Adolescent client views towards the treatment of anorexia nervosa: a review of the literature
Article first published online: 27 SEP 2011
© 2011 Blackwell Publishing
Journal of Psychiatric and Mental Health Nursing
Volume 19, Issue 6, pages 500–508, August 2012
How to Cite
WESTWOOD, L. M. and KENDAL, S. E. (2012), Adolescent client views towards the treatment of anorexia nervosa: a review of the literature. Journal of Psychiatric and Mental Health Nursing, 19: 500–508. doi: 10.1111/j.1365-2850.2011.01819.x
- Issue published online: 2 JUL 2012
- Article first published online: 27 SEP 2011
- Accepted for publication: 21 August 2011
- child and adolescent;
- eating disorders;
- mental health
- • Anorexia nervosa (AN) affects many young people but they can be reluctant to accept treatment. If we understood the views of young people with AN we might be able to develop more acceptable treatments. At the moment, most of what we know about their views is taken from studies of girls and young women.
- • For some young people, having AN means being able to control something, but AN can also be an illness that controls the person. Confusion about control is one of the things that make AN hard to treat.
- • It is difficult to find the right combination of treatments for the physical and psychological symptoms of AN. The research evidence we have does not offer enough guidance for clinicians.
- • Good relationships with clinicians can be difficult to achieve. Young people with AN want clinicians to look after them but at the same time they may resent it when clinicians tell them what to do. However, once they have recovered they often say that they needed firm treatment in order to get better.
This paper reviews current literature in which adolescents with anorexia nervosa (AN) were consulted about their views of their treatment. Published research was systematically retrieved and interrogated during 2009–2010 and analysed using a four-stage model. Eleven studies met the inclusion criteria. Three core themes were identified. AN was perceived as a means of taking control and also something that controlled the individual. Tensions were recognized between client preferences for psychological interventions and treatments that prioritized physical care. Therapeutic alliance emerged as a strategy for overcoming these difficulties but was challenged by client ambivalence towards treatment. Most included studies were qualitative. Young males and individuals who dropped out of treatment were underrepresented in the studies. Adolescents' perspectives on treatment for AN were characterized by paradoxes and tensions. Egosyntonic theory was used as a theoretical construct to interpret findings.