Interpersonal maintaining factors in eating disorder:Skill sharing interventions for carers

The aim of this paper is to describe an intervention designed to share information and skills with carers of people with an eating disorder. The NICE guidelines recommend outpatient management as the first line of treatment for all forms of eating disorders. Hence family members are called upon to provide support within the community. However they are often at a loss as to how best to help. It is common for carers to become anxious, depressed, discouraged and lonely. This can color judgment and some reactions to eating disorder symptoms can be harmful rather than helpful. In both naturalistic studies and randomized controlled trials, family factors have been implicated either as moderators or mediators of outcome. For example high expressed emotion (criticism, hostility and over protection) can adversely impact on the illness. Families can inadvertently be drawn in by the nature of the illness to adjust and accommodate their lives around the symptoms or even enable the continuation of some symptoms. Carers recognize their need for information about how to manage the problem. Sharing information and skills with family members can correct some of the unhelpful attributions and reactions to the illness and can empower non-professional carers to contribute to the process of treatment.