SPICE Study
Research type
Research Study
Full title
Short Psychological Intervention for Children and adolescents with Eating disorders (SPICE) study
IRAS ID
323971
Contact name
Roz Shafran
Contact email
Sponsor organisation
UCL Great Ormond Street Institute of Child Health
ISRCTN Number
ISRCTN16038125
Clinicaltrials.gov Identifier
UCL Data Protection, Z6364106/2023/03/167
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
Eating disorders are common and serious mental health conditions that typically begin in adolescence. There are some effective psychological treatments for eating disorders in children and young people (CYP), including family-based therapy (FBT) and cognitive behavioural therapy (CBT). However, these treatments are costly and time-consuming, and the demand for treatment far outweighs the availability of resources.One way to increase access to psychological support for CYP with eating disorders would be to develop a guided self-help intervention, which is brief in nature and requires less therapist time/input than traditional psychological treatments. The National Institute for Health and Care Excellence (NICE) recommend guided self-help interventions for adults with bulimia nervosa and binge eating disorder. They are also widely used in the treatment of anxiety disorders, depression and behavioural difficulties in CYP. However, child and adolescent eating disorder services in the UK do not routinely use guided self-help interventions as they have not been sufficiently researched.
The overarching aim of this project is to improve access to psychological treatments for CYP affected by eating disorders. Specifically, this preliminary study aims to examine the feasibility, acceptability and preliminary effectiveness of a guided self-help intervention for CYP (aged 8-19 years) with impairing symptoms of eating disorders using a case series design. CYP, and/or their parents/carers, will complete a screening questionnaire and clinical assessment to determine their eligibility for the study. Eligible families will be asked to complete baseline measures before receiving a self-help intervention workbook and 8x30-minute guidance sessions. Questionnaire measures and a clinical assessment will be repeated immediately 12 weeks after the baseline measures, to evaluate CYP outcomes. Families' acceptability of the treatment will also be examined.
This study is funded by a Child Health Research PhD Studentship at UCL Great Ormond Street Institute of Child Health.
Summary of Results
The aim of this study was to conduct a proof-of-concept pilot study of a cognitive behavioural therapy (CBT) guided self-help intervention for children and young people with eating disorders. Children and young people were recruited from two outpatient eating disorder services in England. They received a CBT guided self-help intervention consisting of eight modules and weekly support sessions. Clinical outcomes (eating disorder psychopathology and associated impairment, changes in %median body mass index (BMI), depression, anxiety, and behavioural difficulties) were assessed at baseline and post-intervention (12 weeks). Qualitative data were collected for future intervention refinement. Six female adolescents (aged 13-17) received the CBT guided self-help intervention. All participants completed a minimum of six modules and six support sessions. Quantitative and qualitative feedback suggested that the intervention was acceptable. From baseline to post-intervention, there was a reduction in eating disorder psychopathology and impairment, along with an increase in %median BMI. Outcomes for depression, anxiety and behavioural difficulties were mixed. The CBT guided self-help intervention was feasibly implemented, acceptable to participants, and showed potential to produce clinical benefits. While promising, these findings are preliminary and derived from a small, non-randomised sample of White female adolescents. More rigorous evaluation with a randomised design and a larger, representative sample is warranted.REC name
West of Scotland REC 5
REC reference
23/WS/0097
Date of REC Opinion
26 Jun 2023
REC opinion
Favourable Opinion