Process evaluation of the MOSAIC Trial, Part I: Therapist experiences of delivering two psychological therapies for treatment of anorexia nervosa.
OBJECTIVE
Forming part of a process evaluation of a large randomised controlled trial (the Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related conditions, MOSAIC) comparing two outpatient therapies for Anorexia Nervosa (AN), the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) and Specialist Supportive Clinical Management (SSCM), this study adopted a qualitative approach to examine therapist experiences of treatment delivery.


METHODS
Twenty MOSAIC therapists completed semi-structured interviews. Interviews were recorded, transcribed and analysed thematically.


RESULTS
Themes of positive aspects, challenges and therapeutic fit emerged. MANTRA was seen as structured and flexible but could feel demanding on therapist time and skill. The slow pace and narrower focus of SSCM gave patients space to talk, but the lack of psychological tools and nutritional emphasis could create frustration. Views on the therapeutic relationship and patient-therapy fit differed across treatments.


CONCLUSIONS
Findings provide testable hypotheses about what works for whom, ideas for therapist training, treatment development and delivery.
Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London.
Daniella
D
Waterman-Collins
Beth
B
Renwick
Anna
A
Lose
Martha
M
Kenyon
Lucy
L
Serpell
Lorna
L
Richards
Nicky
N
Boughton
Janet
J
Treasure
Ulrike
U
Schmidt
D000553:Ambulatory Care / Q000379:methods; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D010043:Outcome and Process Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic
Anorexia Nervosa; Process Evaluation; Qualitative Research; Randomised Controlled Trial