Intensive treatment program (ITP): A case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder

Abstract

Objective Family Therapy for Anorexia Nervosa (FT‐AN) is the first line treatment for adolescents with anorexia nervosa in the UK. However, research suggests between 10 and 40% of young people have a poor outcome. For those for whom FT‐AN alone is not effective there is a clear need to develop additional treatments. This paper describes the effectiveness of an additional treatment for adolescents who had not responded to FT‐AN, the Intensive Day Treatment Program (ITP) embedded within a comprehensive outpatient service at the Maudsley Hospital. Method Data from a retrospective chart review of patient files were analyzed for 105 young people aged 11–18 with restrictive eating disorders referred to the program in the first four and a half years of its operation. Results Young people attended ITP for only on average 28.41 days. Over this time they made significant improvements in a range of domains, including weight gain, eating disorder symptomatology, motivation to recover, quality of life and comorbid symptomatology. Young people continued to make improvements post ITP in outpatient treatment provided by the same service and 73.2% had a good or an intermediate outcome at the point of discharge from the service. Discussion This uncontrolled case series indicates that ITP can contribute to positive outcomes for young people who require intensification of treatment. ITP outcomes are discussed in comparison to the published literature concerning day programs for adolescents with a diagnosis of an eating disorder.

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

“…Anorexia nervosa/low weight eating disorders Nine studies for a total of 427 patients examined a familybased day treatment program [262][263][264][265][266][267][268][269][270] (Table 56). Studies varied with regards to the degree to which they included parents in treatment, number of hours/week of programming and length of stay.…”

“…Five studies reported improvement in BMI [264,265,[268][269][270]. Three studies reported on total weight gained in program [262,263,269].…”

“…Six studies examined psychological symptoms with the EDE-Q [264,266,267,[269][270][271]. EDE-Q scores, global and all subscales decreased significantly in these studies.…”

Education, dissemination, and the science of eating disorders: Reflections on the 2019 International Conference on Eating Disorders

“…One of the articles we selected comes from plenary speaker, Dr. Glenn Waller, who completed an innovative study testing a case series of nonunderweight adult patients with an ED using a brief, 10‐session cognitive–behavioral therapy approach (Waller et al, ). We chose an additional article, co‐written by another plenary speaker, Dr. Ivan Eisler, about the acceptability, feasibility, and 3‐month outcomes of a 5‐day multifamily treatment for adults with anorexia nervosa (Simic et al, ).…”

“…We chose an additional article, co-written by another plenary speaker, Dr. Ivan Eisler, about the acceptability, feasibility, and 3-month outcomes of a 5-day multifamily treatment for adults with anorexia nervosa (Simic et al, 2018).…”