Abstract
BackgroundStudies investigating patients’ perspectives towards an abrupt transition from face-to-face to online treatment in eating disorders (EDs) are scarce. The current study aimed to (1) conduct a preliminary assessment of patients’ perspectives regarding this transition, and (2) explore potential demographic, clinical, and treatment-related factors associated with these perspectives.MethodsSixty-three patients with EDs whose treatment was moved to an online format, were surveyed during the COVID-19 lockdown (April–May 2020). A 6-item measure was developed to examine their perspectives toward this transition. Exploratory factor analyses (EFAs) were conducted to confirm the rational-theoretical structure of the measure (Eigenvalue = 3.745, explaining 62.4% of variance). The Cronbach’s alpha value was excellent (α = 0.878). Validated questionnaires were used to measure ED symptoms, general psychopathology, therapeutic alliance, and pandemic anxiety, and their associations with our transition-focused scale and telemedicine satisfaction were examined.ResultsMixed views were found regarding the transition, with the majority (68%) stating that they would not choose to continue online therapy given the option. Longer duration of treatment (r = 0.291, p = 0.022), stronger therapeutic alliance (r = 0.293, p = 0.028), and higher COVID-19 anxiety (r = 0.276, p = 0.029) were linked with more positive views towards the transition.ConclusionsAnalyses suggest that patients’ perspectives towards the transition can be measured using a Likert-type 6-item scale. Findings highlight the various responses to online treatment and indicate a need to identify patients who may face difficulties in the transition to this newly ubiquitous treatment mode. Clinicians should be cognizant of these potential difficulties and consider appropriate modes of treatment in the ongoing pandemic situation.
Highlights
Studies investigating patients’ perspectives towards an abrupt transition from face-to-face to online treatment in eating disorders (EDs) are scarce
The aim of the current study was to conduct a preliminary assessment of patients’ perspectives regarding the transition to online therapy during the first COVID-19 lockdown, and explore potential factors associated with these perspectives
We found that longer duration of pre-lockdown treatment, stronger therapeutic alliance, and high COVID-19 anxiety were associated with a more positive perspective toward the transition
Summary
Studies investigating patients’ perspectives towards an abrupt transition from face-to-face to online treatment in eating disorders (EDs) are scarce. Efforts to control the spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have led to quarantining and social distancing, across the globe, accompanied by considerable psychological implications [1, 2] In this context, ambulatory mental health services shifted from conventional face-to-face treatment to remote online treatment. Taking into account predictions for an increase in ED risks and symptoms during the COVID-19 crisis via several pathways related to disrupted food access and routines, movement and exercise constraints, heightened stress and anxiety, decreased support and, in some cases, the increased possibility of violence [13, 14], the provision of continuous therapy remained a principal goal This unprecedented and abrupt transition was forced upon patients as well as on therapists, with no prior warning or preparation. Due to the lack of studies describing patients’ perspectives, therapists were suddenly in a position of having to rely on the limited literature [15], on in-house institutional professional peer support [16], and on an international exchange of viewpoints and expertise [17]
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