The Individual Within a Condition: A Qualitative Study of Young People's Reflections on Being Treated for Anorexia Nervosa

Abstract

BACKGROUND: Anorexia nervosa is a mental health problem that can seriously impede the physical, social, and psychological functioning of those who develop it. Unfortunately, outcome for this patient group, even after treatment, is not necessarily promising. OBJECTIVE: To explore the views of young people about being treated for anorexia. STUDY: DESIGN: Qualitative interviews were conducted with 10 adolescents. All interviews were recorded with participants' written consent and transcribed verbatim. A thematic analysis was applied to these data. RESULTS: Five themes were derived from the analysis: a) accessing appropriate care, b) balancing the physical and psychological, c) qualities required in professionals, d) help from nonprofessional routes, and e) perceived progress. CONCLUSIONS: Participants were clear about needing to be motivated to change. Practitioners can help by challenging patients in a nonconfrontational manner, treating them as individuals rather than cases of anorexia, and considering their psychosocial and physical functioning. J Am Psychiatr Nurses Assoc, 2008; 13(6), 368.-375. DOI: 10.1177/1078390307309215

Keywords

anorexia nervosa treatment patients' views qualitative research interviews

Get full access to this article

View all access options for this article.

References

Bell, L. (2003). What can we learn from consumer studies and qualitative research in the treatment of eating disorders? Eating and Weight Disorders, 8, 181-187.

Beresin, E.V. , Gordon, C. , & Herzog, D.B. (1989). The process of recovering from anorexia nervosa . In J. R. Bemporad & D. B. Herzog (Eds.), Psychoanalysis and eating disorders. New York: Guilford .

Bowling, A. (2002). Research methods in health: Investigating health and health services (2nd ed.). Maidenhead, PA: Open University Press.

Button, E.J. , & Warren, R.L. (2001). Living with anorexia nervosa: The experience of a cohort of sufferers from anorexia nervosa 7.5 years after initial presentation to a specialized eating disorder service. European Eating Disorders Review, 9, 74-96.

Chisholm, K. (2002). Hungry hell: What it's really like to be anorexic: A personal story. London: Short Books.

Crisp, A. (1997). Anorexia nervosa as flight from growth: Assessment and treatment based on the model. In D. M. Garner & P. E. Garfinkel (Eds.), Handbook of treatment for eating disorders (2nd ed.). New York: Guilford.

Crisp, A.H. , Gelder, M.G. , Rix, S. , Meltzer, H.I. , & Rowlands, O.J. (2000). Stigmatisation of people with mental illnesses. British Journal of Psychiatry, 177, 4-7.

Fairburn, C.G. , & Harrison, P.J. (2003). Eating disorders. The Lancet, 361, 407-416.

Fathallah, J. (2006). Monkey taming. London: Definitions.

10.

Franko, D. (1997). Ready or not? Stages of change as predictors of brief group therapy outcome in bulimia nervosa. Group, 21, 39-45.

11.

Gowers, S. , & Bryant-Waugh, R. (2004). Management of child and adolescent eating disorders: The current evidence base and future directions . Journal of Child Psychology and Psychiatry, 45(1), 63-83.

12.

Gusella, J. , Butler, G. , Nichols, L. , & Bird, D. (2003). A brief questionnaire to assess readiness to change in adolescents with eating disorders: Its applications to group therapy. European Eating Disorders Review, 11(1), 58-71.

13.

Holliday, J. , Wall, E. , Treasure, J. , & Weinman, J. (2005). Perceptions of illness in individuals with anorexia nervosa: A comparison with lay men and women. International Journal of Eating Disorders, 37(1), 50-56.

14.

Hsu, L.K.G. , Crisp, A.H. , & Callender, J.S. (1992). Psychiatric diagnosis in recovered and unrecovered anorectics 22 years after onset of illness: A pilot study. Comprehensive Psychiatry, 33(2), 123-127.

15.

Lemberg, R. , & May, M. (1991). What works in inpatient treatment of eating disorders: The patient's point of view. British Review of Bulimia and Anorexia Nervosa, 5(1), 29-37.

16.

Lindsay, C. (2000). Conquering anorexia: The route to recovery. Chichester, UK: Summersdale.

17.

Macdonald, G. , & Sheldon, B. (1997). Community care for the mentally ill: Consumers' views. International Journal of Social Psychiatry, 43(1), 35-55.

