Humphreys Elspeth, Ladner Tessa, van Draanen Jenna
Eating Disorders Program, Fraser Health Authority, Delta, Canada.
British Columbia Centre on Substance Use, Vancouver, Canada.
J Dual Diagn. 2023 Apr-Sep;19(2-3):153-165. doi: 10.1080/15504263.2023.2192175. Epub 2023 Mar 28.
Eating and substance use disorders (SUD) are generally treated separately, leaving eating disorders (ED) overlooked within substance use treatment. The frequent co-occurrence of SUD and ED is well documented. Despite their many similarities and frequent co-occurrence, these two disorder types continue to be largely treated separately-either sequentially, with the most severe disorder addressed first, or concurrently but in separate programs. Our study, therefore, responds to this lacuna of data on patient and provider treatment needs for integrated ED and SUD treatment, centering the perspectives of women with lived experience of ED and SUD to support the development of therapeutic groups for women in treatment programs. This study was designed as a needs and assets assessment to determine the needs and priorities of women with concurrent ED and SUD for developing group programs. Participants for the needs assessment included both staff members ( = 10) and women receiving treatment ( = 10) who were recruited from a 90-day residential treatment program for women with SUD in British Columbia, Canada. Interviews and focus groups conducted with participants were audio-recorded and transcribed verbatim. Data were thematically analyzed and coded using Dedoose software. Six key themes emerged from the qualitative data and were organized into sections with sub themes. An overarching premise from both staff and program participants was the need for concurrent therapeutic programming, nutritional support, and medical monitoring. The six discrete themes that were elicited included the similarities between ED and SUD, gaps in treatment, community support, family involvement, program participant treatment suggestions, staff treatment suggestions, and family involvement. Throughout this qualitative study, the need for screening and assessment of both disorders along with integrated treatment was stressed by participants, both program participants and staff alike. These findings complement current literature and suggest that pursuing concurrent treatment design may be helpful in addressing unmet program participant needs and could provide a more holistic framework for recovery.
饮食和物质使用障碍（SUD）通常是分开治疗的，这使得饮食失调（ED）在物质使用治疗中被忽视。SUD和ED经常同时出现，这一点已有充分记录。尽管它们有许多相似之处且经常同时出现，但这两种障碍类型在很大程度上仍继续分开治疗——要么按顺序治疗，先治疗最严重的障碍，要么同时治疗但在不同的项目中。因此，我们的研究回应了关于综合ED和SUD治疗的患者及提供者治疗需求的数据空白，以有ED和SUD生活经历的女性的观点为中心，来支持治疗项目中针对女性的治疗小组的发展。本研究旨在进行需求和资产评估，以确定同时患有ED和SUD的女性在制定小组项目方面的需求和优先事项。需求评估的参与者包括工作人员（10名）和接受治疗的女性（10名），他们是从加拿大不列颠哥伦比亚省一个为期90天的针对患有SUD的女性的住院治疗项目中招募的。与参与者进行的访谈和焦点小组讨论进行了录音，并逐字转录。使用Dedoose软件对数据进行了主题分析和编码。定性数据中出现了六个关键主题，并被组织成带有子主题的章节。工作人员和项目参与者的一个总体前提是需要同时进行治疗性规划、营养支持和医疗监测。引出的六个离散主题包括ED和SUD之间的相似之处、治疗差距、社区支持、家庭参与、项目参与者的治疗建议、工作人员的治疗建议以及家庭参与。在整个定性研究中，项目参与者和工作人员都强调了对这两种障碍进行筛查和评估以及综合治疗的必要性。这些发现补充了当前的文献，并表明采用同时治疗设计可能有助于满足未得到满足的项目参与者需求，并可为康复提供一个更全面的框架。
