The FREED Project (first episode and rapid early intervention in eating disorders): service model, feasibility and acceptability

Brown, Amy; McClelland, Jessica; Boysen, Elena; Mountford, Victoria; Glennon, Danielle; Schmidt, Ulrike

doi:10.1111/eip.12382

Cited by 112Eating Disorders and BehaviorsNutrition, Health and Food BehaviorPersonality Disorders and Psychopathology

The FREED Project (first episode and rapid early intervention in eating disorders): service model, feasibility and acceptability

Brown, Amy, McClelland, Jessica, Boysen, Elena, Mountford, Victoria, Glennon, Danielle, Schmidt, Ulrike·2018·Early Intervention in Psychiatry

DOI 10.1111/eip.12382

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Abstract

Aim: Eating disorders (EDs) are disabling disorders, predominantly affecting adolescents and young adults. Untreated symptoms have lasting effects on brain, body and behaviour. Care pathway‐related barriers often prevent early detection and treatment of ED. The aim of this study was to assess the feasibility and acceptability of FREED (First Episode and Rapid Early Intervention for Eating Disorder), a novel service for young people (aged 18–25 years) with recent ED onset (≤3 years), embedded in a specialist adult National Health Service ED service. Specifically, we assessed the impact of FREED on duration of time until specialist service contact (DUSC), duration of untreated ED (DUED) and wait‐times for assessment and treatment compared with patients seen earlier in our service. Acceptability of FREED was also assessed. Methods: Sixty individuals were recruited from September 2014 to August 2015. Fifty‐one of these were compared with 89 patients seen earlier. Results: FREED patients, from areas with minimal National Health Service gatekeeping (14/51), had markedly shorter DUSC and DUED than controls (DUSC: 12.4 months vs. 16.2 months; DUED 13.0 months vs. 19.1 months), whereas those with complex gatekeeping (37/51) had shorter DUED (17.7 months), but longer DUSC (16.9 months) than controls. FREED patients waited significantly less time for both assessment and treatment than controls, had significantly better treatment uptake and were highly satisfied with the process of starting treatment. Conclusions: FREED is a feasible and acceptable service which successfully reduced waiting times. Reductions in DUSC and DUED depend on gatekeeping arrangements. More research is required to establish clinical outcomes of FREED.

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Early intervention in EDs is associated with better outcomes.
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From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [28]

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Additional file 2 of Facilitators and barriers in anorexia nervosa treatment initiation: a qualitative study on the perspectives of patients, carers and professionals
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Additional file 5 of Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study
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Additional file 2 of Adult and child and adolescent psychiatrists' experiences of transition in anorexia nervosa: a qualitative study
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Additional file 1 of Facilitators and barriers in anorexia nervosa treatment initiation: a qualitative study on the perspectives of patients, carers and professionals
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Additional file 1 of A Delphi study to explore clinician and lived experience perspectives on setting priorities in eating disorder services
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Additional file 1 of Characterising illness stages and recovery trajectories of eating disorders in young people via remote measurement technology (STORY): a multi-centre prospective cohort study protocol
Kuehne, C., Phillips, M. D., Moody, S., Bryson, C., Campbell, I. C., Conde, P., Cummins, N., Desrivières, S., Dineley, J., Dobson, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25940077
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Assessing implementation fidelity in the First Episode Rapid Early Intervention for Eating Disorders service model
Richards, K. L., Flynn, M., Austin, A., Lang, K., Allen, K. L., Bassi, R., Brady, G., Brown, A., Connan, F., Franklin-Smith, M., et al. (2021) · BJPsych Open · doi:10.1192/bjo.2021.51 · Cited by 16 · see citing works
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A pilot evaluation of a novel First Episode and Rapid Early Intervention service for Eating Disorders (FREED)
McClelland, J., Hodsoll, J., Brown, A., Lang, K., Boysen, E., Flynn, M., Mountford, V. A., Glennon, D., & Schmidt, U. (2018) · European Eating Disorders Review · doi:10.1002/erv.2579 · Cited by 97 · see citing works
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“I’m truly free from my eating disorder”: Emerging adults’ experiences of FREED, an early intervention service model and care pathway for eating disorders
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Self-citation

Authors: Brown, A., McClelland, J., Boysen, E., Mountford, V., Glennon, D., & Schmidt, U.
Affiliations: South London and Maudsley NHS Foundation Trust (GB)
King's College London (GB)
Corresponding author: Schmidt, Ulrike
ORCID: Brown, Amy
McClelland, Jessica
Mountford, Victoria
Glennon, Danielle
Schmidt, Ulrike
Venue: Early Intervention in Psychiatry
Publisher: Wiley
Published: 2016-09-13
Volume: 12
Issue: 2
Pages: 250-257
ISSN: 1751-7885 (ISSN-L)
1751-7893
DOI: 10.1111/eip.12382
OpenAlex: W2507677419
Cited by: 112
References: 19
Citations by year: 2026: 5 · 2025: 17 · 2024: 20 · 2023: 11 · 2022: 20 · 2021: 16 · 2020: 11 · 2019: 4 · 2018: 4 · 2017: 2 · 2016: 2
FWCI: 5.35
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Early Intervention in Psychiatry (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (submittedVersion)
Funders: Health Foundation (GIFTS 7294/CRM 1216)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: eating disorders, early intervention, young adults, gatekeeping, waiting time, treatment uptake, service acceptability
MeSH terms: Adolescent, Adult, Feeding and Eating Disorders, Feasibility Studies, Female, Humans, Male, Patient Acceptance of Health Care, Time Factors, Young Adult, Early Medical Intervention, Time-to-Treatment

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The FREED Project (first episode and rapid early intervention in eating disorders): service model, feasibility and acceptability

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