maudsley mantra workbook

AN symptomatology and medical risk will be monitored continuously by the case manager. Within the therapy group it was felt that participants really rooted for each other, with a reduced sense of aloneness or isolation being the common cited helpful element of the approach. According to guidelines of the National Institute of Health and Care Excellence (NICE) [4] AN treatment needs to be multidisciplinary including medical care and weight monitoring as well as psychological interventions. An Integrated Group based MANTRA approach is a feasible and effective alternative intervention for community Eating Disorder services. A Cognitive Interpersonal Therapy Workbook for Treating Anorexia https://doi.org/10.1002/eat.23067. Dalle Grave R, Calugi S, Doll HA, Fairburn CG. Social media use: We constructed a self-rating questionnaire based on questions of the Pro-Anorexia Website Survey (PAWS) [58] to assess the frequency of social media use and the influence on ED behavior prior and after the intervention. Seidel M, King JA, Ritschel F, Boehm I, Geisler D, Bernardoni F, et al. A comparative analysis of anorexia nervosa groups on Facebook. Publication date 1871 Topics Mind and body, Psychophysiology Publisher New York, D. Appleton and company Collection library_of_congress; americana Digitizing sponsor The Library of Congress Contributor The Library of Congress Language English. It is NICE recommended and used across UK services and internationally [7]. Missing data will be imputed; the specific imputation model will be developed once the final data is available. Written informed consent from one of the legal representatives (if aged below 18) and the patients assent will be obtained prior to the inclusion in the study. Lose A, Davies C, Renwick B, Kenyon M, Treasure J, Schmidt U, MOSIAC trial group Process evaluation of the maudsley model for treatment of adults with anorexia nervosa trial. Link TM, Beermann U, Mestel R, Gander M. Treatment outcome in female in-patients with anorexia nervosa and comorbid personality disorders prevalence-therapy drop out and weight gain. 2018;26:44761. Where possible their allocated therapist was also the person who weighed them and weighing took place in a clinic room away from other group members. 10.1037/int0000252. Sitting on floor cushions were viewed particularly positively as they made the group feel more informal and as a result contributed to it being easier to share things with the group.. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. 10.4324/9781351171847-18. South London and Maudsley NHS Foundation Trust. 1999;19:7996. PDF The Maudsley model of anorexia nervosa treatment for adolescents and Kupfer J, Brosig B, Brhler E. Toronto-Alexithymie-Skala-26 (TAS-26). The data collection in this study follows the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Our primary goal explored feasibility questions including treatment retention, drop out, acceptability and preliminary treatment outcomes as delivered across three NHS sites in the UK. In order to promote participant retention in research assessment, each participant will be invited personally by the research team. The MANTRA Workbook | MANTRA 2015. Ethical approval was obtained from the Ethics Committee of the Medical University of Vienna (EK 2005/2017). Participants consistently emphasised the therapeutic importance of being open, honest and expressing themselves in the group. This recognition often helped participants make radical changes in their own lives: It was the push I needed to give myself over to inpatient treatment as I saw what the ED was taking away from me and that it was not my friend and how it was tearing down the wonderful ladies in front of me. Future trials should also focus on questions of cost and cost-effectiveness of using group versus individual MANTRA in AN. Due to medical complications as well as high relapse and mortality rates treatment of AN is often challenging [5, 6]. If participants do not respond, their parents will be contacted to establish contact with the participant. ClinicalTrials.gov Identifier: NCT03535714. FMRI studies confirm this pattern; individuals with AN who exhibit emotional suppression or distancing show high rumination and worse weight gain outcomes [26]. Case managers will be responsible for ensuring appropriate follow-up treatment. https://doi.org/10.1002/eat.23122. Startup H, Lavender A, Oldershaw A, Stott R, Tchanturia K, Treasure J, Schmidt U. Correspondence to However, it is unclear whether the high acceptability, low dropout rates or improvements in ED psychopathology observed in adult patients receiving MANTRA [18, 19] can be transferred to adolescents with AN. Based on the authors' pioneering work and up-to-date research at London's Maudsley hospital, A Cognitive Interpersonal Therapy Workbook for Treating Anorexia Nervosa provides adults with anorexia nervosa and the professionals working alongside them with a practical resource to work through together. There were insufficient data to explore EDE-Q scores at assessment, however, there was a significant decrease in EDE-Q Global score between start and end of treatment with a medium effect size, N=15, p=.006, r=.366. The Full of Beans Podcast: MANTRA - The Maudsley Approach on Apple Similar to the original MANTRA program, close others will be invited to participate in 2 to 3 MANTRa sessions if necessary. In terms of content, we created three case vignettes representing typical adolescents suffering from AN, which are introduced in the first chapter and occur in every chapter explaining certain exercises. Int J Eat Disord. The goal of these sessions is: 1) to introduce the manual, to establish baseline