised ndings from nine studies exploring various ways to adapt interventions based on cognitive remediation therapy (CRT), emotion skills training and cognitive behavioural therapy (CBT) to better suit the needs of autistic ED patients (48).…”