Dr Calum Munro
Consultant Psychiatrist in Psychotherapy & Eating Disorders, Honorary Senior Lecturer (University of Edinburgh)
NHS Lothian
Focus area of practical/ clinical work/ research
I have worked as a psychiatrist and a psychological therapist with people suffering eating disorders for 17 years. My clinical work over the last 9 years has been with severe Anorexia Nervosa. I work in a service that delivers more intensive community-based treatment with a focus on treating people with severe problems at home rather than in hospital and providing long term continuity of relationships with professionals.
I have pursued research directly related to the work I do. I was involved in a clinical trial showing the benefit of a computerised psychological treatment for people with bulimic disorders. Since then I have led on the development and evaluation of a model of treatment that can deliver safe community-based care for the vast majority of patients with severe eating disorders. Central to this is a new model of psychological therapy which we have adapted for use in anorexia nervosa, called Schema Therapy (iST-AN). We have also generated preliminary evidence that suggests: treating severe patients in community care reduces treatment costs by reducing inpatient admissions; that patients show high rates of satisfaction with this treatment; that medical risks related to AN can be safely managed within this model of treatment; and that the majority of patients show improvement across eating related, anxiety and depressive symptoms over the course of treatment. We have also completed a qualitative study exploring some of the factors involved in change or being unable to change.
Publications/ Projects/ Activities
In addition to the publications below, we have developed a conceptual framework & treatment manual for our therapy treatment – individual Schema-mode Therapy for Anorexia Nervosa (available on request). I am currently undertaking a naturalistic case series using this therapy for patients with moderate-severe Anorexia Nervosa, in collaboration with colleagues in Australia. I am also working on book chapters about our treatment to contribute to a forthcoming book on the use of Schema Therapy for people with eating problems.
- Hannon J, Eunson L, Munro C. The patient experience of illness, treatment and change, during intensive community treatment for severe anorexia nervosa. (Currently in journal peer review)
- Munro C, Eunson L, Herron A, Allott C. Outcomes of intensive community treatment for severe anorexia nervosa: symptoms, quality of life, weight change and acceptability. (Currently in journal peer review)
- Munro C, Randell L, Lawrie An Integrative Bio-Psycho-Social Theory of Anorexia Nervosa. Clinical Psychology and Psychotherapy 2016; DOI: 10.1002/cpp.2047.
- Davies JE, Cockfield A, Brown A, Corr J, Smith D, Munro The medical risks of severe anorexia nervosa during initial re-feeding and medical stabilisation. Clinical Nutrition 2016; http://dx.doi.org/10.1016/j.clnesp.2016.09.005
- Munro C, Thomson V, Corr J, Randell L, Davies JE, Gittoes C, Honeyman V, Freeman CP. A new service model for the treatment of severe anorexia nervosa in the community: the Anorexia Nervosa Intensive Treatment Team. The Psychiatric Bulletin 2014; 38 (5): 220-225.
- Polnay A, James VAW, Hodges L, Murray GD, Munro C, Lawrie S M. Group therapy for people with bulimia nervosa. Psychological Medicine 2014; 44(11): 2241-2254.
- Sanchez-Ortiz VC, Munro C, Startup H, Treasure J, Schmidt U. The role of email guidance in internet-based cognitive-behavioural self-care treatment for bulimia nervosa. European Eating Disorders Review 2011;19(4):342-8.
- Sanchez-Ortiz V, House J, Munro C, Startup H, Treasure J, Williams C, Schmidt U. ‘A computer isn’t gonna judge you’: A qualitative study of users’ views of an internet-based cognitive behavioral guided self-care treatment package for Bulimia Nervosa and related disorders. Eating And Weight Disorders 2011;16 (2):e93-e101.
- Sanchez-Ortiz VC, Munro C, Stahl D, House J, Startup H, Treasure J, Williams C, Schmidt U. A randomised controlled trial of Internet-based Cognitive-Behavioural Therapy for Bulimia Nervosa or related disorders in a student population. Psychological Medicine 2010; 41(2): 407-417.
Motivation/ Inspiration/ Mission
The suffering and damage to people’s lives and prospects that I have seen among people with eating disorders is what motivates me to try to help. Comparisons of quality of life scores suggest people with severe AN have comparably poor quality of life to those on waiting lists for heart or lung transplantation. Yet, our treatments for helping those with eating and body-image problems are not very effective and most people who have an eating disorder never access any professional help. There continues to be a lack of parity in spending on mental health care and a lack of adequate services and outreach to those with eating disorders or at risk of developing eating and body-image problems. All of these things motivate me in my clinical work and my desire to improve treatment, understanding and access to help for those with eating problems.
I believe that reductionist academic research, in biological, psychological and social fields, has markedly increased our knowledge about the components and processes involved in causing and perpetuating eating problems. However, this is yet to be translated into very effective approaches to the treatment of individuals, or interventions at a group or societal level which facilitate recovery from or prevent the onset of problems with eating and body-image. Furthermore with an apparent increase in psychological distress among female Scottish teenagers in particular, increases in rates of referrals to mental health services and some evidence that social media engagement may have an adverse effect on eating and body image, there is a pressing need for action. This motivates me to pursue an integrative approach to understanding eating disorders and body-image problems, both for the individual patients that I am treating, and to spread understanding among the population in general about how eating disorders can be understood and how they can be tackled.
Contact details:
E-Mail: calum.munro@ed.ac.uk
Phone: 0131 537 6783