iCASK: Carer skills training for inpatients with anorexia nervosa South London and Maudsley NHS Foundation Trust

Hospital admissions for anorexia nervosa are increasing and, following discharge, relapse is common and mortality is high. The symptoms of this serious mental illness affect many aspects of family life. However, carers are often excluded from treatment, despite evidence that their involvement is beneficial.

The iCASK programme aims to tackle this problem by giving patients and carers the skills to manage eating disorder behaviours at home through emotional coaching and behaviour change strategies. 

This project delivered the iCASK programme to 24 families of patients with severe anorexia nervosa admitted to the SLaM Eating Disorders Service.

Patients had guided self-help sessions, and patients and carers had meal support sessions. Carers also attended a full-day workshop on psychoeducation of eating disorders, how to support someone with an eating disorder and transition planning. 

The project team also developed family management materials (videos and workbooks) that illustrate how things can go wrong and give practical suggestions for effective support. Carers were taught to manage their own stress and emotions, using motivational and positive communication.

Early results suggest that iCASK is an acceptable and valued intervention, and can help reduce length of hospital stay while still providing an effective treatment package. It could have cost savings of around £15,500 per patient. 

The timeframes of the project were challenging, and the project has been extended to allow assessment of patient improvement three months post-discharge.

The iCASK intervention will become business as usual at the Trust, based on the evidence of the benefits for patients and families to date.

Contact information

For more information about this project, please contact Janet Treasure, Professor of Psychiatry, King’s College London.