A randomised controlled trial (RCT) of three treatments for anorexia nervosa in adults
Dr Sue Byrne, Research Consultant at the Centre for Clinical Interventions (CCI) and Associate Professor at UWA, has been awarded an NHMRC Project Grant of $584,125 to evaluate three promising new treatments for anorexia nervosa (AN) in adults. Her co-investigators are Australia’s leading researchers/clinicians in the field of eating disorders (Professor Tracey Wade in Adelaide, and Professors Phillipa Hay and Stephen Touyz in Sydney), and other CIs include Professors Christopher Fairburn, Janet Treasure and Ulrike Schmidt from the UK and Dr Virginia McIntosh from New Zealand. Associate investigators include Dr Ross Crosby (from the US) and Dr Anthea Fursland (from CCI).
This Australian multi-centre RCT will be the first of its type in the world. The first treatment is the newly devised Enhanced Cognitive Behaviour Therapy (CBT-E), which was formulated from the transdiagnostic theory for eating disorders (Fairburn, Cooper & Shafran, 2003). The second treatment is the Maudsley Cognitive Motivational Therapy (MCMT; Schmidt & Treasure, 2006), which was designed specifically to treat AN and was formulated from the cognitive-interpersonal maintenance model. The third treatment is non-specific supportive clinical management (SCM; McIntosh et al., 2005), which represents a combination of clinical management and supportive psychotherapy. Over 200 patients will be recruited into the trial. All three treatments will be conducted over a 10 month period, and at the end of treatment patients will be followed-up for one year. The benefits of this research will be significant in informing treatments for AN that are efficacious, theoretically-driven and highly acceptable to patients.
Transdiagnostic internet therapy for internalising disorders
Dr Peter McEvoy from the Centre for Clinical Interventions, along with Dr Nick Titov from the Clinical Research Unit for Anxiety and Depression (Sydney) and Professor Michelle Craske from UCLA, have been awarded an NHMRC Project Grant of $584,375 to develop and evaluate a transdiagnostic, internet-based treatment for anxiety and depression.
Despite the fact that effective treatments are available, fewer than 40% of people with a mental disorder seek treatment. Internet cognitive behavioural therapy (I-CBT) is a promising strategy for reducing barriers to treatment. I-CBT programmes exist for specific mental disorders, and have been demonstrated as clinically effective, cost-effective, and acceptable to consumers. A limitation of I-CBT and face-to-face CBT is that it is usually diagnosis-specific. However, patients frequently experience more than one disorder simultaneously (comorbidity). Diagnosis-specific programmes may fail to address comorbidity and underlying vulnerability, leading to elevated relapse rates. Furthermore, the need for large numbers of disorder-specific manuals and training can act as a disincentive for the dissemination of empirically-validated treatments.
Transdiagnostic treatments employ strategies that have demonstrated their effectiveness across multiple diagnoses. It is hoped that this programme of research on a transdiagnostic approach to I-CBT will reduce costs for clients and service providers, and further improve treatment accessibility and effectiveness.