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J. Clin. Med. 2018, 7(8), 215; https://doi.org/10.3390/jcm7080215

Contingency Contracts for Weight Gain of Patients with Anorexia Nervosa in Inpatient Therapy: Practice Styles of Specialized Centers

1
Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Osianderstr. 5, 72076 Tuebingen, Baden-Wuerttemberg, Germany
2
Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Baden-Wuerttemberg, Germany
3
Clinical Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Nordrhein-Westfalen, Germany
4
Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Alexandrinenstr. 1-3, 44791 Bochum, Nordrhein-Westfalen, Germany
5
Division of Psychosomatic Medicine, Charité University Hospital Berlin, Hindenburgdamm 30, 12200 Berlin, Berlin, Germany
6
Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Niedersachsen, Germany
7
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Baden-Wuerttemberg, Germany
8
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Freiburg, Hauptstr. 8, 79104 Freiburg, Baden-Wuerttemberg, Germany
9
Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Langerstr. 3, 81675 Munich, Bayern, Germany
10
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Muenster, Domagkstr. 22, 48149 Muenster, Nordrhein-Westfalen, Germany
11
Institute and Outpatient Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg-Eppendorf, Hamburg, Germany
12
Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University Duisburg-Essen, Virchowstr. 174, 45147 Essen, Nordrhein-Westfalen, Germany
*
Author to whom correspondence should be addressed.
Received: 1 August 2018 / Revised: 10 August 2018 / Accepted: 11 August 2018 / Published: 14 August 2018
(This article belongs to the Special Issue Anorexia Nervosa)
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Abstract

The treatment of patients with anorexia nervosa (AN) is often challenging, due to a high degree of ambivalence towards recovery and weight gain these patients often express. One part of the multimodal treatment is the utilization of treatment contracts (i.e., contingency contracts) that aim to motivate patients to gain weight by applying positive and negative consequences for the (non-)achievement of weight goals. The main aim of this study is to assess and analyze current standards of contingency contracts’ utilization in German eating disorder centers. n = 76 mental health professionals of twelve specialized university centers in Germany that are currently or were formerly treating patients with AN in an inpatient setting participated. Most experts use contingency contracts in their clinic with weekly weight goals ranging between 500 and 700 g. Overall effectiveness and significance of contingency contracts for the inpatient treatment of patients with AN was rated high. Typical characteristics of a contingency contract in specialized German university hospital centers, such as the most frequent consequences, are described. The survey results assist the planning of further studies aiming to improve the multimodal treatment of patients with AN. For clinical practice, using external motivators such as contingency contracts as well as targeting internal motivation (e.g., by using motivational interviewing) is proposed. View Full-Text
Keywords: Anorexia nervosa; treatment contracts; weight gain; inpatient treatment; survey Anorexia nervosa; treatment contracts; weight gain; inpatient treatment; survey
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Ziser, K.; Giel, K.E.; Resmark, G.; Nikendei, C.; Friederich, H.-C.; Herpertz, S.; Rose, M.; de Zwaan, M.; von Wietersheim, J.; Zeeck, A.; Dinkel, A.; Burgmer, M.; Löwe, B.; Sprute, C.; Zipfel, S.; Junne, F. Contingency Contracts for Weight Gain of Patients with Anorexia Nervosa in Inpatient Therapy: Practice Styles of Specialized Centers. J. Clin. Med. 2018, 7, 215.

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