Effectiveness of temperament based therapy with support: a randomized controlled trial study protocol

Background: Temperament-Based Therapy with Support (TBT-S) is a neurobiologically informed, skills-based intervention for eating disorders in which individuals with anorexia nervosa (AN) and their supports participate together in a multi-family group format over five consecutive days. The program is delivered as an adjunct to treatment as usual (TAU). Although prior studies have demonstrated the feasibility, acceptability, and promising outcomes of TBT-S, its effectiveness remains uncertain, as no previous studies have included a control group. This study aims to evaluate the effectiveness of TBT-S by determining whether adding TBT-S to TAU is superior to TAU alone. Methods: In this multicenter randomized controlled trial (RCT), 120 adults with a diagnosis of AN or atypical AN (AAN) will be randomized to receive either TBT-S in addition to TAU or TAU alone. Individuals with AN/AAN and their supports will complete assessments before and after the TBT-S treatment week, and at 3- and 12-month follow-ups. The primary outcome is change in eating disorder symptomatology from baseline to the 3-month follow-up. Secondary outcomes include changes in quality of life, psychological health, body mass index (BMI), and health care utilization, as well as changes in quality of life and caregiving experience among supports. Discussion: If TBT-S is found to be effective in reducing eating disorder psychopathology, it may represent a valuable and scalable adjunct to standard treatment for adults with AN/AAN.