18.

Maykut, P. , & Morehouse, R. (1994). Beginning qualitative research: A philosophic and practical guide. London and New York: Falmer.

19.

Mays, N. , & Pope, C. (1996). Rigour and qualitative research. In N. Mays & C. Pope (Eds.), Qualitative research in health care. London: BMJ.

20.

Menzie, M. (2003). Diary of an anorexic girl. Nashville, TN: W Publishing Group.

21.

Mond, J.M. , Robertson-Smith, G. , & Vetere, A. (2006). Stigma and eating disorders: Is there evidence of negative attitudes towards anorexia nervosa among women in the community? Journal of Mental Health, 15(5), 519-532.

22.

Nielsen, S. , & Bara-Carril, N. (2003). Family burden of care, and social consequences. In J. Treasure , U. Schmidt , & E. Van Furth (Eds.), Handbook of eating disorders (2nd ed.). Chichester, UK: John Wiley and Sons.

23.

Nilsson, K. , & Hagglof, B. (2006). Patient perspectives of recovery in adolescent onset anorexia nervosa. Eating Disorders: The Journal of Treatment and Prevention, 14(4), 305-311.

24.

Pope, C. , & Mays, N. (1996). Qualitative methods in health and health services research. In N. Mays & C. Pope (Eds.), Qualitative research in health care. London: BMJ.

25.

Ramjan, J.M. (2004). Nurses and the “therapeutic relationship”: Caring for adolescents with anorexia nervosa. Journal of Advanced Nursing, 45(5), 495-503.

26.

Rosenvinge, J.H. , & Klusmeier, A.K. (2000). Treatment for eating disorders from a patient satisfaction perspective: A Norwegian replication of a British study. European Eating Disorders Review, 8, 293-300.

27.

Russell, G.F.M. , Szmukler, G.I. , Dare, C. , & Eisler, I. (1987). An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives of General Psychiatry, 44, 1047-1056.

28.

Sharkey-Orgnero, M.I. (1999). Anorexia nervosa: A qualitative analysis of parents' perspectives on recovery. Eating Disorders: The Journal of Treatment and Prevention, 7(2), 123-141.

29.

Shattell, M. , McAllister, S. , Hogan, B. , & Thomas, S. (2006). “She took the time to make sure she understood”: Mental health patients' experiences of being understood. Archives of Psychiatric Nursing, 20(5), 234-241.

30.

Smith, J.A. , Harre, R. , & Van Langenhare, L. (1995). Rethinking methods in psychology. London: Sage.

31.

Steinhausen, H.C. , Rauss-Mason, C. , & Seidel, R. (1991). Follow-up studies of anorexia nervosa: A review of four decades of outcome research. Psychological Medicine , 21, 447-454.

32.

Stewart, M.C. , Keel, P.K. , & Schiavo, R.S. (2006). Stigmatization of anorexia nervosa. International Journal of Eating Disorders, 39, 320-325.

33.

Tierney, S. , & Wyatt, K. (2005). What works for adolescents with anorexia nervosa? A systematic review of psychosocial interventions. Eating and Weight Disorders, 10(2), 66-75.

34.

Tozzi, F. , Sullivan, P.F. , Fear, J.L. , McKenzi, J. , & Bulik, C.M. (2003). Causes and recovery in anorexia nervosa: The patient's perspective. International Journal of Eating Disorders, 33(2), 143-154.

35.

Treasure, J. , Katzman, M. , Schmidt, U. , Troop, N. , Todd, G. , & de Silva, P. (1999). Engagement and outcome in the treatment of bulimia nervosa: First phase of a sequential design comparing motivation enhancement therapy and cognitive behavioural therapy. Behavior Research and Therapy, 37, 405-418.

36.

Treasure, J. , & Kordy, H. (1998). Evidence based care of eating disorders: Beware the glitter of the randomised controlled trial. European Eating Disorders Review, 6(2), 85-95.

37.

Vitousek, K. , Watson, S. , & Wilson, G.T. (1998). Enhancing motivation for change in treatment resistant eating disorders. Clinical Psychology Review, 18(4), 391-400.

38.

Weltzin, T.E. , Weisensel, N. , Franczyk, D. , Burnett, K. , Klitz, C. , & Bean, P. (2005). Eating disorders in men: Update. Journal of Men's Health & Gender, 2(2), 186-193.