The recruitment and acceptability of a project ECHO® eating disorders clinic: a pilot study of telementoring for primary medical and behavioral health care practitioners

Early identification and intervention are critical to prevent physical and mental health complications, chronicity, and premature death associated with eating disorders. However, primary medical and behavioral health care clinicians often do not feel confident or competent to diagnose and manage patients with eating disorders. This pilot study describes an innovative telementoring project (Project ECHO® Eating Disorders) that builds a geographically defined collaborative learning community to bridge the knowledge gap between eating disorder specialists located in eating disorder service sites and community-based practitioners, often living in remote areas. We describe the program and recruitment strategies and review baseline participant evaluation findings. Continuing Medical Education (CME) evaluation findings are presented as a measure of practitioner acceptability and satisfaction. Content analysis of CME participant evaluation comments provides an understanding of the impact of the program on participant knowledge and intended practice changes. We end with implications for training, practice, and research.

Mutuality of Rogers's therapeutic conditions and treatment progress in the first three psychotherapy sessions

OBJECTIVE

Research on the effects of Rogers's therapeutic relationship conditions has typically focused on the unilateral provision of empathy, unconditional positive regard, and congruence from therapist to client.

METHOD

This study looked at both client and therapist mutuality of the Rogerian therapeutic conditions and the association between mutuality and treatment progress in the first three psychotherapy sessions. Clients (N = 62; mean age = 24.32; 77% female, 23% male) and therapists (N = 12; mean age = 34.32; nine female and three male) rated one another using the Barrett-Lennard Relationship Inventory after the first and third session.

RESULTS

Both clients and therapists perceived the quality of the relationship as improved over time. Client rating of psychological distress (CORE-OM) was lower after session 3 than at session 1 (es = .85, [95% CIs: .67, 1.03]). Hierarchical multiple regression was used to test the predictive power of mutually high levels of the therapeutic conditions on treatment progress. The association between client rating of therapist-provided conditions and treatment progress at session 3 was higher when both clients and therapists rated each other as providing high levels of the therapeutic conditions (R(2) change = .073, p < .03).

CONCLUSIONS

The findings suggest mutuality of Rogers's therapeutic conditions is related to treatment progress.

Observed connection and individuation: relation to symptoms in families of adolescents with bulimia nervosa

OBJECTIVE

To examine the relation between observed familial connection and individuation and adolescent bulimia nervosa (BN) symptoms.

METHOD

As part of a treatment study for adolescent BN, adolescents (n = 54) and their parents participated in a videotaped semi-structured interview. Participants were rated on observed connection and individuation from these interviews using the Scale of Intergenerational Relationship Quality and two measures of connection.

RESULTS

There was a significant negative relation between individuation from parents and adolescent BN symptoms. Connection both to and from mothers and adolescents was negatively associated with BN symptoms. Increased eating concern was significantly associated with a greater likelihood of expressing a desire for more connection with the family.

DISCUSSION

Investigating and understanding family factors present at the time of adolescent BN may assist in providing treatment specific to the needs of the family to best aid the adolescent's recovery process.