Zeiler Michael, Sackl-Pammer Petra, Wittek Tanja, Ohmann Susanne, Werneck-Rohrer Sonja, Truttmann Stefanie, Philipp Julia, Schöfbeck Gabriele, Kopp Konstantin, Krauss Helene, Schmidt Ulrike, Karwautz Andreas, Wagner Gudrun
Eating Disorder Care and Research Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Psychol Psychother. 2025 Jun;98(2):396-415. doi: 10.1111/papt.12562. Epub 2024 Dec 2.
A rising incidence of eating disorders in the young population and limited effectiveness of available treatment approaches underscore the need for innovative therapies. This study explores therapists' perspectives regarding a promising new manualized psychotherapeutic treatment (MANTRa) for adolescents and young adults with anorexia nervosa (AN).
Semi-structured qualitative interviews were conducted with 10 therapists (nine female) who provided 24-34 sessions of MANTRa per patient. Interview topics included positive and negative experiences with MANTRa in general, with the workbook and other components. Reflexive thematic analysis was used to interpret the data. Furthermore, written notes taken by the therapists after each sessions were analysed.
The thematic analysis revealed five overarching themes: (1) Variety of therapeutic tools and content elements included in the workbook; (2) Getting the therapeutic process going; (3) Flexibility in use of the workbook; (4) Impact of the scientific and multidisciplinary framework on quality assurance; (5) Formal design of the workbook. Therapists' case formulation letters to the patients were regarded as powerful tools to strengthen therapeutic alliance and promote recovery. In-depth therapists' training, regular supervision and a multi-professional treatment setting were important factors to ensure high treatment quality.
The findings suggest how the MANTRa content (e.g. inclusion of additional therapeutic tools), the therapists' training and the format (e.g. provision of a digital version) can be improved to reach maximum impact. Therapists' formulation letters may be an effective therapeutic tool not only for AN but also across the spectrum of psychiatric disorders in adolescents and young adults.
年轻人群中饮食失调的发病率不断上升,现有治疗方法效果有限,这凸显了创新疗法的必要性。本研究探讨了治疗师对一种针对神经性厌食症(AN)青少年和青年的有前景的新的手册化心理治疗方法(MANTRa)的看法。
对10名治疗师(9名女性)进行了半结构化定性访谈,这些治疗师为每位患者提供24 - 34节MANTRa治疗课程。访谈主题包括对MANTRa总体的积极和消极体验,以及对工作手册和其他组成部分的体验。采用反思性主题分析来解释数据。此外,还分析了治疗师在每次治疗后所做的书面记录。
主题分析揭示了五个总体主题:(1)工作手册中包含的各种治疗工具和内容元素;(2)推动治疗过程;(3)工作手册使用的灵活性;(4)科学和多学科框架对质量保证的影响;(5)工作手册的形式设计。治疗师给患者的病例制定信被视为加强治疗联盟和促进康复的有力工具。深入的治疗师培训、定期督导和多专业治疗环境是确保高治疗质量的重要因素。
研究结果表明了如何改进MANTRa的内容(如纳入额外的治疗工具)、治疗师培训和形式(如提供数字版本)以达到最大效果。治疗师的制定信可能不仅对神经性厌食症,而且对青少年和青年的各种精神疾病都是一种有效的治疗工具。