Eating Disorder Recovery: A Metaethnography

Eaton, Carrie Morgan

doi:10.1177/1078390319849106

Cited by 19 publications

(13 citation statements)

References 43 publications

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“…The themes ‘Emerging from the eating disorder’ and ‘Development of I’ centre around the experience for the individual. The young people acknowledged the damaging nature of the ED in the theme ‘Emerging from the eating disorder’; which is consistent with Eaton [ 2 ] who described individuals as having a ‘pivotal moment of realisation’ regarding the damage caused by ED. However, the idea of a defining moment did not emerge from the transcripts; Eaton’s Meta-Ethnography is focused on the experiences of adult females and therefore it is possible that young people have a different experience.…”

Section: Discussionsupporting

confidence: 80%

“…However, the idea of a defining moment did not emerge from the transcripts; Eaton's Meta-Ethnography is focused on the experiences of adult females and therefore it is possible that young people have a different experience. Existing research reported a deterioration in interpersonal relationships in the context of damage caused by the ED [2,[31][32][33], as opposed to damage to significant others and the impact on the individual in terms of responsibility for the damage caused to others as was evident in this research.…”

Section: The Role Of the Individualmentioning

confidence: 67%

“…Anorexia nervosa (AN) is a serious condition associated with severe physical [ 1 ] and psychological complications [ 2 ], with one fifth of deaths associated with AN due to completed suicides [ 3 ]. AN is believed to have the highest mortality rate of all mental health conditions [ 4 ] and a higher mortality rate than physical health conditions such as asthma or diabetes [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Exploring the experience of young people receiving treatment for an eating disorder: family therapy for anorexia nervosa and multi-family therapy in an inpatient setting

Coopey

Johnson

2022

J Eat Disord

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Background Research indicates that family therapy for anorexia nervosa (FT-AN) and multi-family therapy (MFT) are effective treatments for adolescents experiencing anorexia nervosa (AN). However, less is known about young people’s experiences of these two treatments, as there is limited qualitative research, and to date no qualitative research within an inpatient setting. It is argued that the lack of such insight limits the development of services for young people experiencing AN. Method Five young people were recruited to the study from a specialist inpatient unit who were receiving treatment on the AN pathway which included both FT-AN and MFT. Semi structured interviews were undertaken and analysed using Interpretative Phenomenological Analysis. Results Four superordinate themes and ten subthemes were developed from the data. The four superordinate themes were: ‘Process of Understanding’, ‘Reviving Connection’, ‘Emerging from the Eating Disorder and ‘Development of I’. Conclusions There appeared to be two overarching concepts: the role of the individual and the role of others, that helpfully framed the results. The superordinate themes: ‘Emerging from the Eating Disorder’ and ‘Development of I’ focused on the development of the individual. Conversely, the superordinate themes: ‘The Process of Understanding’ and ‘Reviving Connection’ were centred on the relationships existing within the family system. The results could help inform future service developments regarding inpatient provision and service design. Plain English Summary The most widely used and recognised treatment for anorexia nervosa in young people is family therapy for anorexia nervosa (FT-AN). An alternative treatment is multi-family therapy (MFT). Both treatments are deemed to be effective and usually happen in the community. However, some hospitals provide these treatments while the young people are in-patients. There is no research exploring young people’s experiences of these two treatments while in an in-patient unit. Young people who had received both FT-AN and MFT in an inpatient setting were asked to share their experiences of these two treatments. Their stories were analysed by a researcher. The analysis identified four themes: ‘Process of Understanding’, ‘Reviving Connection’, ‘Emerging from the Eating Disorder and ‘Development of I’. The results highlighted that the young people appeared to place more value on the role of others and perhaps others changing enabled them to change. The research highlighted the benefit in others’ understanding and therefore how improving societal understanding more broadly would be helpful. The young people reflected that both they and their parents benefited from FT-AN and MFT in an in-patient setting and it is proposed that this could help inform future service developments regarding inpatient provision.

