Specialist psychotherapy with emotion for anorexia in Kent and Sussex: An intervention development and non‐randomised single arm feasibility trial.

Objective: Anorexia nervosa (AN) is a serious eating disorder treated using psychological interventions, yet outcomes remain limited. Emotional difficulties are recognised as a treatment target. This research programme developed and evaluated feasibility of an emotion‐focused therapy for adults with AN. Methods: Phase One intervention development utilised 'intervention mapping'. Qualitative research drew on lived experience highlighting objectives for change. Empirical evidence was synthesised into hypotheses of core emotional difficulties and an associated model of change. Relevant psychotherapeutic theory‐based change methods were integrated to form the Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS) intervention, guidebook and clinician training package. Phase Two tested SPEAKS in a single‐arm, multisite feasibility trial across two specialist services, utilising prespecified progression criteria, and embedded process evaluation. Results: SPEAKS was 9–12 months (40 sessions) of weekly individual psychotherapy, drawing on a range of psychotherapeutic modalities, predominantly Emotion Focused Therapy and Schema Therapy. Forty‐six participants consented to feasibility trial participation; 42 entered the trial and 34 completed. Thirteen of 16 feasibility criteria were met at green level and three at amber, highlighting areas for improving model adherence. Conclusions: A randomised controlled trial is indicated. Therapist training and guidebook adjustments to improve model adherence are suggested. Highlights: Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex is an emotion‐focused intervention for adults with Anorexia nervosa following a proposed causal model of emotion change. Theory, tasks and techniques integrate Emotion Focused Therapy and Schema Therapy, alongside other modalities, to facilitate the proposed change processes.SPEAKS was developed using a clear 'intervention mapping' process, utilising mixed methods and seeking to engage and learn from those with lived experience.This feasibility trial suggests SPEAKS is an acceptable, engaging and clinically feasible intervention and progression to a larger randomised controlled trial is indicated. [ABSTRACT FROM AUTHOR]