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BACKGROUND: Anorexia nervosa (AN) is a serious mental illness associated with high rates of morbidity and mortality. Family-based treatment (FBT) is a well-established treatment for adolescent AN, yet it is underutilized in community settings and is unavailable to many families, particularly those from lower income and racial and ethnic minority backgrounds. Furthermore, some families do not respond optimally to FBT, possibly because of challenges translating skills acquired in office-based treatment settings to naturalistic settings. Home-based treatment could reduce barriers to access and enhance generalization of newly learned treatment skills. Home-based models demonstrate initial feasibility, acceptability, and efficacy for adolescent AN, however, FBT principles have yet to be applied as a stand-alone intervention in a home-based level of care. This paper describes the rationale for and process of adapting FBT principles/interventions to improve fit within a home-based model delivered in the context of community mental health, and discusses potential strengths and opportunities associated with this approach. RESULTS: Adaptations were made through consultation with collaborating community agencies and were guided by the complex interventions framework. The primary modifications included: (1) altered dose; (2) multiple family meals; (3) additional support for meal preparation and supervision; (4) clinician attendance at medical appointments; (5) cultural adaptation; and (6) introduction of distress tolerance and emotion regulation skills. CONCLUSIONS: Implementing FBT in the home may present one promising and novel approach to enhance engagement and treatment outcomes for adolescents with restrictive eating disorders, particularly those who are underserved, but evaluation of efficacy/effectiveness is needed.

The article discusses the diagnosis and management of eating disorder among adolescent and young adult in Rhode Island. It mentions the crucial role of medical providers in establishing an interdisciplinary treatment plan that will help stabilize patients and move them towards recovery. It outlines some tips on how to identify eating disorders in the primary care setting.

BACKGROUND: Eating disorders (eds) are psychiatric illnesses with high rates of morbidity and mortality. healthcare providers often receive inadequate training in evidence-based ed assessment and treatment. DESIGN: Project core (creating opportunities for rhode Island eating disorders Professionals) was developed to disseminate ed training/education and treatment approaches to the healthcare workforce. An interdisciplinary research team partners with pediatric healthcare professionals/trainees and supports them to better understand how to diagnose, manage, and collaborate across disciplines in the care of patients with eds. METHODS: Phase I involves a needs assessment of pediatric healthcare professionals' knowledge, attitudes and needs in treating eds. Phase II involves the development of training/education approaches, and therapeutic interventions for patients with eds. In Phase III approaches/interventions are further developed and disseminated across RI. PRINCIPAL CONCLUSIONS: Project core's goals will address barriers to effective ed treatment in RI and broaden the workforce of interdisciplinary providers trained to recognize and treat patients with EDs across multiple healthcare settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: The purpose of this study was to identify rates of weight recovery among adolescents and young adults with restrictive eating disorders (RED) as part of a quality improvement assessment in an Adolescent Medicine outpatient clinic in Rhode Island. METHODS: A retrospective chart review was completed on 94 randomly selected patients ages 10-21 years old. Demographics, descriptors, time to weight recovery, and participation in other care were recorded. RESULTS: The average age of participants was 15 years; most were female, cis-gender, White, had private insurance, and had one or more co-morbid psychiatric diagnosis. At intake, 81% were <95% treatment goal weight (TGW), with 27% at <80% TGW. Among participants who started at <95% of TGW, 51% achieved >95% of TGW; participants who engaged in a higher level of care were more successful. CONCLUSIONS: This study identifies outcomes and highlights the challenge of weight recovery among patients with RED, even when managed by an expert clinical team. [ABSTRACT FROM AUTHOR]

Competing Interests: We declare no competing interests.