Perceptions of the “anorexic voice”: A qualitative study of health care professionals

Graham, Meghan R; Tierney, Stephanie; Chisholm, Amy; Fox, John R. E.

doi:10.1002/cpp.2393

Cited by 8 publications

(18 citation statements)

References 59 publications

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“…Previous research has highlighted that service‐users desire greater acknowledgement and intervention for the EDV (Davies et al, 2008; Tierney & Fox, 2011), though this is often unfulfilled (Rance et al, 2017). Overall, these findings suggest that Voice Dialogue is mainly acceptable to individuals with AN and could augment existing psychological therapies, as well as helping professionals better appreciate the lived experience of AN (Graham et al, 2019).…”

Section: Discussionmentioning

confidence: 94%

Interviewing anorexia: How do individuals given a diagnosis of anorexia nervosa experience Voice Dialogue with their eating disorder voice? A qualitative analysis

Ling

Serpell

Burnett‐Stuart

et al. 2021

Clin Psychology and Psychoth

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A proportion of individuals given an eating disorder diagnosis describe the experience of an eating disorder 'voice' (EDV). However, methods for working with this experience are currently lacking. Voice Dialogue (Stone & Stone, 1989) involves direct communication between a facilitator and parts of the self to increase awareness, understanding, and separation from inner voices. Adapted forms of this method have shown promise in working with voices in psychosis. This study aimed to explore the experience and acceptability of Voice Dialogue amongst individuals with anorexia nervosa who experience an EDV. Nine women participated in a semistructured interview following a single Voice Dialogue session. Interview transcripts were analysed using interpretative phenomenological analysis (IPA). Three overarching themes were identified as follows: (i) "separating from the EDV";(ii) "better understanding of the EDV"; and (iii) "hopeful, motivated, and afraid of recovery". The majority of participants found Voice Dialogue acceptable and helpful for exploring their EDV. Whilst preliminary, the results suggest that Voice Dialogue has potential in terms of helping individuals establish a more constructive relationship with their EDV and motivating change. Further research is needed to build upon these findings. Implications for addressing the EDV using voice-focused interventions are explored.

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Section: Discussionmentioning

confidence: 94%

Interviewing anorexia: How do individuals given a diagnosis of anorexia nervosa experience Voice Dialogue with their eating disorder voice? A qualitative analysis

Ling

Serpell

Burnett‐Stuart

et al. 2021

Clin Psychology and Psychoth

View full text Add to dashboard Cite

show abstract

“…A supportive and collaborative team are considered to be crucial [ 42 ]. Indeed, consistent with a growing body of research [ 43 – 45 ], the importance of an individualised and patient-centred approach to treatment and recovery was highlighted, whilst noting the ethical considerations of managing patients’ desires and ambivalence towards recovery, within the context of limited resources [ 39 ]. It was recognised that DP programs may limit their offer to a select group of patients who are motivated and able to adhere to treatment boundaries.…”

Section: Discussionmentioning

confidence: 99%

Clinicians’ perspectives on supporting individuals with severe anorexia nervosa in specialist eating disorder intensive treatment settings

et al. 2022

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Background Admissions to intensive treatment (i.e., inpatient [IP] and/or day patient [DP]) for individuals with severe anorexia nervosa (AN) are common. Growing literature indicates potential risks and benefits of each intensive treatment approach; however, existing research has focused on patient and carer perspectives of these treatments. Also, there is scant empirical evidence available for guiding the parameters of intensive treatments for AN. We therefore explored clinicians’ perspectives and experience of supporting adults with severe AN in intensive settings. Methods We conducted twenty one semi-structured interviews with clinicians who deliver intensive treatments (i.e., IP and/or DP) for individuals with severe AN across four specialist Eating Disorder Services in the United Kingdom between May 2020 and June 2021. We asked clinicians about their views and experiences of supporting individuals with severe AN in intensive treatment settings and the challenges and opportunities associated with IP and DP treatment. Data were analysed using reflexive thematic analysis supported by NVivo software. Results Five broad and interrelated themes were identified: (1) Intensive Support; (2) The Severity of Patients’ Illnesses; (3) Hope and Recovery; (4) Which Treatment When; (5) Limited Resources; and (6) Carer Burden. We identified various similarities between the two intensive treatment approaches, including the value of intensive and multidisciplinary support and carer involvement, and the challenge of managing complex and unique needs in resource-limited intensive settings. We also found differences in the relationship of treatment to patients’ home environments, the necessity of patient motivation, and the management of risk. Conclusions Both intensive treatment settings are valued by clinicians; however, there are unique challenges and opportunities for supporting individuals with severe AN within each. Our findings suggest DP treatment may be used as an alternative to IP treatment for individuals with severe AN. However, clear questions remain over which intensive treatment setting is best suited to which patient when and should be the focus of future research.

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“…The process of externalizing equipped participants with tools to combat and hope for recovery. However, the patients without AV presence or unrealized co-existence could lead to fragmented self-identity and disorder denial, which prevents access to required external support (Graham et al, 2019;Ling et al, 2022).…”

Section: Thematic Analysismentioning

confidence: 99%

A Systematic Review of the Influence of Anorexic Voice on the Recovery of Anorexia Nervosa

Dev,

Williams

2024

Preprint

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BACKGROUND: Anorexia nervosa (AN) caused increased mortality, and high readmissions or relapse rates indicates a lack of psychological focus on current AN intervention. Pugh and Waller (2017) thematically analyzed the high frequency of inner-voice prevalent in the AN population, similar to voice hallucinations in other psychological disorders. These remained stigmatized and non-disclosed due to correlations with Schizophrenia. The emotional and psychological AV assisting novel AN intervention is needed. AIM: To review the relationship of AV with self and AN globally, with its influence on recovery using combined research methods. DESIGN: Inductive thematic analysis of qualitative evidence from included studies. The methodological quality and risk of bias assessments of different studies equipped with appropriate tools. SEARCH STRATEGY: Cochrane review, Ovid via MEDLINE, Embase, PubMed, CINAHL, Web of Science, PsychINFO, and ProQuest electronic databases searched for relevant studies selection. REVIEW METHODS: Nine studies (one cross-sectional, one systematic review, four qualitative, and three mixed methods) met the inclusion criterion set. The methodology quality and bias risk assessments employed selective appraisal tool for included combined research methods. All appraisal tools were carefully selected and followed for robust evidence synthesis. RESULTS: The thematic analysis concluded ‘Not one size fits all' and non-generalizable AV for different AN case. The fluctuating AV was studied subjectively since AN onset. The dissociation of AV in AN case significantly assures recovery. CONCLUSION: This review demonstrated improved recovery with better insights in AV’s relationship with patient and AV-inclusive therapies. The need for a novel AV-inclusive psychological therapeutic framework was analysed. The improved motivation, hope, support, and empathy assures treatment success. However, AV standardized framework for unidentified AV in AN patients can possibly trigger and worsen illness.

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Perceptions of the “anorexic voice”: A qualitative study of health care professionals

Cited by 8 publications

References 59 publications

Interviewing anorexia: How do individuals given a diagnosis of anorexia nervosa experience Voice Dialogue with their eating disorder voice? A qualitative analysis

Interviewing anorexia: How do individuals given a diagnosis of anorexia nervosa experience Voice Dialogue with their eating disorder voice? A qualitative analysis

Clinicians’ perspectives on supporting individuals with severe anorexia nervosa in specialist eating disorder intensive treatment settings

A Systematic Review of the Influence of Anorexic Voice on the Recovery of Anorexia Nervosa

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