To increase capacity for detecting eating disorders at their first signs, we encourage the use of a brief, youth-friendly screening tool that can be used in a range of community settings: the ODES-Y
Science and Research Behind FREEDcan
FREEDcan is adapted from an evidence-based early intervention model for eating disorders, FREED. FREED has been extensively studied from pilot to scale-up across the UK and internationally, with promising outcomes emerging.
Notable impacts of FREED
FREED has also been shown to be cost-effective, helping the healthcare system better respond to eating disorders. Key evidence for FREED is detailed on their website.
FREEDcan is an adaptation of FREED UK. In addition, we draw on evidence from Australia, where FREED was successfully adapted to be used in community-based primary healthcare. In the Australian context, an adaptation of FREED called Emerge-ED achieved similar positive outcomes and reached a broad population including those with lower socioeconomic status.
Adapting FREED for Canada
We have taken an intentional approach to adapting FREED, focusing on adding a layer into the existing continuum of care in Canada. This means fitting FREEDcan in between prevention and intensive treatment, in a place where there is currently a gap. We are doing this in a way that brings in what is sometimes referred to as the “three legged stool” of evidence-based practice. This means that we integrate research, clinical, and lived/living experience to build all aspects of FREEDcan.
What does this look like in practice?
One way to think about this evidence-based way of building our model is to think about each of the pillars of FREEDcan. These are:
Research shows that young people may not reach out for help when they are experiencing an eating disorder – it is important to reach out to and engage with them! One of the key players in the FREEDcan model is the FREED Champion, who actively reaches out to young people and meets them where they are.
Strong assessment practices for eating disorders are comprehensive and look at the whole person in context. FREEDcan takes a biopsychosocial approach to assessment and aims to provide this assessment quickly and in a youth-friendly way.
Psychoeducation can make a big difference for young people and their families, helping to provide needed information about the impacts of eating disorders – and what to do about them. FREEDcan embeds psychoeducation throughout the model, including in the resources we create and the interventions we provide.
FREEDcan has developed a “menu” of intervention options that can be used in different settings that have existing or emerging research supporting them. Keeping in mind that most ED research has taken place in intensive settings, some of the interventions used in FREEDcan are “evidence-building.”
Ali, K., Fassnacht, D.B., Farrer, L., Rieger, E., Feldhege, J., Moessner, M., Griffiths, K.M., & Bauer, S. (2020). What prevents young adults from seeking help? Barriers toward help-seeking for eating disorder symptomatology. International Journal of Eating Disorders, 53, 894–906. https://doi.org/10.1002/eat.23266
Allen, K.L., Mountford, V., Brown, A., Richards, K., Grant, N., Austin, A., Glennon, D., & Schmidt, U. (2020). First episode rapid early intervention for eating disorders (FREED): From research to routine clinical practice. Early Intervention in Psychiatry, 14, 625–630. https://doi.org/10.1111/eip.12941
Mills, R., Hyam, L., & Schmidt, U. (2023). A narrative review of early intervention for eating disorders: Barriers and facilitators. Adolescent Health, Medicine and Therapeutics, 14, 217–235. https://doi.org/10.2147/AHMT.S415698
Radunz, M., Ali, K., & Wade, T. D. (2023). Pathways to improve early intervention for eating disorders: Findings from a systematic review and meta-analysis. International Journal of Eating Disorders, 56(2), 314–330. https://doi.org/10.1002/eat.23845
Richards, K.L., Phillips, M., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024). Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study. Journal of Eating Disorders, 12, 45. https://doi.org/10.1186/s40337-024-01000-4 ]
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