title: A randomized controlled trial of an Internet-based cognitive-behavioural skills package for carers of people with anorexia nervosa.
abstract: BACKGROUND
  Anorexia nervosa (AN) poses a major burden on families. Carers (e.g. parents or partners) of people with AN are often highly distressed and may inadvertently respond in ways that can contribute to the maintenance of the disorder, e.g. through high levels of over-involvement and criticism [also known as expressed emotion (EE)]. This study aimed to evaluate the efficacy of a novel web-based systemic cognitive-behavioural (CBT) intervention for carers of people with AN, designed to reduce carer distress and teach skills in how to offer effective support.
  
  
  METHODS
  Carers of people with AN (n=64) were randomly allocated to either the web-intervention, overcoming anorexia online, with limited clinician supportive guidance (by email or phone), or to ad-hoc usual support from the UK patient and carer organization Beat. Carer outcomes were assessed at post-treatment (4 months) and follow-up (6 months).
  
  
  RESULTS
  Compared with the control intervention, web-based treatment significantly reduced carers' anxiety and depression (primary outcome) at post-treatment, with a similar trend in carers' EE. Other secondary outcomes did not favour the online intervention. Gains were maintained at follow-up.
  
  
  CONCLUSIONS
  This is the first ever study to use an online CBT program to successfully reduce carer distress and improve carers' ability to support the person with AN.
authors: King's College London, Institute of Psychiatry, Section of Eating Disorders, London, UK.
authors: M
authors: M
authors: Grover
authors: U
authors: U
authors: Naumann
authors: L
authors: L
authors: Mohammad-Dar
authors: D
authors: D
authors: Glennon
authors: S
authors: S
authors: Ringwood
authors: I
authors: I
authors: Eisler
authors: C
authors: C
authors: Williams
authors: J
authors: J
authors: Treasure
authors: U
authors: U
authors: Schmidt
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D001007:Anxiety / Q000517:prevention & control; D017028:Caregivers / Q000193:education* / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003194:Computer-Assisted Instruction; D003863:Depression / Q000517:prevention & control; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000517:prevention & control; D011795:Surveys and Questionnaires; D055815:Young Adult