scholarly journals “I’m truly free from my eating disorder”: Emerging adults’ experiences of FREED, an early intervention service model and care pathway for eating disorders

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rachel Potterton ◽  
Amelia Austin ◽  
Michaela Flynn ◽  
Karina Allen ◽  
Vanessa Lawrence ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Early Intervention ◽  
Emerging Adults ◽  
Care Pathway ◽  
Support Network ◽  
First Episode ◽  
Service Model ◽  
Access To Treatment ◽  
Rapid Access

Abstract Background Eating disorders (EDs) typically start during adolescence or emerging adulthood, periods of intense biopsychosocial development. FREED (First Episode Rapid Early Intervention for EDs) is a service model and care pathway providing rapid access to developmentally-informed care for emerging adults with EDs. FREED is associated with reduced duration of untreated eating disorder and improved clinical outcomes, but patients’ experiences of treatment have yet to be assessed. Objective This study aimed to assess emerging adults’ experiences of receiving treatment through FREED. Method This study triangulated qualitative data on participants’ experiences of FREED treatment from questionnaires and semi-structured interviews. Participants were 106 emerging adults (aged 16–25; illness duration < 3 yrs) (questionnaire only = 92; interview only = 6; both = 8). Data were analysed thematically. Results Most participants reported psychological and behavioural changes over the course of treatment (e.g. reduction in symptoms; increased acceptance and understanding of difficulties). Participants identified five beneficial characteristics of FREED treatment: i) rapid access to treatment; ii) knowledgeable and concerned clinicians; iii) focusing on life beyond the eating disorder; iv) building a support network; v) becoming your own therapist. Conclusion This study provides further supports for the implementation of early intervention and developmentally-informed care for EDs. Future service model development should include efforts to increase early help-seeking.

scholarly journals Assessing implementation fidelity in the First Episode Rapid Early Intervention for Eating Disorders service model

BJPsych Open ◽  
2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Katie L. Richards ◽  
Michaela Flynn ◽  
Amelia Austin ◽  
Katie Lang ◽  
Karina L. Allen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Early Intervention ◽  
Emerging Adults ◽  
Care Pathway ◽  
Implementation Fidelity ◽  
Wait Time ◽  
First Episode ◽  
Service Model ◽  
Patient Journey ◽  
Care Package

Background The First Episode Rapid Early Intervention for Eating Disorders (FREED) service model is associated with significant reductions in wait times and improved clinical outcomes for emerging adults with recent-onset eating disorders. An understanding of how FREED is implemented is a necessary precondition to enable an attribution of these findings to key components of the model, namely the wait-time targets and care package. Aims This study evaluated fidelity to the FREED service model during the multicentre FREED-Up study. Method Participants were 259 emerging adults (aged 16–25 years) with an eating disorder of <3 years duration, offered treatment through the FREED care pathway. Patient journey records documented patient care from screening to end of treatment. Adherence to wait-time targets (engagement call within 48 h, assessment within 2 weeks, treatment within 4 weeks) and care package, and differences in adherence across diagnosis and treatment group were examined. Results There were significant increases (16–40%) in adherence to the wait-time targets following the introduction of FREED, irrespective of diagnosis. Receiving FREED under optimal conditions also increased adherence to the targets. Care package use differed by component and diagnosis. The most used care package activities were psychoeducation and dietary change. Attention to transitions was less well used. Conclusions This study provides an indication of adherence levels to key components of the FREED model. These adherence rates can tentatively be considered as clinically meaningful thresholds. Results highlight aspects of the model and its implementation that warrant future examination.

The FREED Project (first episode and rapid early intervention in eating disorders): service model, feasibility and acceptability

2016 ◽  
Vol 12 (2) ◽  
pp. 250-257 ◽  
Author(s):  
Amy Brown ◽  
Jessica McClelland ◽  
Elena Boysen ◽  
Victoria Mountford ◽  
Danielle Glennon ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Early Intervention ◽  
First Episode ◽  
Service Model

scholarly journals A pilot evaluation of a novel First Episode and Rapid Early Intervention service for Eating Disorders (FREED)

2018 ◽  
Vol 26 (2) ◽  
pp. 129-140 ◽  
Author(s):  
Jessica McClelland ◽  
John Hodsoll ◽  
Amy Brown ◽  
Katie Lang ◽  
Elena Boysen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Early Intervention ◽  
First Episode ◽  
Early Intervention Service ◽  
Intervention Service

scholarly journals Transitioning To Digital First Line Intervention – Validation Of A Brief Online Screener For Early Identification Of A Suspected Eating Disorder: Study Protocol

