Improving the quality of care for people with eating disorders

Feb 2, 2017 | News

Eating Disorders Awareness Week (EDAW) is recognized in February each year. Last year, we talked with Dr. Josie Geller, director of research, St. Paul’s Hospital Eating Disorders Program, to learn more about common misconceptions about eating disorders.

This year, Dr. Geller has shared with us some of the research she's working on to help improve the quality of care for people with eating disorders.

Collaborative versus directive care
In 2016, Dr. Geller co-authored four research publications focusing on collaborative approaches to improving the quality of care for people with eating disorders. A collaborative approach is care that is free of assumptions or judgments and fosters autonomy by offering patients choices. Directive care, on the other hand, is hierarchical in nature and may involve demands or unsolicited opinions. Dr. Geller’s work has shown that a collaborative approach used by clinicians and carers is linked to higher satisfaction and to more favourable treatment outcomes in individuals with eating disorders.

Currently, Dr. Geller is investigating ways to increase collaborative relationships in both clinical settings and in the relationships individuals with eating disorders have with their loved ones. Despite viewing collaborative support as most helpful, Dr. Geller has found that it is common for both carers and clinicians to be directive. Her team is exploring ways to help us be more collaborative.

Exploring helpful and unhelpful treatment of adolescents with eating disorders
She is a co-author in one study investigating aspects of treatment that adolescents find helpful and unhelpful. It was found that adolescents experienced their quality of care to be greatest when care providers avoided assumptions and judgments, showed interest in aspects other than the adolescent’s eating disorder, and included the adolescent in decision-making.

New tools to assess carers' beliefs and behaviours
Dr. Geller is also co-author of a study involving the development of two new self-report scales that assess carers’ beliefs and behaviours about collaborative versus directive support. These psychometrically sound tools are helping researchers understand the impact that collaborative versus directive care has on treatment effectiveness and determine factors that are associated with using a more collaborative stance.

Using these new tools, Dr. Geller and her team found that carers’ beliefs, interpersonal style, and experience of closeness and history of positive experiences were associated with their ability to maintain a collaborative stance with their loved ones. These findings are being used to enhance interventions for loved ones by exploring carers’ beliefs in treatment, have opportunities to increase awareness of their style, and encouraging them to spend time with their loved ones where the focus is not the eating disorder.

Short Treatment Allocation Tool for Eating Disorders (STATED)
Finally, with colleagues from across the country, Dr. Geller has worked on applications of collaboration at a health service delivery level. She developed an empirically based algorithm, the Short Treatment Allocation Tool for Eating Disorders, or STATED, which incorporates medical stability, symptom severity, and patient engagement information. The STATED is the first of its kind to formally include patient readiness and engagement into treatment decision-making, thus ensuring that patients and clinicians collaboratively determine “right treatment, right patient, right time.”

Dr. Geller is a Scientist at the Centre for Health Evaluation and Outcome Sciences (CHÉOS), Associate Professor of the UBC Department of Psychiatry, and the Director of Research of the St. Paul’s Hospital Eating Disorders Program.

See all of the ways you can participate in EDAW 2017

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