These materials were provided for the support program, organized, and conducted on a volunteer basis by the Association of Doctors and Psychologists “Eating Disorders: Therapy and Prevention” and by a team of psychologists from Patrick’s Mental Health Services (Dublin, Ireland).

We express our deep gratitude to colleagues who led and supported this project:

St Patrick’s Mental Health Services (SPMHS), Dublin, Ireland.

Psychology Department:

Adj Prof Clodagh Dowling, Director of Psychology at SPMHS & Adj Prof at the School of Psychology, University College Dublin (UCD)
Dr. Clíona Hallissey Clinical Psychologist, SPMHS
Dr. Marion Mernagh Clinical Psychologist, SPMHS
Lizzy O’ Brien, Assistant Psychologist, SPMHS

The Psychology Department from SPMHS would like to thank and acknowledge Dr Ken Goss Consultant, Psychologist and founder/ developer of CFT-E for all his support, mentorship and generosity.

Communications Department:

Sinéad Makk, Communications Manager, SPMHS
Katie Crosby, Communications Officer, SPMHS
Tamara Nolan, Director of Communications, SPMHS

Association of Doctors and Psychologists: “Eating Disorders: Therapy and Prevention”

Tetyana Nazarenko: psychologist, psychotherapist, chairman of the board of the Association
Dr Maryna Fatieieva, psychologist, PhD

Marina Svētiņa: nutritionist, Children’s clinical university hospital of Riga (Latvia)

Translator:

Kateryna Chudnenko: psychologist and psychotherapist from St Patrick’s Mental Health Services.

Multi-Family Therapy for Anorexia Nervosa

Young Person Measures

Date:

Name:

Date of Birth:

Age:

Revised Children’s Anxiety and Depression Scale (RCADS)

Instructions: Please put a circle around the word that shows how often each of these things happens to you. There are no right or wrong answers.

	0. Never	1. Sometimes	2. Often	3. Always
1. I worry about things	0	1	2	3
2. I feel sad or empty	0	1	2	3
3. When I have a problem, I get a funny feeling in my stomach	0	1	2	3
4. I worry when I think I have done poorly at something	0	1	2	3
5. I would feel afraid of being on my own at home	0	1	2	3
6. Nothing is much fun anymore	0	1	2	3
7. I feel scared when I have to take a test	0	1	2	3
8. I feel worried when I think someone is angry with me.	0	1	2	3
9. I worry about being away from my parent	0	1	2	3
10. I am bothered by bad or silly thoughts or pictures in my mind	0	1	2	3
11. I have trouble sleeping	0	1	2	3
12. I worry that I will do badly at my school work	0	1	2	3
13. I worry that something awful will happen someone in my family	0	1	2	3
14. I suddenly feel as if I can’t breathe when there is no reason for this	0	1	2	3
15. I have problems with my appetite	0	1	2	3
16. I have to keep checking that I have done things right (like the switch is off, of the door is locked)	0	1	2	3
17. I feel scared if I have to sleep on my own	0	1	2	3
18. I have trouble going to school in the mornings because I feel nervous or afraid	0	1	2	3
19. I have no energy for things	0	1	2	3
20. I worry I might look foolish	0	1	2	3
21. I am tired a lot	0	1	2	3
22. I worry that bad things will happen to me	0	1	2	3
23. I can’t seem to get bad or silly thoughts out of my head	0	1	2	3
24. When I have a problem, my heart beats really fast	0	1	2	3
25. I cannot think clearly	0	1	2	3
26. I suddenly start to tremble or shake when there is no reason for this	0	1	2	3
27. I worry that something bad will happen to me	0	1	2	3
28. When I have a problem, I feel shaky	0	1	2	3
29. I feel worthless	0	1	2	3
30. I worry about making mistakes	0	1	2	3
31. I have to think of special thoughts (like numbers or words) to stop bad things from happening	0	1	2	3
32. I worry what other people think of me	0	1	2	3
33. I am afraid of being in crowded places (like shopping centres, the movies, buses, busy playgrounds)	0	1	2	3
34. All of a sudden I feel really scared for no reason at all	0	1	2	3
35. I worry about what is going to happen	0	1	2	3
36. I suddenly become dizzy or faint when there is no reason for this	0	1	2	3
37. I think about death	0	1	2	3
38. I feel afraid if I have to talk in front of my class	0	1	2	3
39. My heart suddenly starts to beat too quickly for no reason	0	1	2	3
40. I feel like I don’t want to move	0	1	2	3
41. I worry that I will suddenly get a scared feeling when there is nothing to be afraid of	0	1	2	3
42. I have to do some things over and over again (like washing my hands, cleaning, or putting things in a certain order)	0	1	2	3
43. I feel afraid that I will make a fool of myself in front of other people	0	1	2	3
44. I have to do some things in just the right way to stop bad things from happening	0	1	2	3
45. I worry when I go to bed at night	0	1	2	3
46. I would feel scared if I had to stay away from home overnight	0	1	2	3
47. I feel restless	0	1	2	3

