Therapists' experiences with a new treatment combining physical exercise and dietary therapy (the PED-t) for eating disorders: an interview study in a randomised controlled trial at the Norwegian School of Sport Sciences

Maria Bakland, Jorunn Sundgot-Borgen, Rolf Wynn, Jan H Rosenvinge, Annett Victoria Stornæs, Gunn Pettersen, Maria Bakland, Jorunn Sundgot-Borgen, Rolf Wynn, Jan H Rosenvinge, Annett Victoria Stornæs, Gunn Pettersen

Abstract

Objectives: The aim of the current study is to explore how therapists running a guided physical exercise and dietary therapy programme (PED-t) experience their contribution to the treatment of patients with bulimia nervosa and binge eating disorder.

Methods: Ten therapists running the PED-t were semistructurally interviewed and the transcribed interviews were analysed using a systematic text condensation approach.

Setting: The study was run within the context of a randomised controlled trial at the Norwegian School of Sport Sciences.

Results: The therapists experienced their knowledge about physical exercise and nutrition as important and useful, and that they could share their knowledge with the patients in different ways and with confidence in their own role. They also believed that their knowledge could serve as tools for the patients' post-treatment recovery and management of their daily lives. Moreover, the therapists put much effort in adjusting their teaching to fit each individual participant. Finally, they reported their personal qualities as important to build trust and therapeutic alliance.

Conclusions: The terms 'clinical confidence' and 'alliance' may stand out as the overarching 'metacategories' covering the experiences revealed in this study. The clinical implication is that new groups of professionals may have an important role in the treatment of eating disorders.

Trial registration number: NCTO2079935; Results.

Trial registration: ClinicalTrials.gov NCT02079935.

Keywords: eating disorders; mental health; qualitative research.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

References

    1. Fichter MM, Quadflieg N, Hedlund S. Long-term course of binge eating disorder and bulimia nervosa: relevance for nosology and diagnostic criteria. Int J Eat Disord 2008;41:577–86. 10.1002/eat.20539
    1. Keel PK, Brown TA. Update on course and outcome in eating disorders. Int J Eat Disord 2010;43:195–204. 10.1002/eat.20810
    1. Vall E, Wade TD. Predictors of treatment outcome in individuals with eating disorders: a systematic review and meta-analysis. Int J Eat Disord 2015;48:946–71. 10.1002/eat.22411
    1. Treasure J, Claudino AM, Zucker N, et al. . Eating disorders. Lancet 2010;375:583–93. 10.1016/S0140-6736(09)61748-7
    1. Sundgot-Borgen J, Rosenvinge JH, Bahr R, et al. . The effect of exercise, cognitive therapy, and nutritional counseling in treating bulimia nervosa. Med Sci Sports Exerc 2002;34:190–5. 10.1097/00005768-200202000-00002
    1. Mathisen TF, Rosenvinge JH, Pettersen G, et al. . The PED-t trial protocol: The effect of physical exercise and dietary therapy compared with cognitive behavior therapy in treatment of bulimia nervosa and binge eating disorder. BMC Psychiatry 2017;17:180 10.1186/s12888-017-1312-4
    1. Clinton D, Björck C, Sohlberg S, et al. . Patient satisfaction with treatment in eating disorders: cause for complacency or concern? Eur Eat Disord Review 2004;12:240–6. 10.1002/erv.582
    1. Newton T, Hartley P, Sturmey P. Treatment evaluation for eating disorders by clients with eating disorders. Beh Cogn Psychother 1993;21:371–4. 10.1017/S1352465800011693
    1. Rosenvinge JH, Klusmeier AK. Treatment for eating disorders from a patient satisfaction perspective: a Norwegian replication of a British study. Eur Eat Disord Rev 2000;8:293–300. 10.1002/1099-0968(200008)8:4<293::AID-ERV346>;2-4
    1. Swain-Campbell NR, Surgenor LJ, Snell DL. An analysis of consumer perspectives following contact with an eating-disorders service. Aust N Z J Psychiatry 2001;35:99–103. 10.1046/j.1440-1614.2001.00855.x
    1. Bell L. What can we learn from consumer studies and qualitative research in the treatment of eating disorders? Eat Weight Disord 2003;8:181–7. 10.1007/BF03325011
    1. de la Rie S, Noordenbos G, Donker M, et al. . Evaluating the treatment of eating disorders from the patient’s perspective. Int J Eat Disord 2006;39:667–76. 10.1002/eat.20317
    1. Pettersen G, Rosenvinge JH, Wynn R. Eating disorders and psychoeducation--patients’ experiences of healing processes. Scand J Caring Sci 2011;25:12–8. 10.1111/j.1471-6712.2010.00783.x
    1. Pettersen G, Thune-Larsen KB, Wynn R, et al. . Eating disorders: challenges in the later phases of the recovery process: a qualitative study of patients’ experiences. Scand J Caring Sci 2013;27:92–8. 10.1111/j.1471-6712.2012.01006.x
    1. Vanderlinden J, Buis H, Pieters G, et al. . Which elements in the treatment of eating disorders are necessary “ingredients” in the recovery process? A comparison between the patient’s and therapist’s view. Eur Eat Disord Rev 2007;15:357–65. 10.1002/erv.768
    1. de la Rie S, Noordenbos G, Donker M, et al. . The quality of treatment of eating disorders: a comparison of the therapists’ and the patients’ perspective. Int J Eat Disord 2008;41:307–17. 10.1002/eat.20494
    1. Graves TA, Tabri N, Thompson-Brenner H, et al. . A meta-analysis of the relation between therapeutic alliance and treatment outcome in eating disorders. Int J Eat Disord 2017;50:323–40. 10.1002/eat.22672
    1. Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health 2012;40:795–805. 10.1177/1403494812465030
    1. Oliver S, Liabo K, Stewart R, et al. . Public involvement in research: making sense of the diversity. J Health Serv Res Policy 2015;20:1–7. 10.1177/1355819614551848
    1. Webb CA, Derubeis RJ, Barber JP. Therapist adherence/competence and treatment outcome: A meta-analytic review. J Consult Clin Psychol 2010;78:200–11. 10.1037/a0018912
    1. Pettersen G, Rosenvinge JH, Thune-Larsen KB, et al. . Clinical confidence following an interprofessional educational program on eating disorders for health care professionals: a qualitative analysis. J Multidiscip Healthc 2012;5:201 10.2147/JMDH.S33089
    1. Thompson-Brenner H, Satir DA, Franko DL, et al. . Clinician reactions to patients with eating disorders: a review of the literature. Psychiatr Serv 2012;63:73–8. 10.1176/appi.ps.201100050
    1. Horvath AO, Del Re AC, Flückiger C, et al. . Alliance in individual psychotherapy. Psychotherapy 2011;48:9–16. 10.1037/a0022186
    1. Fairburn CG, Patel V. The global dissemination of psychological treatments: a road map for research and practice. Am J Psychiatry 2014;171:495–8. 10.1176/appi.ajp.2013.13111546
    1. Fairburn CG, Patel V. The impact of digital technology on psychological treatments and their dissemination. Behav Res Ther 2017;88:19–25. 10.1016/j.brat.2016.08.012
    1. Fairburn CG, Wilson GT. The dissemination and implementation of psychological treatments: problems and solutions. Int J Eat Disord 2013;46:516–21. 10.1002/eat.22110
    1. Montgomery EC, Kunik ME, Wilson N, et al. . Can paraprofessionals deliver cognitive-behavioral therapy to treat anxiety and depressive symptoms? Bull Menninger Clin 2010;74:45–62. 10.1521/bumc.2010.74.1.45

Source: PubMed

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