Challenges in Making the Transition Between Pediatric and Adult Eating Disorder Programs: A Qualitative Study From the Perspective of Service Providers

Abstract

There is scant research regarding the transition from pediatric to adult eating disorder programs. This study aims to increase understanding of the factors that impede or facilitate successful service transition for individuals with anorexia nervosa moving from pediatric to adult eating disorder programs. Participants included service providers representing pediatric and adult eating disorder programs, in addition to community treatment providers in a large city. The following themes were identified: a) readiness, not age, should determine service transition; and b) implementation of interventions for facilitating transition from pediatric to adult eating disorder programs including appropriate medical follow-up. These findings delineate various factors that may help facilitate or interrupt a seamless and coordinated transition from pediatric to adult eating disorder programs.

Clinician adherence to guidelines in the delivery of family‐based therapy for eating disorders

“…This shift in practice might reflect the clinician's desire to respect the adolescent's transition to adulthood, as reflected in a more family‐client collaborative approach, including more individual sessions. The pattern employed with the transitional‐aged group is also similar to that outlined elsewhere, given that clinicians report feeling that families should be encouraged to be supportive of treatment rather than leading it . As bulimia nervosa tends to have a later age of onset than anorexia nervosa, it is possible that the change in practice with older clients explains why recommended FBT techniques were used less frequently among clinicians working with a greater proportion of bulimia nervosa cases.…”

“…The pattern employed with the transitional-aged group is also similar to that outlined elsewhere, given that clinicians report feeling that families should be encouraged to be supportive of treatment rather than leading it. 29 As bulimia nervosa tends to have a later age of onset than anorexia nervosa, it is possible that the change in practice with older clients explains why recommended FBT techniques were used less frequently among clinicians working with a greater proportion of bulimia nervosa cases. Although it might be very appropriate for clinicians who work with older clients to facilitate more ownership of the tasks of refeeding/symptom interruption by the client (rather than the parents), these changes in practice across age groups are not supported empirically, and there are no systematic studies exploring the effectiveness of the various FBT techniques with transitional-aged clients.…”

Identifying core components and indicators of successful transitions from child to adult mental health services: a scoping review

“…The first is from Blum et al [15], who conceptualize a transition as "the purposeful, planned movement of adolescents and young adults with chronic medical conditions from child-centered to adult-oriented health care systems". Blum's definition was referred in nine of the reviewed articles, yet it is not specific to transitions in mental health care [3,7,13,14,[36][37][38][39][40].The second is from Singh et al [13], who build on the definition from Blum et al [15], adding four specific criteria for determining whether transitions in care were optimal or successful. Further, unlike Blum et al [15], these criteria are specific to transitions from CAMHS to AMHS.…”

Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times

“…, Dimitropoulos et al . ). Challenges to successful transition have also been studied from Swedish, Irish and Australian perspectives, all with a similar view that this difficult period needs much further consideration (McGorry , Lindgren et al .…”

“…The issues raised here are not stand alone to the United Kingdom and are reflected across many other countries. Notable findings in the United States and Canada highlight a severe concern for the lack of appropriate transition services and the potential for failings in young people's care (Davis & Sondheimer 2005, Davis et al 2006, Dimitropoulos et al 2013. Challenges to successful transition have also been studied from Swedish, Irish and Australian perspectives, all with a similar view that this difficult period needs much further consideration (McGorry 2011, Lindgren et al 2013, McNamara et al 2013.…”