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Section: Discussionsupporting

confidence: 80%

Section: The Role Of the Individualmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Exploring the experience of young people receiving treatment for an eating disorder: family therapy for anorexia nervosa and multi-family therapy in an inpatient setting

Coopey

Johnson

2022

J Eat Disord

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“…When attempts to maintain a sense of masculinity were made through ED symptomology, they were confounded by the awareness that the behaviours were stereotypically female [ 34 ]. The notion of women gaining a sense of control from an ED is supported by the literature [ 46 ] highlighting there is not a disparity between genders in this particular experience.…”

Section: Discussionmentioning

confidence: 72%

“The male elephant in the room”: a qualitative evidence synthesis exploring male experiences of eating disorders

Coopey

Johnson

2022

J Eat Disord

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Background Men are believed to be underrepresented in eating disorder services; there are many reasons presented to account for this such as a lack of recognition and detection. Due to the physical and psychological complexity of an eating disorder it is important to understand this underrepresentation. This qualitative evidence synthesis aimed to explore the literature relating to men’s experiences of an eating disorder, in order to synthesise the findings and offer a more coherent understanding. Method A systematic search of the literature was undertaken. Inclusion and exclusion criteria were applied to the findings resulting in 14 papers deemed suitable for inclusion. A Meta-Ethnographic approach to synthesising the data of the 89 participants was undertaken. Results Four themes were identified: ‘Societal Construction of the Perfect Male’; ‘Striving to Maintain a Masculine Identity’; ‘The Interconnectedness of Control and Self-Worth’, and ‘The Hidden Man’. There appeared to be an underlying concept relating to the conflict of being a man, with what is perceived to be a ‘woman’s illness’ and how this challenged the men’s experiences of masculinity. Conclusions Being a man with an eating disorder conflicted with societal norms, exacerbating their experience of having an eating disorder.. To resolve this, gendered norms need to shift, at societal level as well as considering how best to improve understanding and recognition of men with an eating disorder at the first point of help seeking.

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“…The qualitative ED literature consistently reports that patients value the therapeutic relationship in treatment as supportive to recovery [ 26 , 30 , 31 , 34 ]. In the most recent of these meta syntheses Karlson et al [ 31 ] offers a patient-constructed definition of therapist qualities and relationship attributes that patients experience as helpful.…”

Section: Main Textmentioning

confidence: 99%

Conceptualising specialist supportive clinical management (SSCM): current evidence and future directions

et al. 2022

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Background Current evidence-based treatments for adult anorexia nervosa (AN) have limitations, with high attrition, very poor outcomes for 20% of people, and no clearly superior manualised therapy for adults with AN. Specialist Supportive Clinical Management (SSCM) was designed as a control treatment but has evolved as a valid first line treatment. The present paper aims to provide an overview of the evidence base for SSCM and a pedagogical reconceptualization with expansion by theoretical integration (TI). Body A secondary meta-analysis endorses SSCM as a promising treatment. This paper positions SSCM as a manualised therapy for adult AN with six unique features, namely (1) a philosophy which is person-centred, non-prescriptive, and informed by the person’s strengths and values, (2) a focus on the person through inclusion of supportive psychotherapy and problem (clinical management), within target symptoms as defined in relation to AN, (3) a flexible and responsive therapy that could be delivered by a variety of clinicians with experience treating AN (4) a commitment to reversing starvation though a directional approach and a defined yet flexible stance on dietetic intervention (5) a commitment to the therapeutic relationship within all three phases of treatment, and (6) a therapy ‘uncluttered’ by specific mandates. In addition, this paper positions SSCM as a treatment that may be strengthened by other modalities and may also be adapted to the treatment of other eating disorders (ED), not just AN. The level of therapist sophistication to deliver upon the supportive psychotherapy component is explored and future directions are offered. Conclusion SSCM is a unique and valid first line treatment for AN and would benefit from further expansion in line with emerging understandings of AN to strengthen it as a treatment. Speculation on aspects of potency would benefit from further testing. The proposed re-conceptualisation of SSCM in the context of its evidence may strengthen it as a treatment overall, position it as adaptable for treatment of other eating disorders and make it more accessible to clinicians.

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Eating Disorder Recovery: A Metaethnography

Cited by 19 publications

References 43 publications

Exploring the experience of young people receiving treatment for an eating disorder: family therapy for anorexia nervosa and multi-family therapy in an inpatient setting

Exploring the experience of young people receiving treatment for an eating disorder: family therapy for anorexia nervosa and multi-family therapy in an inpatient setting

“The male elephant in the room”: a qualitative evidence synthesis exploring male experiences of eating disorders

Conceptualising specialist supportive clinical management (SSCM): current evidence and future directions

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