Obstacles and facilitators of therapeutic alliance among adolescents with anorexia nervosa, their parents and their psychiatrists: A qualitative study.


Journal

Clinical child psychology and psychiatry
ISSN: 1461-7021
Titre abrégé: Clin Child Psychol Psychiatry
Pays: England
ID NLM: 9604507

Informations de publication

Date de publication:
Jan 2020
Historique:
pubmed: 28 10 2019
medline: 14 4 2020
entrez: 26 10 2019
Statut: ppublish

Résumé

Therapeutic alliance is one of the most important aspects of treatment of adolescents with anorexia nervosa. Little is known about the facilitators and obstacles of its process in this situation. We aimed to explore the experience of therapeutic alliance in inpatient treatment among adolescents with anorexia nervosa, their parents and their psychiatrists. This qualitative study, using semi-structured interviews, took place in France. Data collection by Forty-one participants were included, 15 teenaged girls, 18 parents and 8 psychiatrists. Analysis showed two themes: (1) what facilitates an alliance in treatment - with four facilitators: (a) human qualities, (b) an active role in the treatment, (c) taking time and (d) taking care of the entire family and (2) what impedes an alliance in treatment with four obstacles: (a) being too close or too distant, (b) focusing on weight, (c) control and constraints and (d) psychiatrization. Collaborative work between paediatricians and psychiatrists could facilitate therapeutic alliance with parents. Definition of therapeutic alliance in this situation should be enlarged to include the adolescent-parent relationship. It is necessary to construct specific items to integrate these specific aspects to existing scales.

Sections du résumé

BACKGROUND BACKGROUND
Therapeutic alliance is one of the most important aspects of treatment of adolescents with anorexia nervosa. Little is known about the facilitators and obstacles of its process in this situation. We aimed to explore the experience of therapeutic alliance in inpatient treatment among adolescents with anorexia nervosa, their parents and their psychiatrists.
METHODS METHODS
This qualitative study, using semi-structured interviews, took place in France. Data collection by
RESULTS RESULTS
Forty-one participants were included, 15 teenaged girls, 18 parents and 8 psychiatrists. Analysis showed two themes: (1) what facilitates an alliance in treatment - with four facilitators: (a) human qualities, (b) an active role in the treatment, (c) taking time and (d) taking care of the entire family and (2) what impedes an alliance in treatment with four obstacles: (a) being too close or too distant, (b) focusing on weight, (c) control and constraints and (d) psychiatrization.
CONCLUSION CONCLUSIONS
Collaborative work between paediatricians and psychiatrists could facilitate therapeutic alliance with parents. Definition of therapeutic alliance in this situation should be enlarged to include the adolescent-parent relationship. It is necessary to construct specific items to integrate these specific aspects to existing scales.

Identifiants

pubmed: 31648525
doi: 10.1177/1359104519882765
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

16-32

Auteurs

Jordan Sibeoni (J)

Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, France.
ECSTRRA Team, UMR-1153, Inserm, Université de Paris, France.

Laurence Verneuil (L)

ECSTRRA Team, UMR-1153, Inserm, Université de Paris, France.

Léa Poulmarc'h (L)

Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, France.

Massimiliano Orri (M)

McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Canada.
Bordeaux Population Health Research Center, INSERM U1219, University of Bordeaux, France.

Elise Jean (E)

Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, France.

Marc-Antoine Podlipski (MA)

Centre Hospitalier du Rouvray, Fédération Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Rouen - CH du Rouvray, France.

Priscille Gérardin (P)

Centre Hospitalier du Rouvray, Fédération Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Rouen - CH du Rouvray, France.

Anne Révah-Lévy (A)

Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, France.
ECSTRRA Team, UMR-1153, Inserm, Université de Paris, France.

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Classifications MeSH