Collaborative care in eating disorders treatment: exploring the role of clinician distress, self-compassion, and compassion for others.

Background: Collaborative care is described as showing curiosity and concern for patient experiences, providing choices, and supporting patient autonomy. In contrast, in directive care, the clinician has authority and the patient is expected to adhere to a treatment plan over which they have limited influence. In the treatment of eating disorders, collaborative care has been shown to be more acceptable and produce better outcomes than directive care.

Self-compassion and its barriers: predicting outcomes from inpatient and residential eating disorders treatment.

Background: Individuals with eating disorders (EDs) experience barriers to self-compassion, with two recently identified in this population: Meeting Standards, or concerns that self-compassion would result in showing flaws or lead to loss of achievements or relationships, and Emotional Vulnerability, or concerns that self-compassion would elicit difficult emotions such as grief or anger. This exploratory study examined the utility of self-compassion and two barriers to self-compassion in predicting clinical outcomes in intensive ED treatments.

Method: Individuals in inpatient (n = 87) and residential (n = 68) treatment completed measures of self-compassion and fears of self-compassion, and ten clinical outcome variables at pre- and post-treatment.

Path to practising self-compassion in a tertiary eating disorders treatment program: A qualitative analysis.

Objective: Although self-compassion has been shown to facilitate eating disorder (ED) remission, significant barriers to acquiring this skill have been identified. This is particularly true for tertiary care populations, where ED behaviours provide a valued identity and readiness issues are highly salient. In this research, the voices and perspectives of patients who have recovered as well as those in later stages of tertiary care treatment were captured using qualitative methods.

The relation between two barriers to self-compassion and clinical characteristics in individuals with eating disorders.

Unlabelled: There is growing support for the role of self-compassion in recovery from an eating disorder (ED) and two types of barriers have been identified in this population: (a) fears that self-compassion will result in a failure to meet personal and interpersonal standards (meeting standards); and (b) fears that self-compassion gives rise to difficult emotions such as grief and unworthiness (emotional vulnerability).

Objective: This research examined the relative contribution of meeting standards and emotional vulnerability barriers to the clinical characteristics of individuals with EDs.

Method: Participants (N = 349) completed the fears of compassion for self-scale, and measures of self-compassion, ED and psychiatric symptom severity, interpersonal and affective functioning, quality of life and readiness for ED change.

Is experiencing care as collaborative associated with enhanced outcomes in inpatient eating disorders treatment?

In eating disorders inpatient care, mandatory treatment components are central to effective service delivery. Thus, fostering a collaborative care environment that supports autonomy, competence, and connection can be challenging. This study examined whether collaborative care is associated with better outcomes in adult inpatient treatment and explored a possible determinant of collaborative care, the manner in which mandatory treatment components were delivered (e.

Barriers to self-compassion in the eating disorders: The factor structure of the fear of self-compassion scale.

Unlabelled: Individuals with eating disorders (EDs) endorse fears of being self-compassionate, as assessed by the Fears of Compassion for Self scale (FCSelf; Gilbert, McEwan, Matos, & Rivis, 2011), and higher fears predict poorer treatment outcomes. Previous research using the FCSelf demonstrated a single factor solution in a non-clinical sample.

Objectives: This research sought to explore the factor structure of the FCSelf in a clinical population and to examine correlations with associated constructs.

Is stage of change enough? Confidence as a predictor of outcome in inpatient treatment for eating disorders.

Objective: While stage of change has been shown to be a robust predictor of eating disorder treatment outcome, little attention has been paid to the role of confidence. This study sought to better understand the role of confidence and the possible interaction it may have with stage of change in promoting eating disorder symptom change.

Method: Participants were adult women in inpatient treatment for eating disorders.

The Short Treatment Allocation Tool for Eating Disorders: current practices in assigning patients to level of care.

Objective: The Short Treatment Allocation Tool for Eating Disorders ( is a new evidence-based algorithm developed to match patients to the most clinically appropriate and cost-effective level of care (Geller et al., 2016). The objective of this research was to examine the extent to which current practices are in alignment with recommendations.

The relation between patient characteristics and their carers' use of a directive versus collaborative support stance.

Objectives: Collaborative support provided by carers (family and friends) of individuals with eating disorders has been shown to be integral to patient motivation and clinical outcome. Little is known about factors that contribute to carers' use of collaborative, as opposed to directive, support stance. This exploratory research investigated associations between patient characteristics and carers' support beliefs and behaviors.

