Premature termination of eating disorder treatment - a qualitative study of therapist perspectives

Abstract

Background: High dropout rates are a problem in eating disorder treatment and the knowledge about how therapists who work in this field understand and intervene to reduce drop out is scarce. The aim of this study was to explore how therapists understand and work to prevent dropout during eating disorder treatment. Methods: Five focus group interviews with a total number of 17 therapists were conducted. The therapists all worked in specialized mental health care and had different occupational backgrounds, including psychologists, specialist nurses, and doctors. All of them reported receiving training in CBT-E. Transcripts were analysed using a reflexive thematic analysis. Results: Our analysis resulted in the development of three main themes: (1) Accepting dropout; (2) Balancing resources; and (3) Recognizing the demands of treatment. Conclusions: Our findings suggest that preparation for treatment is conceptualized by therapists as something quite separate from treatment itself and as crucial for preventing dropout and providing good treatment results. Interestingly, interventions and processes during treatment received much less focus in the discussions among therapists during the interviews. Trial registration: This project has been approved by Regional Committees for Medical and Health Research Ethics in Norway (REK), REK-number 55,304.