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.

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.

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 “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 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

First episode rapid early intervention for eating disorders: A two‐year follow‐up

2019 ◽  
Vol 14 (1) ◽  
pp. 137-141 ◽  
Author(s):  
Akira Fukutomi ◽  
Amelia Austin ◽  
Jessica McClelland ◽  
Amy Brown ◽  
Danielle Glennon ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Early Intervention ◽  
First Episode

scholarly journals Early weight gain trajectories in first episode anorexia: predictors of outcome for emerging adults in outpatient treatment

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
A. Austin ◽  
M. Flynn ◽  
K. L. Richards ◽  
H. Sharpe ◽  
K. L. Allen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Weight Gain ◽  
Emerging Adults ◽  
Clinical Outcomes ◽  
Outpatient Treatment ◽  
Early Response ◽  
First Episode ◽  
Treatment Start ◽  
Early Weight Gain

Abstract Background Early response to treatment has been shown to be a predictor of later clinical outcomes in eating disorders (EDs). Specifically, early weight gain trajectories in anorexia nervosa (AN) have been shown to predict higher rates of later remission in inpatient treatment. However, no study has, as of yet, examined this phenomenon within outpatient treatment of first episode cases of AN or in emerging adults. Methods One hundred seven patients with AN, all between the ages of 16 and 25 and with an illness duration of < 3 years, received treatment via the first episode rapid early intervention in eating disorders (FREED) service pathway. Weight was recorded routinely across early treatment sessions and recovery outcomes (BMI > 18.5 kg/m2 and eating psychopathology) were assessed up to 1 year later. Early weight gain across the first 12 treatment sessions was investigated using latent growth mixture modelling to determine distinct classes of change. Follow-up clinical outcomes and remission rates were compared between classes, and individual and clinical characteristics at baseline (treatment start) were tested as potential predictors. Results Four classes of early treatment trajectory were identified. Three of these classes (n = 95), though differing in their early change trajectories, showed substantial improvement in clinical outcomes at final follow-up. One smaller class (n = 12), characterised by a ‘higher’ start BMI (> 17) and no early weight gain, showed negligible improvement 1 year later. Of the three treatment responding groups, levels of purging, depression, and patient reported carer expressed emotion (in the form of high expectations and low tolerance of the patient) determined class membership, although these findings were not significant after correcting for multiple testing. A higher BMI at treatment start was not sufficient to predict optimal clinical outcomes. Conclusion First episode cases of AN treated via FREED fit into four distinct early response trajectory classes. These may represent subtypes of first episode AN patients. Three of these four trajectories included patients with substantial improvements 1 year later. For those in the non-response trajectory class, treatment adjustments or augmentations could be considered earlier, i.e., at treatment session 12.

scholarly journals Will a comprehensive, person-centered, team-based early intervention approach to first episode illness improve outcomes in eating disorders?

2016 ◽  
Vol 49 (4) ◽  
pp. 374-377 ◽  
Author(s):  
Ulrike Schmidt ◽  
Amy Brown ◽  
Jessica McClelland ◽  
Danielle Glennon ◽  
Victoria A. Mountford
Keyword(s):  
Eating Disorders ◽  
Early Intervention ◽  
First Episode ◽  
Intervention Approach
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