Abstract
BackgroundFor some young persons diagnosed with anorexia nervosa, treatment will inevitably involve phases where hospitalization is required. Inspired by the encouraging evidence-base for outpatient family-based treatment for adolescent anorexia nervosa, clinicians and program developers have started to incorporate outpatient family-based treatment principles into higher levels of care. During family-based inpatient treatment, collaborative efforts are largely directed toward the parents of the adolescent. Consequently, the therapeutic focus on the young person is more of an indirect one. With this study we aimed to understand how young persons with lived experience from a family-based inpatient treatment setting, where the adolescents were admitted together with their parents, viewed therapeutic aspects related to staff-patient collaboration and staff-related behaviors.MethodsThirty-seven semi-structured interviews of former adolescent inpatients were conducted. Participants’ post-treatment reflections were inductively analyzed by applying a thematic analytic framework.ResultsBased upon user perspectives from a treatment setting highly influenced by a family therapeutic approach, findings revealed that former inpatients prefer tailored treatment and a collaborative approach. Eight subthemes constituting two main themes emerged: 1) There are no ready-made solutions. Staff should facilitate collaboration by tailoring treatment toward the young person’s perspectives, and 2) Emphasizing skills that matter. Staff should display a non-judgmental stance, educate patients, stimulate motivation, enable activities and prevent iatrogenic effects during the stay.ConclusionsThis study adds valuable user perspectives to the ongoing work with adapting family-based frameworks into higher levels of care. Clinicians could benefit from viewing their practice from the standpoint of the young person’s post-treatment reflections. From their unique perspectives as having lived experience and hence, “insider knowledge” with a specific treatment situation, clinicians are reminded of the importance of being mindful on the young persons’ views.
Highlights
For some young persons diagnosed with anorexia nervosa, treatment will inevitably involve phases where hospitalization is required
Quite a few participants reflected that a more adolescent-oriented approach was needed, and that health care professionals should be mindful of individual differences in needs and vulnerabilities, with flexibility in potential solutions
Our findings extend prior qualitative research which has shown that patients with Eating disorder (ED) often value aspects associated with the therapeutic alliance, preferring treatment as a joint and collaborative effort, as demonstrated in main theme 1 [29,30,31,32]
Summary
For some young persons diagnosed with anorexia nervosa, treatment will inevitably involve phases where hospitalization is required. Inspired by the encouraging evidence-base for outpatient family-based treatment for adolescent anorexia nervosa, clinicians and program developers have started to incorporate outpatient familybased treatment principles into higher levels of care. Motivated by the encouraging evidence for outpatient FBT [10], clinicians and program developers have started to incorporate FBT principles into higher levels of care [11,12,13,14]. These developments could be a promising step for those in need of hospitalization, more research is needed on how to tailor and adapt familybased interventions into inpatient care [15, 16]
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