Clinician Perspectives on Barriers and Enablers to Autism-Affirming Eating Disorder Care.

IF 3.2 2区心理学 Q1 PSYCHIATRY

European Eating Disorders Review Pub Date : 2026-07-25 DOI:10.1002/erv.70157

Emy Nimbley, Amelia Austin, Kate Tchanturia, Kai Thomas, Catherine R G Jones, Karri Gillespie-Smith, Fiona Duffy

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引用次数: 0

Abstract

Objective: Autistic people with an eating disorder (ED) report more negative experiences of ED treatment and are at greater risk of requiring higher intensity services. Current ED treatment options do not fully meet underpinning drivers of autistic people's experiences of EDs. There remains little guidance or understanding on how autism-informed adaptations are implemented. This paper aims to explore clinician-perceived barriers and enablers to implementing autism-affirming adaptations in UK ED services.

Method: Semi-structured interviews were conducted with 12 clinicians in multidisciplinary roles across UK ED services who were beginning to implement autism-affirming care. Data were analysed using critical realist thematic analysis.

Results: Clinicians described many barriers associated with implementing autism-affirming care underpinned by longstanding beliefs about the risks of accommodating ED behaviours. This contributed to anxiety about making adaptations to care and the potential to over- or under-accommodate autistic needs. An underlying assumption that evidence-based practice solely equates to manualised treatment for EDs constrained adaptation. A commitment to individualised formulation and care, regardless of diagnosis, and valuing a diverse multidisciplinary team were key enablers. System-level barriers included siloed autism and ED resources and training.

Conclusions: Autism-affirming adaptations challenge some core underpinning messages historically embedded in siloed ED services.

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临床医生对自闭症确认饮食失调护理的障碍和促进因素的看法。

目的：患有进食障碍（ED）的自闭症患者报告ED治疗的负面经历更多，并且需要更高强度服务的风险更大。目前的ED治疗方案并不能完全满足自闭症患者ED经历的基本驱动因素。关于如何实施与自闭症相关的适应措施，目前还没有多少指导或了解。本文旨在探讨在英国ED服务中实施自闭症确认适应的临床医生感知的障碍和推动因素。方法：对12名在英国ED服务中担任多学科角色的临床医生进行了半结构化访谈，他们开始实施自闭症确认护理。数据分析采用批判现实主义主题分析。结果：临床医生描述了许多与实施自闭症确认护理相关的障碍，这些障碍是由长期以来关于适应ED行为风险的信念所支撑的。这导致了对适应照顾和可能过度或不足适应自闭症需求的焦虑。一个潜在的假设是，循证实践完全等同于对急诊科的手动治疗，这限制了适应。对个性化配方和护理的承诺，无论诊断如何，以及重视多元化的多学科团队是关键的促成因素。系统层面的障碍包括孤立的自闭症和ED资源和培训。结论：自闭症确认适应挑战了一些历史上嵌入孤立ED服务的核心基础信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Eating Disorders Review PSYCHOLOGY, CLINICAL-

CiteScore

8.90

自引率

7.50%

发文量

期刊介绍： European Eating Disorders Review publishes authoritative and accessible articles, from all over the world, which review or report original research that has implications for the treatment and care of people with eating disorders, and articles which report innovations and experience in the clinical management of eating disorders. The journal focuses on implications for best practice in diagnosis and treatment. The journal also provides a forum for discussion of the causes and prevention of eating disorders, and related health policy. The aims of the journal are to offer a channel of communication between researchers, practitioners, administrators and policymakers who need to report and understand developments in the field of eating disorders.