motivation and enhance this by drawing on exercises from relevant early MANTRA workbook sessions, including formulation 2) to psycho-educate in regard weight, nutrition and links to the putative maintenance factors and to set initial weight and nutrition targets, 3) to provide time for questions and to work through any worries or practicalities around joining the group. Participants particularly valued some of the adaptations made to the MANTRA programme in order to integrate it with the group dynamic and use other group-participants to bring MANTRA concepts to life in novel and therapeutically effective ways: Engaging with thinking styles and relationships with others exercise and discussing these as a group because it bought it to life and helped to apply the new strategies during the rest of the week.. Designguide.com building design professionals, residential design The theoretical basis of MANTRA is the Cognitive-Interpersonal Maintenance Model of AN [22, 23] which considers predisposing personality traits like obsessive-compulsive and anxious-avoidant traits to be key vulnerability factors enhancing the risk of developing AN and contributing to the maintenance of the illness. If the results of this study are promising, this information can be used to design a larger randomized-controlled trial. Depression will be measured with the Beck Depression Inventory (BDI-2) [44], a self-rating questionnaire with excellent internal consistency (Cronbachs =.92) observed in an adolescent population [45]. American Psychiatric Association. Bulik CM, Berkman ND, Brownley KA, Sedway JA, Lohr KN. Additionally, a completer analysis will be conducted as a secondary analysis. pro-anorexic beliefs) might be particularly relevant during adolescence and emerging adulthood, a developmental stage characterized by identity exploration and self-focus. Treatments for Anorexia Nervosa (AN) are somewhat effective, but there is room for improvement. Relapse from remission at two- to four-year follow-up in two treatments for adolescent anorexia nervosa. Oldershaw A, Startup H. 18 building the healthy adult in eating disorders. 2nd ed. Reflections do not need to be verbalised and can be represented using an object, sometimes other group members put voice to the feeling state. Accessed 17 Dec 2020. Therapists said they were honored to accompany their patients on this journey. They will not be blind to the intervention but are part of the independent research team and not involved in the clinical treatment and psychotherapy. Additional t-tests will be used to explore group differences between intervention (MANTR-a) and control group (TAU). Self-rating questionnaires will be completed by the participants online via Limesurvey. This paper is a study protocol for a multi-center cohort study assessing the feasibility, acceptability and efficacy of an adapted version of the MANTRA treatment program for adolescents and young adults with AN (subsequently named MANTRa) compared to psychotherapeutic treatment as usual (TAU). Flyers presenting the results in simplified form will be prepared and sent to the participants and their parents if desired. The site is secure. 2020;34:4860. A Cognitive-Interpersonal Therapy Workbook for Treating Anorexia Participants valued exercises where core aspects of the MANTRA programme could be realised either spatially or relationally with other group members. Process evaluation of the MOSAIC trial, part I: therapist experiences of delivering two psychological therapies for treatment of anorexia nervosa. Your privacy choices/Manage cookies we use in the preference centre. Furthermore, the Window of Emotional Tolerance (WoT) for those with AN is narrow; intellectualised - or paper and pencil type approaches to therapy can enable patients to remain safe yet emotionally cut off blocking social and emotional processing [31]. Eating Disorder Examination (EDE) [40] global score at 12 months. 2010;67:102532. The UK National Health Service National Research Ethics Service guidance [43] established that this study did not require ethical approval as outcomes were collected as part of routine clinical practice. The treatment approach and workbook emerged from listening carefully to patients and carers in order to understand their perspective and their needs for a successful treatment. The trial described in this study protocol paper is a multi-center cohort study, which will evaluate the efficacy of MANTRa (n=50) compared with TAU (n=50) in a sample of adolescent and young adult outpatients with AN. Central coherence and cognitive flexibility: Computergesttztes Kartensortierverfahren (CKV) [49] is the German version of the Wisconsin Card Sorting Task which measures cognitive flexibility and set-shifting ability. Full demographics are presented in Table2. Anorexia Nervosa (AN) characterised by restricted eating, driven by intense fear, in the context of weight, shape and eating concerns [1] has the highest mortality rates of any psychiatric disorder [2, 3]. Eating Disorders: Recognition and Treatment (Guideline). Acceleration of changes in session impact during contrasting time-limited psychotherapies. J Clin Med. However, alongside this, participants also recognised that engaging with others in the group was a necessary means to engage with their own emotions. We also added a new chapter about social media and mobile applications to the workbook which was based on materials provided by South London and Maudsley NHS Foundation Trust [35], because social media platforms provide the opportunity and risk to communicate and exchange illness related as well as health-related thoughts known to be frequently used by adolescents [36]. Westmoreland P, Krantz MJ, Mehler PS. