Therapists’ Experiences of Working with Ethnic Minority Females with Eating Disorders: A Qualitative Study

Abstract

Ethnic minority females are less likely to receive a diagnosis or treatment for an eating disorder (ED). This study captured the experiences of therapists who have worked with ethnic minority females to improve outcomes for this group. Twelve therapists in the United Kingdom, London were recruited for semi-structured interviews and thematic analysis was used to analyse the data. Shame was cited as a barrier to accessing help. This influenced therapeutic work such as not challenging shame or linking this to a negative interpretation of parents. Emotional and interpersonal factors were thought to be more common risk factors for the ED. The minimising of weight and shape concern and non-fat-phobic anorexia was thought to lead to a complex and delayed route to accessing ED services. Therapists felt restricted by service management who they felt required them to deliver a narrow range of therapies that had not necessarily demonstrated therapeutic outcomes in ethnic minority females. Nevertheless, therapists reported using curiosity to guide their cultural adaptations when feeling uncertain. When working with ethnic minority females, therapists face challenges from the therapeutic and diagnostic framework that services are aligned to. Creative solutions to address this include adapting the patient care pathway, referral guides, cultural reflective practice, and the use of cultural genograms and scripts in therapeutic work to address unmet needs.

Barriers and facilitators affecting treatment uptake behaviours for patients with eating disorders: A systematic review synthesising patient, caregiver and clinician perspectives

“…Disagreements were settled by a third, independent rater. In total, 73 studies were deemed eligible to be included in the current review (Ali et al., 2020; Andersen et al., 2021; Becker et al., 2003; Becker et al., 2010; Bye et al., 2018; Byrom et al., 2022; Cachelin & Striegel‐Moore, 2006; Cachelin et al., 2001; Cavazos‐Rehg et al., 2020; Chowbey et al., 2012; Ciao et al., 2020; Coelho et al., 2021; Couturier et al., 2013; Dayal et al., 2015; Dearden & Mulgrew, 2013; Del Valle et al., 2017; Elran‐Barak et al., 2018; Escobar‐Koch et al., 2010; Evans et al., 2011; Fitzsimmons‐Craft, Balantekin, et al., 2020; Fitzsimmons‐Craft, Eichen, et al., 2020; Fitzsimmons‐Craft, Krauss, et al., 2020; Forrest et al., 2017; Goodwin & Fitzgibbon, 2002; Gorse et al., 2013; Grammer et al., 2022; Griffiths et al., 2015; Griffiths et al., 2018; Grillot & Keel, 2018; Gulliksen et al., 2015; Hamilton et al., 2022; Hartman‐Munick et al., 2021; Hepworth & Paxton, 2007; Herman et al., 2014; Javier & Belgrave, 2019; Kanakam, 2021; Kästner et al., 2021; Lazare et al., 2021; Leavey et al., 2011; Lebow et al., 2021; Linardon, Shatte, et al., 2020; Linardon, Rosato, et al., 2020; Linardon et al., 2021; Lipson et al., 2017; Liu et al., 2022; Ma et al., 2021; Maier et al., 2014; Malova & Dunleavy, 2021; Martin‐Wagar et al., 2021; McClay et al., 2016; Meyer, 2001; Moessner et al., 2016; Mond et al., 2009; Neyland & Bard...…”

“…Cachelin & Striegel-Moore, 2006;Cachelin et al, 2001;Cavazos-Rehg et al, 2020;Chowbey et al, 2012;Ciao et al, 2020;Coelho et al, 2021;Couturier et al, 2013;Dayal et al, 2015;Dearden & Mulgrew, 2013;Del Valle et al, 2017;Elran-Barak et al, 2018;Escobar-Koch et al, 2010;Evans et al, 2011;Fitzsimmons-Craft, Balantekin, et al, 2020;Fitzsimmons-Craft, Eichen, et al, 2020;Fitzsimmons-Craft, Krauss, et al, 2020;Forrest et al, 2017;Goodwin & Fitzgibbon, 2002;Gorse et al, 2013;Grammer et al, 2022;Griffiths et al, 2015;Griffiths et al, 2018;Grillot & Keel, 2018;Gulliksen et al, 2015;Hamilton et al, 2022;Hartman-Munick et al, 2021;Hepworth & Paxton, 2007;Herman et al, 2014;Javier & Belgrave, 2019;Kanakam, 2021;Kästner et al, 2021;Lazare et al, 2021;Leavey et al, 2011;Lebow et al, 2021;Linardon, Shatte, et al, 2020;Linardon, Rosato, et al, 2020;Linardon et al, 2021;Lipson et al, 2017;…”

Perceptions of health professionals in providing care for people with anorexia nervosa and bulimia nervosa: a systematic review and meta-synthesis of qualitative studies

“…The 19 articles analyzed 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 were published between 2022 and 2010, showing that the phenomenon studied is relatively new in the specialized literature. More than 60% (n = 12) 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 of them were published in the last five years. Most studies were carried out in England (n = 8) 38 , 39 , 40 , 41 , 46 , 47 , 51 , 54 .…”

“…More than 60% (n = 12) 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 of them were published in the last five years. Most studies were carried out in England (n = 8) 38 , 39 , 40 , 41 , 46 , 47 , 51 , 54 . Three are from Canada 45 , 53 , 55 and two from Australia 44 , 48 .…”

“…Regarding data collection, we observed that most studies were conducted through individual interviews characterized by in-depth, semi-structured, and open questions (n = 17) 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 50 , 51 , 52 , 53 , 56 . Only three studies used focus groups 49 , 54 , 55 .…”