Telehealth transition in a comprehensive care unit for eating disorders: Challenges and long‐term benefits

Abstract

The 2019 novel coronavirus disease (COVID-19) pandemic has forced many eating disorder medical stabilization units to consider adjustments that uphold both the quality of care delivered to patients while also observing social distancing public health directives for patients and staff. To date, inpatient facilities for eating disorders (both medical stabilization units and higher level of care facilities) have not needed to consider how to translate services to electronic platforms, given that most of these programs have in-person staff. We outline our transition to telehealth broadly, emphasizing some unexpected benefits of using telehealth services that we plan on integrating into our work-flow post COVID-19. These may be useful for other higher level of care eating disorder programs, including medical stabilization units, residential, partial hospitalization, and intensive outpatient programs. We also highlight aspects of transition that have been more challenging for this particular patient population, warranting the need for in-person services.

COVID-19 and binge eating: Patient perceptions of eating disorder symptoms, tele-therapy, and treatment implications

“…With regard to patient perceptions of tele-therapy, the majority of participants cited having a positive experience that was akin to, if not preferred to, in-person therapy. These findings are also inconsistent with the limited literature that exists on this topic, in which patients were found to generally prefer in-person therapy to tele-therapy (Datta et al, 2020;Fernández-Aranda et al, 2020), although in Datta et al (2020), these preferences were cited in the context of an inpatient sample. In our study, tele-therapy was viewed positively in large part due to the convenience and accessibility of this modality of therapy.…”

“…Qualitative findings from pilot study found that patients missed the structure of in-person treatment and weekly weigh-ins (Fernández-Aranda et al, 2020). In another qualitative exploration of patient perceptions of group therapy, while the majority failed to cite dislikes of virtual groups, the general consensus was a preference for connectedness of in-person groups (Datta, Derenne, Sanders, & Lock, 2020). The research thus far regarding eating disorder patient perceptions of tele-therapy has been limited to quantitative analysis of the frequency of tele-therapy use or informal assessments of patient perceptions of group therapy.…”

Doing remote systemic psychotherapy during a pandemic

“…While some evidence exists (see for example Wade et al 2020;Dross et al 2020;Datta et al 2020), we do not yet clearly know which people facing which presenting problems will be best suited to maintaining this way of working. Likewise, it is not yet clear how families find remote service delivery.…”

Impact of the COVID-19 Pandemic on Disordered Eating Behavior: Qualitative Analysis of Social Media Posts (Preprint)

“…Additionally, acceptance of telemedicine may vary by ED subtype, with evidence suggesting that individuals with the anorexia nervosa subtype may be least content with the transition to remote treatment [12]. In inpatient settings, care teams have been reduced in size, visitations have been limited, and admission criteria have become more stringent [16,17,20]. To abide by social distancing guidelines, group therapy sessions have been cancelled or conducted remotely, limiting patients' access to familiar social support networks, though also reducing opportunity for body comparisons [20].…”

“…In inpatient settings, care teams have been reduced in size, visitations have been limited, and admission criteria have become more stringent [16,17,20]. To abide by social distancing guidelines, group therapy sessions have been cancelled or conducted remotely, limiting patients' access to familiar social support networks, though also reducing opportunity for body comparisons [20]. Additionally, physical and financial barriers to treatment may arise among patients with limited computer or internet access [18] and among those whose income has been adversely affected by business closures.…”