Experiences of intensive treatment settings for people with eating disorders

Eating disorders (EDs) are complex mental health difficulties that impact the individual, their supporters and society. Increasing numbers are being admitted into intensive treatment (i.e., inpatient, day-patient or acute medical settings). The lived experience perspective of what helps and hinders ED recovery during intensive treatment is an emerging area of interest. This review explored clients’ perspectives of what helps and hinders ED recovery during intensive treatment. A systematic literature search and quality appraisal yielded 30 published studies for inclusion. Thematic synthesis generated six themes; collaborative care; intensive environment; negotiating identity; focus on mind and body; specialist support; and support from others. This review identified that a person-centred, biopsychosocial approach is necessary throughout treatment, with support from a sufficiently resourced and adequately trained multidisciplinary team. Improving physical health remains fundamental, though psychological support is also essential to understand what causes and maintains the ED and facilitate a shift away from an ED-dominant identity. Carers and peers who instil hope and offer empathy and validation are valuable sources of support. Future research should explore what works best for whom and why, evaluating patient- and carer-focused psychological interventions and dietetic support, and should explore how to mitigate against potential harm during intensive treatment.