The New Maudsley Method
The New Maudsley Method
The aim of the New Maudsley Method is to lower anxiety and distress in carers who may be family members and to give these carers some communication tools to help engage their loved one to improve their self-esteem and develop the resilience to embark on change. Carers suffer considerable levels of psychological distress, anxiety and depression when faced with supporting a loved one with an eating disorder (Anastasiadou et al., 2014; Zabala et al., 2009). Furthermore, the manner in which carers respond to the illness often exacerbates the symptoms or maladaptive behaviour. It is important for carers to remain involved (especially concerning food and eating) for practical, legal and moral reasons (Treasure et al., 2010). The New Maudsley Method specifically focuses on carers understanding the psycho-social impact of the eating disorder and provides a skills-based programme to help ameliorate these behaviours.
The New Maudsley Method should not be directly compared with the Maudsley Family Therapy programme, also known as Family-Based Treatment (FBT) or the Maudsley Approach. The latter is a family therapy routed approach for the treatment of anorexia nervosa devised by Christopher Dare and colleagues at the Maudsley Hospital in London in 1985. Maudsley Family Therapy is an evidenced-based approach to the treatment of anorexia nervosa and bulimia nervosa in adolescents, whose efficacy has been supported by empirical research (Dare & Eisler, 1997; Lock et al., 2001; Russell et al., 1987).
The New Maudsley Method is not an overall treatment for eating disorders, but is intended to be used in tandem with whatever plan for restoring and normalising nutrition is applicable. The model adheres to the guiding principle that ''eating is non-negotiable'' and emphasizes the importance of setting consistent boundaries with meal planning in a very specific manner based on skilful compassionate communication. Consequently, it is an adjunct not a replacement. It can be particularly useful in supporting those parents who may be struggling.
Professor Janet Treasure, one of the authors of the New Maudsley Method, has been working at the Maudsley Hospital in eating disorders since 1981 and was involved when the first trial of FBT was in progress with younger patients. Thus, the New Maudsley Method has evolved in order to adapt to the needs of adult patients as well. There have also been changes in the delivery and content of FBT, first with separated family therapy and more recently multi-family workshops.
Raising carer anxiety and a desire to control can be less suitable for older patients or for patients where this has been counterproductive. The New Maudsley Method provides an additional treatment protocol for parents and clinicians with the focus on the quality of communication between the carer and their loved ones. Its primary aim is to reduce stress and anxiety in carers and equip them with a similar skill set to that encountered in clinicians in an inpatient setting. Again, it should be emphasized that the skills described in this website are intended to be used as an adjunct to treatment, as opposed to a treatment in their own right.
Several research studies have shown that skills training programmes for carers, such as the New Maudsley Method have shown high carer acceptability (Grover et al., 2011a; Grover et al., 2011b; Sepulveda et al., 2008a; Sepulveda et al., 2008b; Treasure et al., 2007; Sepulveda et al., 2008a; Sepulveda et al., 2008b; Treasure et al., 2007) as well as showing significant reductions in carer anxiety and depression, expressed emotion, burden and accommodation and enabling as well as significant increases in carer psychological wellbeing and self-efficacy. Carers also reported an improvement in the wellbeing and eating disorder behaviours of the sufferer (Goddard et al., 2011). In a recent RCT, the group who had received the skills training (NMM) had reduced eating disorder symptomatology .