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Young people’s experience of individual cognitive remediation therapy (CRT) in an inpatient eating disorder service: a qualitative study

  • Lucia GiombiniEmail author
  • Sophie Nesbitt
  • Lauren Waples
  • Emilia Finazzi
  • Abigail Easter
  • Kate TchanturiaEmail author
Original Article

Abstract

Introduction and Purpose

Current literature shows promising results regarding the efficacy of Cognitive Remediation Therapy for Anorexia Nervosa (AN); however, there is a paucity of studies considering the use of CRT in Young People (YP). The aim of this study was to examine YP’s experiences of individual CRT in an inpatient eating disorder unit.

Method

Seventy letters following a cycle of eight individual CRT sessions were analysed using thematic analysis, adopting an inductive approach. Inter-rater reliability of findings was ensured.

Results

The following six higher-order themes, each with lower-order themes, were identified: engaging aspects of CRT; identifying thinking skills; relevance to real-life situations; encountering personal challenges; making sense of the rational of CRT; suggestions for further improvements. YP reported enjoying CRT and described increased learning about their thinking styles and their skills from the activities undertaken during therapy. Some participants were able to apply learning outside of therapy and less frequently to difficulties related to the illness.

Conclusion

Feedback from patients suggests CRT is a useful intervention for YP with AN, which could facilitate their engagement in the treatment, while tackling neuropsychological processes underlying psychological symptoms of AN. Exploring participants’ experience of CRT has highlighted specific elements of the intervention perceived as beneficial by YP, and areas where adaption could be made. This will allow clinicians to further develop the intervention from a service users’ perspective, tailoring the sessions to their needs.

Keywords

Anorexia nervosa Cognitive remediation therapy Young people Qualitative study Service users’ experience 

Notes

Acknowledgements

The authors would like to thank all the young people at Rhodes Wood Hospital who took part in the study. Dr Tchanturia would like to acknowledge Swiss Anorexia Foundation.

Funding

Dr Easter is funded by a King’s Improvement Senior Postdoctoral Research Fellowship award. King’s Improvement Science is a part of the NIHR CLAHRC South London and comprises a specialist team of improvement scientists and senior researchers based at King’s College London. Its work is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), Guy’s and St Thomas’ Charity, the Maudsley Charity and the Health Foundation. Dr Giombini is funded by Elysium Healthcare. The funders played no role in the design, analysis or preparation of the manuscript for the present study. The views expressed are those of the authors and not those of NIHR, King’s Health Partners, King’s College London and Elysium Healthcare.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study at the admission following the declaration of Helsinki.

Ethical approval

For this study, formal ethical approval is not required as the therapy, assessments and feedback letters from service users were a part of the standard treatment programme, and were conducted to inform the content of the Cognitive Remediation Therapy sessions.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Rhodes Wood Hospital, Elysium HealthcareLondonUK
  2. 2.Institute of Psychiatry, Psychology and Neuroscience, PO59 Psychological MedicineKing’s CollegeLondonUK
  3. 3.Health Services Research and Population Research Department, Institute of Psychiatry, Psychology and NeuroscienceKing’s CollegeLondonUK
  4. 4.Department of PsychologyIllia UniversityTbilisiGeorgia
  5. 5.South London and Maudsley NHS Foundation Trust, Eating Disorders National ServiceLondonUK

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