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Therapist written goodbye letters: evidence for therapeutic benefits in the treatment of anorexia nervosa.
Behav Cogn Psychother. 2020 Jul; 48(4):419-431.BC

Abstract

BACKGROUND

Despite their use in clinical practice, there is little evidence to support the use of therapist written goodbye letters as therapeutic tools. However, preliminary evidence suggests that goodbye letters may have benefits in the treatment of anorexia nervosa (AN).

AIMS

This study aimed to examine whether therapist written goodbye letters were associated with improvements in body mass index (BMI) and eating disorder symptomology in patients with AN after treatment.

METHOD

Participants were adults with AN (n = 41) who received The Maudsley Model of Anorexia Treatment for Adults (MANTRA) in a clinical trial evaluating two AN out-patient treatments. As part of MANTRA, therapists wrote goodbye letters to patients. A rating scheme was developed to rate letters for structure and quality. Linear regression analyses were used to examine associations between goodbye letter scores and outcomes after treatment.

RESULTS

Higher quality letters and letters that adopted a more affirming stance were associated with greater improvements in BMI at 12 months. Neither the overall quality nor the style of goodbye letters were associated with improvements in BMI at 24 months or reductions in eating disorder symptomology at either 12 or 24 months.

CONCLUSIONS

The results highlight the potential importance of paying attention to the overall quality of therapist written goodbye letters in the treatment of AN, and adopting an affirming stance.

Authors+Show Affiliations

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. School of Psychology, University of Western Australia, Perth, Australia.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Oxford Adult Eating Disorder Service, Warneford Hospital, Oxford, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Hope Wing, Porters Avenue Health Centre, Dagenham, Essex, UK.The Phoenix Wing, St Ann's Hospital, Tottenham, London, UK.The Phoenix Wing, St Ann's Hospital, Tottenham, London, UK.Oxford Adult Eating Disorder Service, Warneford Hospital, Oxford, UK.Oxford Adult Eating Disorder Service, Warneford Hospital, Oxford, UK.Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.School of Psychology, Flinders University, Adelaide, Australia.Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32178754

Citation

Simmonds, Jess, et al. "Therapist Written Goodbye Letters: Evidence for Therapeutic Benefits in the Treatment of Anorexia Nervosa." Behavioural and Cognitive Psychotherapy, vol. 48, no. 4, 2020, pp. 419-431.
Simmonds J, Allen KL, O'Hara CB, et al. Therapist written goodbye letters: evidence for therapeutic benefits in the treatment of anorexia nervosa. Behav Cogn Psychother. 2020;48(4):419-431.
Simmonds, J., Allen, K. L., O'Hara, C. B., Bartholdy, S., Renwick, B., Keyes, A., Lose, A., Kenyon, M., DeJong, H., Broadbent, H., Loomes, R., McClelland, J., Serpell, L., Richards, L., Johnson-Sabine, E., Boughton, N., Whitehead, L., Treasure, J., Wade, T., & Schmidt, U. (2020). Therapist written goodbye letters: evidence for therapeutic benefits in the treatment of anorexia nervosa. Behavioural and Cognitive Psychotherapy, 48(4), 419-431. https://doi.org/10.1017/S1352465820000089
Simmonds J, et al. Therapist Written Goodbye Letters: Evidence for Therapeutic Benefits in the Treatment of Anorexia Nervosa. Behav Cogn Psychother. 2020;48(4):419-431. PubMed PMID: 32178754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapist written goodbye letters: evidence for therapeutic benefits in the treatment of anorexia nervosa. AU - Simmonds,Jess, AU - Allen,Karina L, AU - O'Hara,Caitlin B, AU - Bartholdy,Savani, AU - Renwick,Beth, AU - Keyes,Alexandra, AU - Lose,Anna, AU - Kenyon,Martha, AU - DeJong,Hannah, AU - Broadbent,Hannah, AU - Loomes,Rachel, AU - McClelland,Jessica, AU - Serpell,Lucy, AU - Richards,Lorna, AU - Johnson-Sabine,Eric, AU - Boughton,Nicky, AU - Whitehead,Linette, AU - Treasure,Janet, AU - Wade,Tracey, AU - Schmidt,Ulrike, Y1 - 2020/03/17/ PY - 2020/3/18/pubmed PY - 2020/3/18/medline PY - 2020/3/18/entrez KW - anorexia nervosa KW - eating disorders KW - goodbye letters KW - psychotherapy KW - treatment SP - 419 EP - 431 JF - Behavioural and cognitive psychotherapy JO - Behav Cogn Psychother VL - 48 IS - 4 N2 - BACKGROUND: Despite their use in clinical practice, there is little evidence to support the use of therapist written goodbye letters as therapeutic tools. However, preliminary evidence suggests that goodbye letters may have benefits in the treatment of anorexia nervosa (AN). AIMS: This study aimed to examine whether therapist written goodbye letters were associated with improvements in body mass index (BMI) and eating disorder symptomology in patients with AN after treatment. METHOD: Participants were adults with AN (n = 41) who received The Maudsley Model of Anorexia Treatment for Adults (MANTRA) in a clinical trial evaluating two AN out-patient treatments. As part of MANTRA, therapists wrote goodbye letters to patients. A rating scheme was developed to rate letters for structure and quality. Linear regression analyses were used to examine associations between goodbye letter scores and outcomes after treatment. RESULTS: Higher quality letters and letters that adopted a more affirming stance were associated with greater improvements in BMI at 12 months. Neither the overall quality nor the style of goodbye letters were associated with improvements in BMI at 24 months or reductions in eating disorder symptomology at either 12 or 24 months. CONCLUSIONS: The results highlight the potential importance of paying attention to the overall quality of therapist written goodbye letters in the treatment of AN, and adopting an affirming stance. SN - 1469-1833 UR - https://www.unboundmedicine.com/medline/citation/32178754/Therapist_written_goodbye_letters:_evidence_for_therapeutic_benefits_in_the_treatment_of_anorexia_nervosa L2 - https://www.cambridge.org/core/product/identifier/S1352465820000089/type/journal_article DB - PRIME DP - Unbound Medicine ER -
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