Therapist Adherence in the Strong Without Anorexia Nervosa (SWAN) Study: A Randomized Controlled Trial of Three Treatments for Adults with Anorexia Nervosa
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Date
2015Author
Andony, Louise J
Tay, Elaine
Allen, Karina L
Wade, Tracey Diane
Hay, Phillipa
Touyz, Stephen
McIntosh, Virginia V W
Treasure, Janet
Schmidt, Ulrike H
Fairburn, Christopher G
Erceg-Hum, David M
Fursland, Anthea
Crosby, Ross D
Byrne, Susan M
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Show full item recordAbstract
Objective: To develop a psychotherapy
rating scale to measure therapist adherence
in the Strong Without Anorexia
Nervosa (SWAN) study, a multi-center
randomized controlled trial comparing
three different psychological treatments
for adults with anorexia nervosa. The
three treatments under investigation
were Enhanced Cognitive Behavioural
Therapy (CBT-E), the Maudsley Anorexia
Nervosa Treatment for Adults (MANTRA),
and Specialist Supportive Clinical
Management (SSCM).
Method: The SWAN Psychotherapy Rating
Scale (SWAN-PRS) was developed, after
consultation with the developers of the
treatments, and refined. Using the SWANPRS,
two independent raters initially
rated 48 audiotapes of treatment sessions
to yield inter-rater reliability data. One
rater proceeded to rate a total of 98
audiotapes from 64 trial participants.
Results: The SWAN-PRS demonstrated
sound psychometric properties, and
was considered a reliable measure of
therapist adherence. The three treatments
were highly distinguishable by
independent raters, with therapists
demonstrating significantly more
behaviors consistent with the actual
allocated treatment compared to the
other two treatment modalities. There
were no significant site differences in
therapist adherence observed.
Discussion: The findings provide support
for the internal validity of the SWAN
study. The SWAN-PRS was deemed suitable
for use in other trials involving CBT-E,
MANTRA, or SSCM. VC 2015 The Authors.
International Journal of Eating Disorders
Published by Wiley Periodicals, Inc.
Description
The Authors. International Journal of Eating Disorders Published by Wiley Periodicals, Inc.
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