Cognitive interpersonal maintenance model of eating disorders: intervention

evaluation and for further refinement of the underpinning theoretical framework. The cognitive interpersonal maintenance model of eating disorders provides a theoretical basis for carer interventions. Carers’ expressed emotion (e.g. emotional overinvolvement, criticism and hostility) and enabling and accommodating behaviours are proposed to maintain the illness. The model, which can be applied trans-diagnostically, describes a causal chain whereby high levels of carer unmet needs and a reduced ability to cope contribute to carers’ high expressed emotion and ineffective strategies in managing symptoms. These responses cause distress in carers and allow eating disorder symptoms to flourish. Expert Carers Helping Others (ECHO), a self-help intervention for carers, targets these proposed interpersonal maintaining factors. Expert Carers Helping Others can be supplemented with telephone coaching sessions using the principles of motivational interviewing, a client-centred therapeutic tool employed to elicit behaviour change. Preliminary studies found that the intervention improved carer well-being. Hypotheses to be tested in this study were: