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Specialist Supportive Clinical Management for anorexia nervosa: what it is (and what it is not).

Senior Lecturer, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand, and; Clinical Psychologist, Canterbury District Health Board, Christchurch, New Zealand. Senior Lecturer and Clinical Psychologist, Psychology Department, University of Canterbury, New Zealand. Distinguished Professor, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, and; Professor, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, and; Professor, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists. 2020;(2):156-159
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Abstract

OBJECTIVE Specialist Supportive Clinical Management (SSCM) is a psychotherapy comprising a clinical management focus addressing anorexia nervosa (AN) symptoms and a supportive therapy component. SSCM has been an active control therapy in randomised controlled trials for AN, but has proven to be an effective therapy in its own right. There has been speculation about how this relatively straightforward therapy works. Some of the commentaries and descriptors used for SSCM, however, do not reflect the content or principles of SSCM. This paper clarifies areas of misunderstanding by describing what SSCM is and what it is not, particularly in relation to commentary about its constituent characteristics. CONCLUSIONS SSCM utilises well established clinical management for AN (with a sustained focus on normalised eating and weight restoration) coupled with supportive therapy principles and strategies. Common factors across both arms include core counselling skills and a positive therapeutic alliance to promote adherence and retention in treatment for AN. Compared to other comparator therapies to date, SSCM is a simpler therapy without unique or novel theoretically derived strategies. Comparable outcomes with more complex psychotherapies raise the question of whether the combined core components of SSCM may be sufficient for many people with AN.