Clinician stance in the treatment of chronic eating disorders

Long-term outcome studies of anorexia nervosa have shown that a significant number of individuals do not fully recover from their eating disorder symptoms. Individuals who develop chronic eating disorders may express either strong ambivalence about symptom reduction or a complete lack of interest in change. As a result, clinicians can find this group particularly challenging. This report expands upon a treatment stance based on principles of Motivational Interviewing that addresses difficulties typically encountered in working with this population. The stance outlines a mission statement and specific clinician behaviours that promote engagement and alliance with this group, including the communication of beliefs that foster client self-acceptance, not making assumptions, being curious, active, and on the same side, and maximizing client responsibility for change. Copyright (C) 2001 John Wiley & Sons, Ltd and Eating Disorders Association.