Strengths and Difficulties Questionnaire (SDQ) S11-17

Instructions: For each item, please mark the box for Not True, Somewhat True or Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain or the item seems daft! Please give your answers on the basis of how things have been for you over the last six months.

	0. Not True	1. Somewhat True	2. Certainly True
1. I try to be nice to other people. I care about their feelings	0	1	2
2. I am restless, I cannot stay still for long	0	1	2
3. I get a lot of headaches, stomach-aches, or sickness	0	1	2
4. I usually share with others (food, games, pens etc.)	0	1	2
5. I get very angry and often lose my temper	0	1	2
6. I am usually on my own. I generally play alone or keep to myself	0	1	2
7. I usually do as I am told	0	1	2
8. I worry a lot	0	1	2
9. I am helpful if someone is hurt, upset or feeling ill	0	1	2
10. I am constantly fidgeting or squirming	0	1	2
11. I have one good friend or more	0	1	2
12. I fight a lot. I can make other people do what I want	0	1	2
13. I am often unhappy, down-hearted or tearful	0	1	2
14. Other people my age generally like me	0	1	2
15. I am easily distracted, I find it difficult to concentrate	0	1	2
16. I am nervous in new situations. I easily lose confidence	0	1	2
17. I am kind to younger children	0	1	2
18. I am often accused of lying or cheating	0	1	2
19. Other children or young people pick on me or bully me	0	1	2
20. I often volunteer to help others (parents, teachers, children)	0	1	2
21. I think before I do things	0	1	2
22. I take things that are not mine from home, school or elsewhere	0	1	2
23. I get along better with adults than with people my own age	0	1	2
24. I have many fears, I am easily scared	0	1	2
25. I finish the work I’m doing. My attention is good	0	1	2

Do you have any other comments or concerns?
______________________________________________________________

Overall, do you think that you have difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people?
No	Yes – minor difficulties	Yes – definite difficulties	Yes – severe difficulties

If you answered “Yes”, please answer the following questions about these difficulties:

How long have these difficulties been present?
Less than a month	1-5 months	6-12 months	Over a year

Do these difficulties upset or distress you?
Not at all	Only a little	Quite a lot	A great deal

Do the difficulties interfere with your everyday life in the following areas?
HOME LIFE	Not at all	Only a little	Quite a lot	A great deal
FRIENDSHIPS	Not at all	Only a little	Quite a lot	A great deal
CLASSROOM LEARNING	Not at all	Only a little	Quite a lot	A great deal
LEISURE ACTIVITIES	Not at all	Only a little	Quite a lot	A great deal

Do these difficulties made it harder for those around you (family, friends teachers etc.)?
Not at all	Only a little	Quite a lot	A great deal

Strengths and Difficulties Questionnaire (SDQ) S18+

Instructions: For each item, please mark the box for Not True, Somewhat True or Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain. Please give your answers on the basis of how things have been for you over the last six months.