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders. Furthermore, there was also a flexibility afforded to therapists in the treatment delivery which may hinder replication. WB supported the collection of data across sites and initial data analysis, which was overseen by HS. Bernard H, Burlingame G, Flores P, Greene L, Joyce A, Kobos JC, et al. 1 for details). In both groups, patients will be contacted twice via telephone and afterwards once or twice via text message/email. The Psychotherapy Motivation Questionnaire (FPTM-40) [61] measures the motivation to attend psychotherapy from a patients perspective. Common emotional themes often fed into the main topic of discussion. Quality of life will be measured with the German version of the Inventory for Assessment of Quality of Life in Children and Adolescents (ILK) [48], a self-rating questionnaire with acceptable internal consistency (Cronbachs =.55.76) measured in an adolescent population. I remember coming away feeling a bit more settled. Dips in motivation are discussed, idiosyncratic aspects of an individuals formulation can be addressed and ED relevant goals negotiated and monitored. Group participants are invited to select an object or card (objects were gathered via charity shops as well as an email request around the departments to bring in any small objects, toys, pictorial cards etc.) German Society for Psychosomatic Medicine and Medical Psychotherapy. Participants also valued the support they received from the group, and the opportunity to support others. J Psychother Integr. A randomised controlled trial (RCT) (group vs individual MANTRA) exploring postulated mechanisms of change (social and emotional processing) on core outcome (EDEQ and BMI) with a comprehensive follow up period, would enable comprehensive exploration. https://doi.org/10.1026/0084-5345.32.1.14. Blte S, Feineis-Matthews S, Leber S, Dierks T, Hubl D, Poustka F. The development and evaluation of a computer-based program to test and to teach the recognition of facial affect. Empirical foundations for writing in prevention and psychotherapy: mental and physical health outcomes. MANTRA, Eating Disorder Service, Middle House, Maudsley Hospital, Denmark Hill, London SE5 8AZ. Offering a sense that change was possible, with a suggestion that it would be helpful for people who had benefited from previous groups to come back and talk about their experiences to enhance this aspect of group-based MANTRA. . BMI tables were replaced by BMI-percentile graphs. A cognitive interpersonal therapy workbook for treating anorexia nervosa: the Maudsley model. Kronmller K-T, Hartmann M, Reck C, Victor D, Horn H, Winkelmann K. Die therapeutische Beziehung in der Kinder- und Jugendlichen-Psychotherapie. Feasibility data of: retention, acceptability and effectiveness; alongside the qualitative capture of participant experiences of treatment is presented. 1Of available data (n=27), 3 participants engaged in regular purging and 4 in regular bingeing, defined as at least once per week over the past 28days [48]. Schmidt U, Startup H, Treasure J. Relevant concomitant care permitted during trial). Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. The treatment of anorexia nervosa (AN) is often challenging due to medical complications as well as high relapse and mortality rates. Furthermore, case managers are committed to this project and will further motivate the patients to participate in follow-up assessments. The Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) Training Programme. Cookies policy. https://doi.org/10.1001/archgenpsychiatry.2010.128. https://doi.org/10.1007/s40519-013-0050-y. A Cognitive-Interpersonal Therapy Workbook for Treating Anorexia Nervosa: The Maudsley Model: Amazon.co.uk: Schmidt, Ulrike, Startup, Helen, Treasure, Janet: 9781138832893: Books Health, Family & Lifestyle Psychology & Psychiatry Applied Psychology Buy new: 21.99 RRP: 24.99 Save: 3.00 (12%) FREE Returns FREE delivery Saturday, 27 May. Mattejat F, Remschmidt H. ILK-Inventar zur Erfassung der Lebensqualitt bei Kindern und Jugendlichen: Ratingbogen fr Kinder, Jugendliche und Eltern: Manual. Front Psychol. Several participants raised issues relating to the mix of people in the group; one mentioned that she was the only young person in the group and another that he was the only man. To account for a dropout rate of 25%, a total of 50 patients will be recruited for the MANTRa intervention group. Am J Med. Fleischhaker C, Sixt B, Schulz E. DBT-A: Dialektisch-behaviorale Therapie fr Jugendliche. sharing sensitive information, make sure youre on a federal PDF The Maudsley Anorexia Nervosa Treatment for Adults (MANTRA): a In addition, we will ask patients about their experiences with the MANTRa treatment program at T2 using 5 open-ended questions and we will interview the MANTRa therapists with semi-structured interviews. The allocation of patients to the therapists will be based on availability and local proximity in both groups. In this study, we also include the broad spectrum of AN patients (full-syndrome AN, atypical AN, weight-restored AN) in our sample to increase the generalizability of our results for different stages of the illness. Christensen KA, Haynos AF. Two psychologists trained and supervised in conducting the EDE interview by a senior clinical psychologist (G.W.) Caglar-Nazali HP, Corfield F, Cardi V, Ambwani S, Leppanen J, Olabintan O, et al. 2018. https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home. The outcome of anorexia nervosa in the 20th century. 2017;26:148399. Pugh M. Cognitive behavioural chairwork: distinctive features: Routledge; 2019.
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