By On December 15th, 2017

National Eating Disorder Association awards $50,000 grant to develop eating disorder treatment app

People seeking treatment for an eating disorder run into an alarming number of roadblocks, detours, and complications on their way to recovery. Many encounter physicians who are poorly trained and underequipped to properly recognize and treat these disorders. Even worse, a significant number of people don’t respond to the currently available treatment methods.

Researchers from the University of Kansas are working to change this, however, with the help of a $50,000 grant from the National Eating Disorders Association (NEDA). The team is developing an app to help clinicians provide better and more personalized treatment.

“Sadly, for 40 to 60 percent of patients with an eating disorder, the very best available treatments simply don’t work,” said Kelsie Forbush, M. Erik Wright Assistant Professor of Clinical Psychology at KU, who is leading the development of the app. “Researchers and clinicians have put a lot of time and energy into developing new treatments for eating disorders, but the majority of these new treatments have not improved outcomes.”

Rather than take this approach, Forbush explained the app is inspired by a new perspective in mental illness research called “patient-focused treatment outcomes” research.

“Instead of developing new types of treatments, patient-focused treatment outcomes research is designed to improve outcomes by monitoring patient progress and providing feedback directly to therapists to enhance ongoing treatment,” she said. “Research in other areas of mental illness shows that monitoring patient outcomes on a week-to-week basis can increase positive outcomes by as much as 20 percent and reduce the number of patients who would have a poor outcome by 10 percent, so it’s a potentially powerful way to help patients get better.”

This approach has faced difficulties when addressing eating disorders, though. The researchers have noticed that most clinicians simply don’t have the time or proper training to perform weekly client-focused outcome assessments.

“Clinicians are incredibly busy and some therapists simply don’t have the time to track, analyze and interpret outcomes at every session for every patient,” said Forbush. “Some clinicians are also unsure of how to interpret patients’ scores. A clinician might think, ‘I see my patient has a certain score — what does that mean, and what should I do differently?’ Patient-focused treatment outcomes research enables therapists to treat their clients faster, with fewer sessions, and leads to better end-of-treatment outcomes. It works because therapists are getting feedback at each session and can more easily adjust their treatment accordingly.”

The new smartphone app is designed to help clinicians track and evaluate a patient’s response to treatment as it is happening by using computer-adaptive technology (CAT).

The app asks patients to complete a series of questions from two recognized mental health diagnostic tools: the Eating Pathology Symptoms Inventory (EPSI) and the Inventory of Depression and Anxiety Symptoms (IDAS). As users answer questions, the app uses CAT to determine which questions to ask next, shortening the survey process without impacting the accuracy of the results.

“The client will use a smartphone or tablet,” Forbush said. “A client will answer questions and their data will be visible to clinicians on a user-friendly, web-based platform. Clinicians will also get easy-to-interpret ‘signal warnings’ to let them know if their patient is on track, if they need to adjust or intensify their treatment, or if their patient is in danger of a poor outcome. Our app is designed so that clinicians won’t have to worry about interpretation, they’ll get feedback on their patients’ outcome without having to analyze the results themselves.”

“Clinicians don’t have a crystal ball,” Forbush said. “If they’re not assessing outcomes, they can’t be 100 percent accurate in predicting how clients are doing. The dashboard will signal clinicians each week — here’s how your client is doing — with the user-friendly warnings and helpful tips and strategies to consider implementing if clients are not doing well. Our work is important. If we can improve client outcomes, this will have a major impact on public health by reducing the number of clients who die as a result of complications from an eating disorder.”

Thanks to the recently announced support from NEDA, the team says they will be able to test the app in a number of eating-disorder treatment settings, allowing them to better develop the app.

“When we received news that our grant was funded, therapists started emailing me about how excited they are to work together on this study,” she said. “It’s incredibly rewarding to have the opportunity to partner with clinicians so we can work together to make a difference for people with the deadliest form of mental illness.”

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