The short term effectiveness of day treatment for eating disorders in reducing psychosocial impairment: utilizing the clinical impairment assessment in routine practice

Pages11-22
DOIhttps://doi.org/10.1108/MHRJ-10-2014-0039
Date14 March 2016
Published date14 March 2016
AuthorZoe Meropi Hepburn,Sam Clark-Stone
The short term effectiveness of day
treatment for eating disorders in reducing
psychosocial impairment: utilizing the
clinical impairment assessment in routine
practice
Zoe Meropi Hepburn and Sam Clark-Stone
Zoe Meropi Hepburn is Senior
Clinician and Researcher and
Sam Clark-Stone is Lead
Clinician, both at
Gloucestershire Eating
Disorders Service, 2gether
NHS Foundation Trust,
Cheltenham, UK.
Abstract
Purpose The purpose of this paper is to investigate the effectiveness of a day treatment programme (DTP)
in reducing psychosocial impairment, changing attitudes, restoring body-weight and decreasing binge/vomit
symptoms among 52 individuals (aged 16+) with eating disorders. It was hypothesized that day treatment
would result in improvements across all variables measured.
Design/methodology/approach In a within-participants design, demographic, physiological and
psychological measures were taken on admission to and at discharge from a DTP in the UK. Quantitative
outcomes were analysed.
Findings In total, 40 participants were considered to have received an adequate dose of the DTP, having
completed at least four weeks on the programme. Analyses supported all hypotheses, with all improvements
being statistically significant. Large effect sizes were evident for all outcomes across the whole sample other
than shape concern attitudes and weight concern attitudes, which reduced with moderate and moderate-to-
large effect sizes, respectively.
Originality/value This study provides new evidence of the effectiveness of day treatment in reducing
psychosocial impairment resulting from eating disorder psychopathology. It remains for future research to
determine whether these outcomes can be sustained over the longer term.
Keywords Quantitative, Anorexia nervosa, Bulimia nervosa, Effectiveness, Outcome,
Binge eating disorder, Day treatment, Eating disorder, Day programme, Partial hospital
Paper type Research paper
Introduction
Background
Eating disorders lead to physical morbidity, psychosocial impairment (Fairburn and Harrison,
2003) and the highest mortality rate of any of the psychiatric disorders (Herzog et al., 2000).
Characterized by a core psychopathologyin which the importance of shape, weight and
eating, and their control are over-evaluated (Fairburn, 2008), eating disorders are commonly
measured for severity with reference to these attitudes and their associated features (including
low body-weight, psychological distress, psychosocial impairment, binge-eating and behaviours
Received 16 October 2014
Revised 12 April 2015
20 July 2015
Accepted 21 July 2015
With thanks to the staff and
patients at the Gloucestershire
Eating Disorders Day Treatment
Programme.
DOI 10.1108/MHRJ-10-2014-0039 VOL. 21 NO. 1 2016, pp. 11-22, © Emerald Group Publishing Limited, ISSN 1361-9322
j
MENTALHEALTH REVIEW JOURNAL
j
PAG E 11

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