The eight constructs may have central functions in the maintenance of AN and should be regarded when patients' motivation and goals for treatment are assessed. Further study of the possible functions of the constructs in maintaining AN is warranted.

Treatment models of eating disorders highlight the significance of working with emotional acceptance and coping in this patient group. Knowledge about how patients understand the relationships between their negative emotions and their anorectic behaviour may be an important addition to treatment programmes for AN.

Objective: Reluctance to recover may explain poor treatment outcome and high dropout and relapse rates in the treatment of anorexia nervosa (AN). This study systematically explored what AN patients describe as interfering with their wish to recover. Method: Two independent samples of women with AN (total N = 36) were interviewed in-depth using a phenomenological study design. Interviews were tape recorded, transcribed and analysed using QSR-NVIVO7 (QSR International, Melbourne, Australia) software. Results: Seven core obstacles were found to interfere with informants' wish to recover as follows: (i) 'perceiving judgements'; (ii) 'feeling stuck'; (iii) 'feeling distressed'; (iv) 'denying AN'; (v) 'eating'; (vi) 'gaining weight'; and (vii) 'appreciating the benefits'. Conclusion: The wish to recover is an autonomously based, fundamental motivational requirement for becoming ready to change. Understanding factors that contribute to this wish adds to the clinician's toolbox in motivational work with AN patients.

There is accumulating evidence that across treatment modality, the manner in which treatment is delivered is critical to therapeutic change. Our findings increase the understanding of factors that may be associated with treatment retention, further help seeking, and overall treatment outcome. These exploratory and informant-centered results could guide clinicians in developing a strong therapeutic alliance with AN-patients and promote increased knowledge about the mechanisms that engage this population.

No abstract

In this study we explored circumstances, reflections, and reactions to first treatment contact in 34 women (aged 18-51) diagnosed with anorexia nervosa (AN) (DSM-IV). Using methods from grounded theory we identified how the meeting came about, what motivated the patients, and how they reacted to the conversation. The results suggest that (a) health care professionals need to demonstrate effective professional communication skills and proficient knowledge about eating disorders in early contacts; (b) treatment goals other than recovery from AN should be explored; and

Our sample of AN patients' motivation to recover may be described using three dimensions: content, quality, and quantity, and may also include motives with no behavioral intention. Sustained therapeutic success may rest upon the therapist's ability to identify and ally with the patient's motives to recover.

Individuals with anorexia nervosa may have quite varied body image experiences in different contexts. The contexts identified in this study may be a point of departure for clinicians in helping their patients to explore their subjective body image experiences and to connect these with emotional, cognitive and relational contexts in a psychologically meaningfully way.