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Emotion Coaching Interest Survey

WELL Center Program for Caregivers of Adolescents with Eating Disorders

The WELL Center is providing a targeted emotion coaching intervention for caregivers of adolescents with eating disorders who are receiving Family Based Treatment from a certified provider. Some information about this research study:

This is not a treatment or intervention study for your child/adolescent
- We will not collect data regarding your child and will have no contact with your child during the study period
This program is provided free of charge
This program does not require medication
This is a group-based intervention. We anticipate having 3-5 families per group
Study sessions will take place via a HIPAA-compliant Zoom videoconferencing platform

Weekend and evening sessions are available.

To see whether you are eligible to participate in the emotion coaching intervention, please complete the survey below.

This survey must be completed by a parent or legal guardian of a child with an eating disorder.

For more information about the study, please click here:

How did you first hear about the WELL Center?

Professional referral, such as from a psychologist, physician, or nutritionist

Family member, friend, acquaintance

Postcard

Flyer

Drexel's website

Other

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What is your first name?

* must provide value

What is your last name?

What is your email address?

* must provide value

What is your phone number?

* must provide value

Do you live in the United States

* must provide value

Yes

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What is your child's age?

* must provide value

What is your child's gender?

Please describe your child's gender

Has your child been diagnosed with an eating disorder?

* must provide value

Yes

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What is their diagnosis?

Who were they diagnosed by (psychologist, psychiatrist, treatment team)? Please be as specific as possible.

* must provide value

Do they currently have an evaluation scheduled?

* must provide value

Yes

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What is the date and location of their evaluation?

* must provide value

Is your child currently in therapy for an eating disorder? If your child is only taking medication and not receiving psychological intervention, please say no.

* must provide value

Yes

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What time of treatment are they receiving? Please be as specific as possible, including treatment type (therapy, medication, nutrition/dietitian, etc) and provider/practice name.

If applicable, which of the following treatments is your child involved in?

Therapy - Family Based Treament

Therapy - Cognitive Behavioral Therapy

Therapy - Other

Medical monitoring

Psychiatry/medication management

Nutrition services

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What level of treatment is your child receiving?

Outpatient

Intensive outpatient (IOP)

Partial hospitalization (PHP)

Residential

Inpatient/medical stabilization

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What was their treatment start date?

Are they on a waitlist to start treatment?

* must provide value

Yes

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What is their tentative treatment start date? If unknown, write "unknown"

Is your child currently receiving medical monitoring for their eating disorder?

* must provide value

Yes

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Does your child have a second parental figure who would be willing and able to participate in the emotion coaching intervention? We recommend that all parents who are participating in FBT also participate in this emotion coaching intervention.

My child has another parental figure who would be willing and able to participate in the intervention

My child has another parental figure, but I am unsure if they would be willing or able to participate in the intervention

My child has another parental figure, but they would not be willing or able to participate in the intervention

My child does not have another parental figure in their life

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You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.