AUTHOR=Hyam Lucy , Yeadon-Ray Olivia , Richards Katie , Semple Amy , Allen Karina , Owens Jill , Jackson Aileen , Semple Laura , Glennon Danielle , Di Clemente Giulia , Griffiths Jess , Mills Regan , Schmidt Ulrike 

TITLE=“FREED instils a bit of hope in the eating disorder community… that things can change.”: an investigation of clinician views on implementation facilitators and challenges from the rapid scaling of the First Episode Rapid Early Intervention for Eating Disorders programme

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1327328

DOI=10.3389/fpsyt.2024.1327328

ISSN=1664-0640

ABSTRACT=Introduction: First Episode Rapid Early Intervention for Eating Disorders (FREED) is the leading eating disorder (ED) early intervention model for young people. Research has shown that it reduces the duration of untreated illness, improves clinical outcomes, and has costsavings. However, less is known about the experience of implementing FREED. This study aimed to investigate the views and experiences of adopting, implementing, and sustaining FREED from the perspective of clinical staff.Methods: Seven focus groups were conducted involving 26 clinicians. Thematic analysis was used, with the Non-Adoption, Abandonment and Challenges to Scale-up, Spread and Sustainability (NASSS) framework being applied to organise subthemes and determine facilitators and barriers. NASSS was also used to rate the complexity of themes as either: simple (straightforward, predictable, few components), complicated (multiple interrelating components), or complex (dynamic, unpredictable, not easily divisible into constituent components).Results: 16 subthemes were identified under seven broader themes representing each domain of the NASSS framework. Key barriers and areas of complexity included factors related to EDs as an illness (e.g., high acuity and prevalence), and organisational complexity (e.g., staffing shortages, lack of managerial/team support). Key facilitators included positive clinician/adopter attitudes, a supportive national network, and the ability for FREED to be flexible/adaptable over time.The FREED model appears to be desirable to clinical staff. Wider team and managerial support were perceived to be particularly important to its successful implementation, as were the national network and supervision. Key areas of complexity include staffing issues and high ED acuity/prevalence. These barriers to implementation need to be managed and investment continued to expand and improve early intervention for EDs further.