	0. Not True	1. Somewhat True	2. Certainly True
1. I try to be nice to other people. I care about their feelings	0	1	2
2. I am restless, I cannot stay still for long	0	1	2
3. I get a lot of headaches, stomach-aches, or sickness	0	1	2
4. I usually share with others, for example food or drink	0	1	2
5. I get very angry and often lose my temper	0	1	2
6. I would rather be alone than with other people	0	1	2
7. I am generally willing to do what other people want	0	1	2
8. I worry a lot	0	1	2
9. I am helpful if someone is hurt, upset or feeling ill	0	1	2
10. I am constantly fidgeting or squirming	0	1	2
11. I have at least one good friend	0	1	2
12. I fight a lot. I can make other people do what I want	0	1	2
13. I am often unhappy, depressed or tearful	0	1	2
14. Other people generally like me	0	1	2
15. I am easily distracted, I find it difficult to concentrate	0	1	2
16. I am nervous in new situations. I easily lose confidence	0	1	2
17. I am kind to children	0	1	2
18. I am often accused of lying or cheating	0	1	2
19. Other people pick on me or bully me	0	1	2
20. I often offer to help others (family members, friends, colleagues)	0	1	2
21. I think before I do things	0	1	2
22. I take things that are not mine from home, work or elsewhere	0	1	2
23. I get along better with older people than with people my own age	0	1	2
24. I have many fears, I am easily scared	0	1	2
25. I finish the work I’m doing. My attention is good	0	1	2

Do you have any other comments or concerns?
______________________________________________________________

Overall, do you think that you have difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people?
No	Yes – minor difficulties	Yes – definite difficulties	Yes – severe difficulties

If you answered “Yes”, please answer the following questions about these difficulties:

How long have these difficulties been present?

Less than a month

1-5 months

6-12 months

Over a year

Do these difficulties upset or distress you?

Not at all

Only a little

Quite a lot

A great deal

Do the difficulties interfere with your everyday life in the following areas?
Getting along with the people you are closest to (e.g. family, partner)	Not at all	Only a little	Quite a lot	A great deal
Making and keeping friends	Not at all	Only a little	Quite a lot	A great deal
Work or study	Not at all	Only a little	Quite a lot	A great deal
Hobbies, sports or other leisure activities	Not at all	Only a little	Quite a lot	A great deal

Do these difficulties made it harder for those around you (family, friends etc.)?
Not at all	Only a little	Quite a lot	A great deal

SCORE-15

Instructions: We would like you to tell us about how you see your family at the moment. So we are asking for YOUR view of your family.

When people say ‘your family’ they often mean the people who live in your house. But we want you to choose who you want to count as the family you are going to describe.

For each item, make your choice by putting a circle around just one of the options numbered 1 to 5. If a statement was “We are always fighting each other” and you felt this was not especially true of your family, you would put a tick in box 4 for “Describes us: not well”.

Do not think for too long about any question, but do try to circle on of the options for each question.

	1. Describes us: Very well	2. Describes us: well	3. Describes us: Partly	4. Describes us: Not well	5. Describes us: Not at all
1. In my family we talk to each other about things which matter to us	1	2	3	4	5
2. People often don’t tell each other the truth in my family	1	2	3	4	5
3. Each of us gets listened to in our family	1	2	3	4	5
4. It feels risky to disagree in our family	1	2	3	4	5
5. We find it hard to deal with everyday problems	1	2	3	4	5
6. We trust each other	1	2	3	4	5
7. It feels miserable in our family	1	2	3	4	5
8. When people in my family get angry they ignore each other on purpose	1	2	3	4	5
9. We seem to go from one crisis to another in my family	1	2	3	4	5
10. When one of us is upset they get looked after within the family	1	2	3	4	5
11. Things always seem to go wrong for my family	1	2	3	4	5
12. People in the family are nasty to each other	1	2	3	4	5
13. People in my family interfere too much in each other’s lives	1	2	3	4	5
14. In my family we blame each other when things go wrong	1	2	3	4	5
15. We are good at finding new ways to deal with things that are difficult	1	2	3	4	5

What words would best describe your family?
____________________________________________________________________________________________________________________________________________________________________________________________________________

What is the problem/challenge that brought you to therapy? The main problem is
____________________________________________________________________________________________________________________________________________________________________________________________________________

How severe is it? Please mark your answer on the line below:
No problem at all Really bad

How are you managing as a family?

Very well Very badly

Do you think the therapy here will be / has been helpful?

Very helpful Unhelpful

Rosenberg Self-Esteem Scale (RSE)

Instructions: Please record the appropriate answer for each item, depending on whether you

Strongly agree, agree, disagree, or strongly disagree with it.

