Associations between therapy experiences and perceived helpfulness of treatment for people with eating disorders

Rahul Mital; Phillipa Hay; Janet E Conti; Haider Mannan

doi:10.1186/s40337-022-00601-1

Associations between therapy experiences and perceived helpfulness of treatment for people with eating disorders

J Eat Disord. 2022 Jun 14;10(1):80. doi: 10.1186/s40337-022-00601-1.

Authors

Rahul Mital¹, Phillipa Hay^{2

3

4}, Janet E Conti^{5

6}, Haider Mannan⁵

Affiliations

¹ School of Medicine, Western Sydney University, Locked Bag 1797 Penrith South 2715, Sydney, Australia.
² School of Medicine, Western Sydney University, Locked Bag 1797 Penrith South 2715, Sydney, Australia. p.hay@westernstdney.edu.au.
³ Translational Health Research Institute, Western Sydney University, Sydney, Australia. p.hay@westernstdney.edu.au.
⁴ South West Sydney Local Health District, Campbelltown, Australia. p.hay@westernstdney.edu.au.
⁵ Translational Health Research Institute, Western Sydney University, Sydney, Australia.
⁶ School of Psychology, Western Sydney University, Sydney, Australia.

Abstract

Background: Although eating disorders cause significant impairment to an individual's function, many people disengage from treatment. There is a paucity of literature that focuses on both positive and negative aspects of eating disorder treatment experiences as perceived by the experiencing person. This study aimed to identify the associations between features of therapy with perceived treatment helpfulness across individuals' most and least helpful treatment experiences.

Methods: An online cross-sectional survey was developed and disseminated, with the data of participants (n = 235) being utilised for statistical analyses, including multiple linear regressions.

Results: As predicted, factors in the therapeutic relationship such as the therapist's ability to instil a sense of hope, provide freedom of choice, understand the person, and address participant concerns had significant explanatory value in perceived treatment helpfulness. Contrary to our hypothesis, change being retrospectively identified as important or possible by the participant did not have a high degree of relation. These outcomes highlighted the significance of the therapeutic relationship in governing positive treatment experiences and responses. The results also suggested motivation to change when commencing treatment may not be strongly related to perceived treatment helpfulness and support further exploration.

Keywords: Feeding and eating disorders; Multivariate analysis; Patient participation; Regression analysis; Therapeutic alliance; Therapeutics; Treatment failure.

Plain language summary

Eating disorders can cause a large impact to the lives of those living with them and their loved ones. There is a need for research from the perspective of the individual with lived eating disorder experience to shape treatment for these conditions. This study aimed to address this need by investigating features of therapy and how they impacted the overall perception of treatment helpfulness. It was found that therapist related factors, such as providing freedom of choice around change and instilling hope, accounted for a large contribution to helpfulness. It was also found that motivation may not necessarily have to be high when commencing treatment to result in better ratings of treatment helpfulness.