Treatment-engagement fears in family-oriented interventions: validation of the caregiver traps scale for eating disorders

ABSTRACT

As more caregivers of children (of any age) struggling with an eating disorder are recruited as partners in care, it is important to identify potential barriers to such involvement. The Caregiver Traps Scale for Eating Disorders (CTS-ED) was developed as a measure of caregiver fears with respect to treatment-engagement. The purpose of this study was to evaluate its psychometric properties. One hundred and twenty four parents of children with ED participated in the validation of this instrument. Data were analyzed through exploratory factor analysis. The exploratory factor analysis revealed one factor, accounting for 39% of the variance, with a mean of 3.99 (scale from 1 to 7), indicating that caregivers endorsed clinically significant fears relating to their involvement in their child’s treatment. The scale yielded high internal consistency (α = .89). As expected, the CTS-ED was significantly positively correlated with a measure of accommodating and enabling of ED symptoms, and negatively correlated with a measure of parental self-efficacy. This scale shows promise as a measure for clinicians and researchers to identify parental fears that could potentially fuel accommodating, enabling or treatment-interfering behaviors. Suggestions for its utility as a clinical and supervision tool are also provided.

Clinical Significance

• Development of an assessment tool to identify caregiver fears with respect to therapy engagement in the context of family-oriented interventions for eating disorders

• Tool has the potential to increase the positive involvement of caregivers to support their child (of any age) with an eating disorder

• Tool can be used clinically and to support self-reflective practices to improve compassionate clinician engagement of caregivers struggling to support their child

Acknowledgments

We would like to thank Thomas Vaughan-Johnston for his assistance with the statistical analyses in this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Services included independent counseling, unspecified outpatient services and psychological treatment for another mental illness.

2. The revision to the scale was minor, and included the replacement of the term “anorexia nervosa” for “eating disorder” to increase its applicability across clinical presentations.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.