Developing Solutions to the Waitlist Problem for Eating Disorder Treatments.

Abstract

We examine the small amount of research to date that describes and/or evaluates waitlist interventions as a precursor to treatment for an eating disorder (ED) with the intent to provide recommendations for future research that can further test the efficacy and effectiveness of waitlist interventions. A review of published studies showed the standard of proof about the usefulness of waitlist interventions to be slight, with important gaps in our knowledge. One such gap was whether recovered people with lived experience could provide support to adults waiting for treatment. We briefly present new research evaluating this approach (N = 40), where people waiting for treatment were randomized to waitlist as usual or guided self-help with a trainee psychologist or a person with lived experience. Eight published studies across 10 different programs are described; N = 7 addressed waitlists for children and adolescents, and only three were randomized controlled trials. Our new research did not support the involvement of people with lived experience at this stage of the treatment journey. The results suggest some promise of waitlist interventions. Parents waiting for family-based treatment were able to improve weight and nutritional health in their children and experienced improved self-efficacy with respect to managing the ED. Provision of a waitlist intervention to adults may increase the probability of later engagement in treatment. It is still not possible to conclude whether waitlist interventions improve outcomes over treatment compared to those who did not receive such an intervention. We make five recommendations for future research.