The readiness and motivation interview for families (RMI-Family) managing pediatric obesity: study protocol.

Background: Experts recommend that clinicians assess motivational factors before initiating care for pediatric obesity. Currently, there are no well-established clinical tools available for assessing motivation in youth with obesity or their families. This represents an important gap in knowledge since motivation-related information may shed light on which patients might fail to complete treatment programs.

Social support satisfaction in adults with eating disorders: Does stance matter?

Although the role of social support is clearly established in the recovery of youth with eating disorders, little is known about factors that contribute to support satisfaction and improved treatment outcome in adults. This study examined the contribution of patient factors and perceived support stance used by family and friends in determining social support satisfaction. Individuals meeting DSM-IV criteria for an eating disorder (n = 182) completed measures of eating disorder and psychiatric severity, interpersonal functioning, perceived support stance used by family and friends, and social support satisfaction.

Support stance in carers of adults with eating disorders: Factors associated with collaborative versus directive approaches.

Unlabelled: The support provided by family and friends is integral to patient motivation and clinical outcomes across health care populations. However, little is known about factors that promote or interfere with the type of support offered.

Objective: This research examined factors associated with collaborative versus directive support among carers of adults with eating disorders.

Developing and Pilot Testing the Readiness and Motivation Interview for Families in Pediatric Weight Management.

Clinical acumen is often used to assess families' motivation prior to initiating pediatric obesity management due to a lack of available tools. The purpose of this pilot study was to (i) develop and (ii) pilot test the "Readiness and Motivation Interview for Families" (RMI-Family) in pediatric weight management. We conducted 5 focus groups with parents (n = 15), youth with obesity (n = 11), and health care providers (n = 8) to explore perceptions of barriers to making healthy behaviour changes, which led to the creation of the RMI-Family as a semi-structured interview.

The psychometric properties of the Readiness and Motivation Questionnaire: a symptom-specific measure of readiness for change in the eating disorders.

Readiness for change, as assessed by the readiness and motivation interview (RMI), predicts a number of clinical outcome variables in eating disorders including enrollment in intensive treatment, symptom change, dropout, and relapse. Although clinically useful, the training and administration of the RMI is time consuming. The purpose of this research was to (a) develop a self-report, symptom-specific version of the RMI, the readiness and motivation questionnaire (RMQ), that can be used to assess readiness for change across all eating disorder diagnoses and (b) establish its psychometric properties.

The efficacy of a brief motivational intervention for individuals with eating disorders: a randomized control trial.

Objective: Individuals with eating disorders are often ambivalent about recovery, and previous research has shown that readiness for change predicts enrollment in intensive treatment, symptom change, dropout, and relapse. Given the demonstrated importance of readiness for change, researchers and clinicians have turned to investigating interventions designed to enhance motivation. The purpose of this research was to determine the efficacy of Readiness and Motivation Therapy (RMT), a five-session individual preparatory intervention for individuals with eating disorders.

Factors associated with improvements in readiness for change: low vs. normal BMI eating disorders.

Objective: To examine factors associated with improvements in readiness for change as a function of body mass index (BMI) in individuals assessed for eating disorders treatment.

Method: Participants (n = 128) completed the Readiness and Motivation Interview (RMI) and measures of psychiatric and eating disorder symptoms, quality of life, and self-esteem at baseline and at 5-month follow-up.

Results: Participants whose readiness for change showed improvements in psychiatric symptom severity, global self-esteem, and in the importance of friendships as a determinant of self-esteem.

Readiness to change dietary restriction predicts outcomes in the eating disorders.

This study examined the relationship between readiness and motivation to change eating disorder symptoms and clinical outcomes during and following intensive residential eating disorder treatment. Sixty-four women completed the Readiness and Motivation Interview (RMI) at baseline, and a subset of participants were reassessed at post-treatment (n=45) and at 6 month follow-up (n=38). The RMI provides readiness scores for each of four symptom domains: restriction, cognitive, bingeing, and compensatory strategies.

Beyond shape and weight: exploring the relationship between nonbody determinants of self-esteem and eating disorder symptoms in adolescent females.

Objective: Recent research using the Shape and Weight-Based Self-Esteem (SAWBS) Inventory has shown that basing self-esteem on shape and weight is related to eating disorder and psychiatric symptoms. This study examined the relationship between other determinants of self-esteem assessed in the SAWBS Inventory (e.g.