Collaborative versus directive interventions in the treatment of eating disorders: Implications for care providers.

Abstract

Her current area of research is readiness and motivation for change in adolescents with eating disorders. SHAWNA GOODRICH received her MSW from Simmons College, Boston, MA, in 1992. She is a doctoral student in the Department of Anthropology and Sociology at the University of British Columbia. Her current research interests are critical feminist social theory and institutional enthnography. FRANCES HASTINGS received her BA in dietetics from the University of British Columbia in 1990. She works as a dietician in the Eating Disorders Program at St. Paul's Hospital in Vancouver. She is interested in tailoring dietary interventions for clients with eating disorders according to their readiness for change. THIS RESEARCH WAS SUPPORTED by grants awarded to Josie Geller, Shawna Goodrich, and Frances Hastings from the St.

Treatment perception in adolescent onset anorexia nervosa: Retrospective views of patients and parents

“…21 The parents' and former patient's emphasis on her own ''willpower'' and ''wish to recover'' as the most important helpful factors may indicate that motivation and ''readiness for change'' are important issues in recovering from ED. 23 Both parents viewed support from the mother as somewhat more important in overcoming ED than support from the father (Table 4). Among the helpful factors for parents, mothers rated support from friends and colleagues as significantly more important than fathers did, indicating that mothers may be more likely to make use of support from a broader social network.…”

“…The study did not include questions about whether patients retrospectively thought they themselves should have been allowed to influence the treatment more, or whether they evaluated positively that medical aspects of the treatment had been ''nonnegotiable''. 21,23 Further research exploring the views of patients with AN on such issues is needed.…”

“…[21][22][23] Knowledge about how young patients with AN and their parents perceive treatment, and what they view as helpful, is important when planning and conducting treatment. However, there is a paucity of studies concerning patients' own experiences and perspectives on their treatment and recovery.…”

“…Thus, issues related to motivation and ''readiness for change'' are essential in AN treatment. 23 ED specialists agree that parents should be included in the treatment of young patients with AN. 24 Treatment engagement and adherence in children and adolescents depend on the parents' trust in treatment, as well as on the adolescents' own motivation.…”

Object Relations and Relationships with Parents as Predictors of Motivation to Recover from Eating Disorders

“…In other populations, it has been shown that the match between patient's and therapist's expectations regarding treatment is important to the patient's motivation to change. Similar findings have emerged in eating disorders-collaborative treatment approaches were rated by both clients and therapists as more likely than directive treatment approaches to keep patients in treatment and to promote adherence with treatment recommendations (Geller, Brown, Zaitsoff, Goodrich, & Hastings, 2003). Motivational interviewing (Miller & Rollnick, 2002) was developed in order to address adherence problems and enhance readiness and motivation for recovery by, for example, combining elements of style (like warmth or empathy) and technique.…”