2020 ◽  
Author(s):  
Emma Bryant ◽  
Jane Miskovic-Wheatley ◽  
Stephen Touyz ◽  
Ross D Crosby ◽  
Eyza Koreshe ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Early Intervention ◽  
Discriminant Validity ◽  
Screening Tool ◽  
Test Reliability ◽  
Baseline Survey ◽  
Pathways To Care ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background: Only one in four people with eating disorders seeks treatment, and of those who do seek treatment, 20% go on to experience a chronic course. Early intervention has been associated with better prognosis, with those seeking specialised intervention in the early stages of their illness more than twice as likely to achieve remission. Current screening measures typically require expert administration and are rarely validated across a spectrum of DSM-5 eating disorder presentations or for online use. In light of COVID-19 and increasing reliance on telehealth technologies in the intervention and delivery of mental health services, online assessments suitable for self-referral are likely to be the first step to seeking care. InsideOut Institute has developed a 6-item online screening tool for the purposes of identifying eating disorder risk and symptomatology, aimed specifically at increasing help-seeking behaviour in subsyndromal and early presentations. Methods: This study investigates the reliability and validity of the InsideOut Institute Screener (IOI-S), using a cross-sectional survey research design. Participants aged 14 and over will complete an extensive baseline survey battery for evaluation. 50% of participants will be randomly selected for one follow-up re-test of the IOI-S only, two weeks post initial testing. The IOI-S will be analysed for statistical reliability on two parameters: internal consistency and test re-test reliability, and for statistical validity on four parameters: concurrent validity, sensitivity and specificity, convergent and discriminant validity. Discussion: The rapid and ongoing shift to digital intervention has highlighted gaps and opportunities in our pathways to care. Adequate screening for eating disorders is a major gap. This study aims to validate an online screening tool for use in telehealth early intervention, designed for users seeking information for a suspected eating disorder. The screener meets those at risk ‘where they are’ (i.e. online) and may improve timely referrals to relevant services. This is of particular salience as face-to-face healthcare and traditional frontline interventions are disrupted, and we are challenged to re-design our practices to deliver diagnostic and treatment services in highly adaptive digital contexts.Trial registration: N/A

scholarly journals Transitioning To Digital First Line Intervention – Validation Of A Brief Online Screener For Early Identification Of A Suspected Eating Disorder: Study Protocol

2020 ◽  
Author(s):  
Emma Bryant ◽  
Jane Miskovic-Wheatley ◽  
Stephen Touyz ◽  
Ross D Crosby ◽  
Eyza Koreshe ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Early Intervention ◽  
Discriminant Validity ◽  
Screening Tool ◽  
Test Reliability ◽  
Baseline Survey ◽  
Pathways To Care ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background: Only one in four people with eating disorders seeks treatment, and of those who do seek treatment, 20% go on to experience a chronic course. Early intervention has been associated with better prognosis, with those seeking specialised intervention in the early stages of their illness more than twice as likely to achieve remission. Current screening measures typically require expert administration and are rarely validated across a spectrum of DSM-5 eating disorder presentations or for online use. In light of COVID-19 and increasing reliance on telehealth technologies in the intervention and delivery of mental health services, online assessments suitable for self-referral are likely to be the first step to seeking care. InsideOut Institute has developed a 6-item online screening tool for the purposes of identifying eating disorder risk and symptomatology, aimed specifically at increasing help-seeking behaviour in subsyndromal and early presentations. Methods: This study investigates the reliability and validity of the InsideOut Institute Screener (IOI-S), using a cross-sectional survey research design. Participants aged 14 and over will complete an extensive baseline survey battery for evaluation. 50% of participants will be randomly selected for one follow-up re-test of the IOI-S only, two weeks post initial testing. The IOI-S will be analysed for statistical reliability on two parameters: internal consistency and test re-test reliability, and for statistical validity on four parameters: concurrent validity, sensitivity and specificity, convergent and discriminant validity. Discussion: The rapid and ongoing shift to digital intervention has highlighted gaps and opportunities in our pathways to care. Adequate screening for eating disorders is a major gap. This study aims to validate an online screening tool for use in telehealth early intervention, designed for users seeking information for a suspected eating disorder. The screener meets those at risk ‘where they are’ (i.e. online) and may improve timely referrals to relevant services. This is of particular salience as face-to-face healthcare and traditional frontline interventions are disrupted, and we are challenged to re-design our practices to deliver diagnostic and treatment services in highly adaptive digital contexts.

scholarly journals “I’m not a teenager, I’m 22. Why can’t I snap out of it?”A Qualitative Exploration of Seeking Help for a First-Episode Eating Disorder During Emerging Adulthood

