1. The Mental Health Research Network is part of the National Institute for Health Research and
supports studies in England.
SUNLOWS 2013 SEMINARS
A collaboration between the North London and the
South London & South East Hub of the NIHR MHRN
www.sunlows.org.uk
■ May 31 2013 2pm - 4pm
Dr Juliana Onwumere will present two studies relating to improving relationships in psychosis.
Study Status: Closed
A cognitive model of caregiving in psychosis:
There is a long history of research into the attributes of carers of people with psychosis, but few
interventions target their distress or their difficulties. The study aims to describe an empirically
based model of the relationships of those caring for people with psychosis to inform clinical and
theoretical advances. The study team developed a model of informal carer relationships in psy-
chosis, based on an integration of the literature and elaborating on the concept of expressed
emotion. The model accounts for divergent outcomes of three relationship types: positive, over-
involved and critical/hostile relationships.
Needs for closure in caregivers of people with psychosis:
The aim of the study was to determine how carer need for closure relates to expressed emotion.
It also examined the links between carer need for closure and patient functioning including patient
need for closure. In a cross-sectional study, 70 caregivers of patients with psychosis completed
the Need for Closure Scale (NFCS), the Camberwell Family Interview (CFI) and measures of
distress, burden, coping and social network. The NFCS was assessed in terms of its two pri-
mary dimensions: a need for simple structure (NFSS) and Decisiveness. Patients also completed
measures of psychotic symptoms and affect, and in 50 matched caregiver patient dyads, direct
comparisons were undertaken between caregiver and patient NFCS scores.
■ June 28 2013 24th 2pm - 4pm
ECHO/CASIS – A presentation by Charlotte Rhind and Rebecca Hibbs
Both studies relate to interventional research into assisting those caring for someone diagnosed
with Anorexia Nervosa.
ECHO
Status of Study: Open
Carers of people with Anorexia Nervosa (AN) experience high levels of distress and burden and as
well can respond to the illness in ways that can maintain the symptoms of AN. Also, family interven-
tions have the most success in AN but it is unclear how they work and there is a need for research to
define the process by which interventions exert their effects. Expert Carers Helping Others (ECHO)
is a self directed intervention for carers that aims to reduce their distress, burden and improve their
self efficacy and coping skills. In addition, specific communication strategies are taught to enable
carers to encourage behaviour change within the person they care for. Previous research has found

2. ECHO benefits community samples of carers but there is no objective data from patients so it is
unclear whether they intervention has subsidiary effects on those with AN. This pilot study (ECHO)
will examine whether ECHO is helpful for a sample of carers who care for a young person with AN
who is receiving outpatients, and whether the patients benefit at 12 month follow up. In addition, this
project will test whether additional telephone support enhances the effects of the self help version
of the intervention.
CASIS
Status of Study: Closed
Anorexia nervosa is one of the commonest chronic conditions in adolescence and has profound
physical, psychological, developmental and psychosocial effects on the individual and her/his family
and has large care costs for society. The NICE guidelines concluded that there was insufficient evi-
dence to make confident treatment recommendations for anorexia nervosa. One factor that makes
interpretation of RCT evidence difficult is poor adherence to treatment. In part this is because of
poor patient acceptability for interventions including nutritional advice, medication, inpatient treat-
ment and CBT but in addition clinicians intervene to change treatment (increase the intensity eg in-
patient treatment) if treatment effectiveness is poor. In contrast to individual interventions those that
involve the family are effective and acceptability appears to be less of a problem. Eating disorders
have a profound interpersonal impact. The quality of life of family members is severely impaired and
stress levels are high. This contributes to high expressed emotion, which in turn has been found to
impact negatively on the course of the illness. In addition families accommodate to eating disorder
behaviours and this can also maintain the disorder. Educational interventions for families in the form
of groups or training materials have been shown to improve the wellbeing of family members and
possibly also positively impact on the course of the eating disorder. A period of partnership working
between academics in the UK, BEAT and individual carers and users has led to the development of
a variety of training and self help materials (books, DVD, web) to facilitate the care giving role. These
materials supplemented with guidance (telephone coaching, workshops, CASIS) improve carer well
being and reduce factors that negatively impact on the course of the illness.
■ July 26 2013 2pm - 4pm
CPA and Recovery – A presentation by Dorothy Gould
Service users’ experiences of recovery under the 2008 Care Programme Approach
Status of Study: Closed
This study was set up to explore how effective service users find the 2008 Care Programme Ap-
proach in promoting recovery as they understand it, to put forward their views and recommenda-
tions about the recovery role of the Approach as well as to produce a checklist of good practice for
mental health professionals involved in this Approach. Dorothy Gould will present the results of the
study.
■ August 30 2013 2pm - 4pm
START: ‘Systemic Therapy For At Risk Teens’ presented by Dr. Stephen Butler and Angeline
Dharmaindra
Status of Study: Closed
START is a major research study spread across 9 areas in the UK investigating a form of interven-
tion for young people and their
families who are experiencing difficulties at home, at school and sometimes with the law. This way
of helping young people and their families is new to the UK. The research team aim to compare
Multisystemic Therapy (MST) with other services that are currently offered to young people and
their families who are considered to be at ‘high risk’ of requiring out-of-home care such as foster-
ing, social care or custody if associated with antisocial behaviour such as conviction as a young
offender.
For more information please contact: info@sunlows.org.uk