Clinician experiences of treating eating disorders and the use of clinical supervision

Objective: Clinicians working with individuals with eating disorders encounter unique emotional, cognitive and behavioural responses. Such responses may impact on clinician self-care and wellbeing, and are linked to clinician burnout and poor treatment outcomes. Supervision can protect against such deleterious consequences. At present there is limited theoretical literature and no empirical literature relating to the supervision of eating disorder clinicians.

Method: A three round Delphi Methodology was employed to explore the experiences of clinicians from a range of professional backgrounds who work therapeutically with individuals with anorexia nervosa, along with the role of supervision and relevant key supervision requirements.

Results: Positive experiences were more frequently reported than negative experiences. Key negative emotions comprised sadness, anxiety, frustration and inadequacy. The impact on clinicians thinking about food and their own body-image were divergent.
A large number of statements reflecting the core elements of supervision including areas of discussion, reflection, outcomes, supervisor qualities, the supervisory relationship, barriers and facilitators reached consensus. No consensus was reached regarding discussing clinicians’ thoughts about food, body-image or personal eating disorder history.

Discussion: Implications for clinical practice include using these findings to challenge persistent beliefs that individuals with anorexia nervosa are undesirable to treat, and to help identify appropriate support where challenging experiences arise. Results relating to supervision can form the basis of future supervision guidelines in this field. Study limitations and implications for future research are discussed.