2020 ◽  
Author(s):  
Rachel Potterton ◽  
Amelia Austin ◽  
Karina Allen ◽  
Vanessa Lawrence ◽  
Ulrike Schmidt
Keyword(s):  
Emerging Adulthood ◽  
Emerging Adults ◽  
Transition To Adulthood ◽  
Help Seeking ◽  
Care Pathway ◽  
First Episode ◽  
Developmental Phase ◽  
Structured Interviews ◽  
Recent Onset ◽  
Challenges And Opportunities

Abstract Background: Eating disorders (EDs) typically have their onset during adolescence or the transition to adulthood. Emerging adulthood (~18-25 years) is a developmental phase which conceptually overlaps with adolescence but also has unique characteristics (e.g. increased independence). Emerging adults tend to come to ED services later in illness than adolescents, and emerging adulthood’s unique characteristics may contribute to such delays. Objective: This study aimed to explore attitudes towards ED symptoms, and their implications for help-seeking, amongst emerging adults receiving ED treatment through FREED, an early intervention care pathway. Method: Participants were 14 emerging adults (mean age 20.9 years; SD=2.0), all currently receiving specialist treatment for a first-episode, recent-onset (< 3 years) ED. Semi-structured interviews relating to experiences of help-seeking were conducted, and data were analysed thematically. Results: Symptom egosyntonicity, gradual reappraisal and feelings of exclusion from ED discourse were key attitudinal phases prior to help-seeking, each of which had distinct implications for help-seeking. Conclusions: Emerging adults with first-episode EDs show a distinct set of help-seeking-related challenges and opportunities (e.g. help-seeking for others; help-seeking at transitions; self-sufficiency). This research might be used to inform the development and evaluation of interventions which aim to facilitate help-seeking amongst emerging adults with first-episode recent-onset EDs.

scholarly journals Transitioning To Digital First Line Intervention – Validation Of A Brief Online Screener For Early Identification of A Suspected Eating Disorder: Study Protocol

2020 ◽  
Author(s):  
Emma Bryant ◽  
Jane Miskovic-Wheatley ◽  
Stephen Touyz ◽  
Ross D Crosby ◽  
Eyza Koreshe ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Early Intervention ◽  
Discriminant Validity ◽  
Screening Tool ◽  
Test Reliability ◽  
Baseline Survey ◽  
Pathways To Care ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background: Only one in four people with Eating Disorders (ED) seeks treatment, and of those who do seek treatment, 20% go on to experience a chronic course. Early intervention has been associated with better prognosis, with those seeking specialised intervention in the early stages of their illness more than twice as likely to achieve remission. Current screening measures typically require expert administration and are rarely validated across a spectrum of DSM-5 eating disorder presentations or for online use. In light of COVID-19 and increasing reliance on telehealth technologies in the intervention and delivery of mental health services, online assessments suitable for self-referral are likely to be the first step to seeking care. InsideOut Institute has developed a 6-item online screening tool for the purposes of identifying eating disorder risk and symptomatology, aimed specifically at increasing help-seeking behaviour in subsyndromal and early presentations. Methods: This study investigates the reliability and validity of the InsideOut Institute Screener (IOI-S), using a cross-sectional survey research design. Participants aged 14 and over will complete a baseline survey battery consisting of the EDE-Q, the SCOFF questionnaire, the IOI-S and either the MC-SDS (adults) or CSD-S (adolescents) for evaluation. 30% of participants will be randomly selected for one follow-up re-test of the IOI-S only, two weeks post initial testing. The IOI-S will be analysed for statistical reliability on two parameters: internal consistency and test re-test reliability, and for statistical validity on four parameters: concurrent validity, sensitivity and specificity, convergent and discriminant validity. Discussion: The rapid and ongoing shift to digital intervention has highlighted gaps and opportunities in our pathways to care. Adequate screening for eating disorders is a major gap. This study aims to validate an online screening tool for use in telehealth early intervention, designed for users seeking information for a suspected eating disorder. The screener meets those at risk ‘where they are’ (i.e. online) and may improve timely referrals to relevant services. This is of particular salience as face-to-face healthcare and traditional frontline interventions are disrupted, and we are challenged to re-design our practices to deliver diagnostic and treatment services in highly adaptive digital contexts.Trial registration: N/A

scholarly journals The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes

2021 ◽  
Author(s):  
Amelia Austin ◽  
Michaela Flynn ◽  
James Shearer ◽  
Mike Long ◽  
Karina Allen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Early Intervention ◽  
Clinical Outcomes ◽  
First Episode

First episode rapid early intervention for eating disorders (FREED): From research to routine clinical practice

2020 ◽  
Vol 14 (5) ◽  
pp. 625-630 ◽  
Author(s):  
Karina L. Allen ◽  
Victoria Mountford ◽  
Amy Brown ◽  
Katie Richards ◽  
Nina Grant ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Clinical Practice ◽  
Early Intervention ◽  
Routine Clinical Practice ◽  
First Episode
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