Research Review: Practitioners’ perspectives on ethical issues within the treatment of eating disorders: Results from a concept mapping study

By: Laurie Cooper, Psy.D., HSP, CED-S

It is widely agreed that Eating disorder practitioners face a number of ethical issues that are unique to the treatment of eating disorders.  In this study, practitioners from eating disorder specific professional listservs were given a prompt to “Generate statements (short phrases or sentences) that describe particular ethical issues that you, as a clinician, have faced or that you feel are pertinent to the treatment of patients with eating disorders”.  The authors then employed a method called concept mapping (a.k.a. Q-Sort) to have participants from multiple disciplines (psychologists, psychiatrists, counselors, social workers, general practitioner/internists/pediatrician, nutritionist/registered dietitians, student, and a nurse) categorize these statements and rate their frequency and impact on patient care.  

The most frequently occurring issues included those related to Lack of Evidence Based Practice, followed by Insurance Barriers, Insufficient Level of Care, Limited Access to Expertise, Patient Autonomy and Family Involvement.  Of these ethical issues, the participants rated Insurance Barriers as the most impactful on patient care, followed by, Patient Autonomy, Insufficient Leve of Care, Limited Access to expertise, Lack of Evidence Based Practice and Family Involvement.

The authors conclude that these findings suggest that overcoming insurance related barriers re: access to care and balancing patients’ autonomy and well-being should be the focus of future research and public policy efforts.  Additionally, they argue for a universally adopted standardized guidelines for ethical eating disorder treatment which would ensure greater access and equality in eating disorder treatment.