Browsing by Author "Engelberg, Marla"
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Item Open Access A qualitative evaluation of team and family perceptions of family-based treatment delivered by videoconferencing (FBT-V) for adolescent Anorexia Nervosa during the COVID-19 pandemic(2022-07-26) Couturier, Jennifer; Pellegrini, Danielle; Grennan, Laura; Nicula, Maria; Miller, Catherine; Agar, Paul; Webb, Cheryl; Anderson, Kristen; Barwick, Melanie; Dimitropoulous, Gina; Findlay, Sheri; Kimber, Melissa; McVey, Gail; Paularinne, Rob; Nelson, Aylee; DeGagne, Karen; Bourret, Kerry; Restall, Shelley; Rosner, Jodi; Hewitt-McVicker, Kim; Pereira, Jessica; McLeod, Martha; Shipley, Caitlin; Miller, Sherri; Boachie, Ahmed; Engelberg, Marla; Martin, Samantha; Holmes-Haronitis, Jennifer; Lock, JamesAbstract Background During the COVID-19 pandemic, outpatient eating disorder care, including Family-Based Treatment (FBT), rapidly transitioned from in-person to virtual delivery in many programs. This paper reports on the experiences of teams and families with FBT delivered by videoconferencing (FBT-V) who were part of a larger implementation study. Methods Four pediatric eating disorder programs in Ontario, Canada, including their therapists (n = 8), medical practitioners (n = 4), administrators (n = 6), and families (n = 5), participated in our study. We provided FBT-V training and delivered clinical consultation. Therapists recorded and submitted their first four FBT-V sessions. Focus groups were conducted with teams and families at each site after the first four FBT-V sessions. Focus group transcripts were transcribed verbatim and key concepts were identified through line-by-line reading and categorizing of the text. All transcripts were double-coded. Focus group data were analyzed using directed and summative qualitative content analysis. Results Analysis of focus group data from teams and families revealed four overarching categories—pros of FBT-V, cons of FBT-V, FBT-V process, and suggestions for enhancing and improving FBT-V. Pros included being able to treat more patients and developing a better understanding of family dynamics by being virtually invited into the family’s home (identified by teams), as well as convenience and comfort (identified by families). Both teams and families recognized technical difficulties as a potential con of FBT-V, yet teams also commented on distractions in family homes as a con, while families expressed difficulties in developing therapeutic rapport. Regarding FBT-V process, teams and families discussed the importance and challenge of patient weighing at home. In terms of suggestions for improvement, teams proposed assessing a family’s suitability or motivation for FBT-V to ensure it would be appropriate, while families strongly suggested implementing hybrid models of FBT in the future which would include some in-person and some virtual sessions. Conclusion Team and family perceptions of FBT-V were generally positive, indicating acceptability and feasibility of this treatment. Suggestions for improved FBT-V practices were made by both groups, and require future investigation, such as examining hybrid models of FBT that involve in-person and virtual elements. Trial registration ClinicalTrials.gov NCT04678843 .Item Open Access Correction: A qualitative evaluation of team and family perceptions of family-based treatment delivered by videoconferencing (FBT-V) for adolescent Anorexia Nervosa during the COVID-19 pandemic(2022-12-08) Couturier, Jennifer; Pellegrini, Danielle; Grennan, Laura; Nicula, Maria; Miller, Catherine; Agar, Paul; Webb, Cheryl; Anderson, Kristen; Barwick, Melanie; Dimitropoulos, Gina; Findlay, Sheri; Kimber, Melissa; McVey, Gail; Paularinne, Rob; Nelson, Aylee; DeGagne, Karen; Bourret, Kerry; Restall, Shelley; Rosner, Jodi; Hewitt-McVicker, Kim; Pereira, Jessica; McLeod, Martha; Shipley, Caitlin; Miller, Sherri; Boachie, Ahmed; Engelberg, Marla; Martin, Samantha; Holmes-Haronitis, Jennifer; Lock, JamesItem Open Access Family-based treatment for transition age youth: parental self-efficacy and caregiver accommodation(2018-06-06) Dimitropoulos, Gina; Landers, Ashley L; Freeman, Victoria E.; Novick, Jason; Cullen, Olivia; Engelberg, Marla; Steinegger, Cathleen; Le Grange, DanielAbstract Background Family-Based Treatment (FBT) is the first line of care in paediatric treatment while adult programs focus on individualized models of care. Transition age youth (TAY) with Anorexia Nervosa (AN) are in a unique life stage and between systems of care. As such, they and their caregivers may benefit from specialized, developmentally tailored models of treatment. Methods The primary purpose of this study was to assess if parental self-efficacy and caregiver accommodation changed in caregivers during the course of FBT-TAY for AN. The secondary aim was to determine if changes in parental self-efficacy and caregiver accommodation contributed to improvements in eating disorder behaviour and weight restoration in the transition age youth with AN. Twenty-six participants (ages 16–22) and 39 caregivers were recruited. Caregivers completed the Parents versus Anorexia Scale and Accommodation and Enabling Scale for Eating Disorders at baseline, end-of-treatment (EOT), and 3 months follow-up. Results Unbalanced repeated measures designs for parental self-efficacy and caregiver accommodation towards illness behaviours were conducted using generalized estimation equations. Parental self-efficacy increased from baseline to EOT, although not significantly (p = .398). Parental self-efficacy significantly increased from baseline to 3 months post-treatment (p = .002). Caregiver accommodation towards the illness significantly decreased from baseline to EOT (p = 0.0001), but not from baseline to 3 months post-treatment (p = 1.000). Stepwise ordinary least squares regression estimates of eating disorder behaviour and weight restoration did not show that changes in parental-self efficacy and caregiver accommodation predict eating disorder behaviour or weight restoration at EOT or 3 months post-treatment. Conclusions Our findings demonstrate, albeit preliminary at this stage, that FBT-TAY promotes positive increases in parental self-efficacy and assists caregivers in decreasing their accommodation to illness behaviours for transition age youth with AN. However, changes in the parental factors did not influence changes in eating and weight in the transition age youth.