1 = Strongly agree

2 = Agree

3 = Disagree

4 = Strongly disagree

	1= Strongly agree	2 = Agree	3 = Disagree	4 = Strongly agree
1. On the whole I am satisfied with myself.	1	2	3	4
2. At times I think I am no good at all.	1	2	3	4
0. I feel that I have a number of good qualities.	1	2	3	4
1. I am able to do things as well as most other people.	1	2	3	4
2. I feel I do not have much to be proud of.	1	2	3	4
3. I certainly feel useless at times.	1	2	3	4
4. I feel that I am a person of worth, at least on equal plane with others.	1	2	3	4
5. I wish I could have more respect for myself.	1	2	3	4
6. All in all, I am inclined to feel that I am a failure.	1	2	3	4
7. I take a positive attitude towards myself.	1	2	3	4

EATING QUESTIONNAIRE (EDE-Q)

Instructions: The following questions are concerned with the PAST FOUR WEEKS ONLY (28 days). Please read each question carefully and circle the appropriate number. Please answer all the questions.

ON HOW MANY DAYS OUT OF THE PAST 28 DAYS …

days

1-5

days

6-12

days

13-15

days

16-22

days

23-27

days

Every

day

Have you been deliberately trying to limit the amount of food you eat to influence your shape or weight?

Have you gone for long periods of time (8 hours or more) without eating anything to influence your shape weight?

Have you tried to avoid eating any foods which you like to influence your shape or weight?

Have you tried to follow definite rules regarding your eating to influence your shape or weight; for example, a calorie limit, a set amount of food, or rules about what or when you should eat?

Have you wanted your stomach to be empty?

Has thinking about food or its calorie content made it much more difficult to concentrate on things you are interested in; for example, read, watch TV, or follow a conversation?

Have you been afraid of losing control over eating?

Have you had episodes of binge eating?

Have you eaten in secret? (Do not count binges)

10.

Have you wanted your stomach to be flat?

11.

Has thinking about shape or weight made it more difficult to concentrate on things you are interested in; for example, read, watch TV or follow a conversation?

12.

Have you had a definite fear that you might gain weight or become fat?

13.

Have you felt fat?

14.

Have you had a strong desire to lose weight?

OVER THE PAST 28 DAYS…

15.

On what proportion of times that you have eaten have you felt guilty because the effect on your shape or weight? (Do not count binges) (Circle the number which applies)

0 – None of the times

1 – A few of the times

2 – Less than half the time

3 – Half the time

4 – More than half the time

5 – Most of the time

6 – Every time

16.

Over the past four weeks (28 days), have there been any times when you have felt that you have eaten what other people would regard as an unusually large amount of food given the circumstances? (Please put appropriate number in box)

0 – No

1 – Yes [ ]

17.

How many such episodes have you had over the past four weeks?

[ ]

18.

During how many of these episodes of overeating did you have a sense of having lost control over your eating?

[ ]

19.

Have you had other episodes of eating in which you have had a sense of having lost control and eaten too much, but have not eaten an unusually large amount of food given the circumstances?

0 – No

1 – Yes

How many such episodes have you had over the past four weeks?

[ ]

21.

Over the past four weeks have you made yourself sick (vomit) as a means of controlling your shape or weight?

0 – No

1 – Yes

22.

How many times have you done this over the past four weeks?

[ ]

23.

Have you taken laxatives as a means of controlling your shape or weight?

0 – No

1 – Yes

24.

How many times have you done this over the past four weeks?

[ ]

25.

Have you taken diuretics (water tablets) as a means of controlling your shape or weight?

0 – No

1 – Yes

26.

How many times have you done this over the past four weeks?

[ ]

27.

Have you exercised hard as a means of controlling your shape or weight?

0 – No

1 – Yes

28.

How many times have you done this over the past four weeks?

[ ]

OVER THE PAST 28 DAYS… (Please circle the number which best describes your behaviour)

NOT AT ALL

SLIGHT-LY

MODER-ATELY

MARK-EDLY

29.

Has your weight influenced how you think about (judge) yourself as a person?

30.

Has your shape influenced how you think about (judge) yourself as a person?

31.

How much would it upset you if you had to weigh yourself once a week for the next four weeks?

32.

How dissatisfied have you felt about your weight?

33.

How dissatisfied have you felt about your shape?

34.

How concerned have you been about other people seeing you eat?

35.

How uncomfortable have you felt seeing your body; for example, in the mirror, in shop window reflections, while undressing or taking a bath or shower?

36.

How uncomfortable have you felt about others seeing your body; for example, in communal changing rooms, when swimming or wearing tight clothes?