Sara Wetzler1, Corinna Hackmann2,3, Guy Peryer4,5, Kelsey Clayman6, Donna Friedman7, Kristina Saffran8, Jody Silver9, Margaret Swarbrick10, Elizabeth Magill11, Eric F van Furth12,13, Kathleen M Pike11. 1. Department of History of Science, Harvard University, Cambridge, Massachusetts, USA. 2. Department of Research and Development, Norfolk and Suffolk Foundation Trust, Norfolk, UK. 3. Norwich Medical School, University of East Anglia, Norfolk, UK. 4. School of Health Sciences, University of East Anglia, Norfolk, UK. 5. St. Nicholas Hospice Care, Suffolk, UK. 6. Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York, USA. 7. Project Heal, East Cooper Behavioral Health, Mount Pleasant, South Carolina, USA. 8. Project Heal, Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA. 9. Collaborative Support Programs of New Jersey, Freehold, New Jersey, USA. 10. Collaborative Support Programs of New Jersey, Rutgers Health University Behavioral Health Care, Piscataway, New Jersey, USA. 11. Global Mental Health WHO Collaborating Centre, Columbia University Irving Medical Center, New York City, New York, USA. 12. Leiden University Medical Center, Leiden, The Netherlands. 13. Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands.
Abstract
BACKGROUND: An extensive literature exists describing treatment interventions and recovery from eating disorders (EDs); however, this body of knowledge is largely symptom-based and from a clinical perspective and thus limited in capturing perspectives and values of individuals with lived experience of an ED. In this study, we performed a systematic review to coproduce a conceptual framework for personal recovery from an ED based on primary qualitative data available in published literature. METHODS: A systematic review and qualitative meta-synthesis approach was used. Twenty studies focusing on ED recovery from the perspective of individuals with lived experience were included. The studies were searched for themes describing the components of personal recovery. All themes were analyzed and compared to the established connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (CHIME) and Substance Abuse and Mental Health Services Administration (SAMHSA) frameworks of recovery, which are applicable to all mental disorders. Themes were labeled and organized into a framework outlining key components of the ED personal recovery process. RESULTS: Supportive relationships, hope, identity, meaning and purpose, empowerment, and self-compassion emerged as the central components of the recovery process. Symptom recovery and its relationship to the personal recovery process are also significant. DISCUSSION: Individuals with lived experience of EDs noted six essential elements in the personal ED recovery process. This framework is aligned with several of the key components of the CHIME and SAMHSA frameworks of recovery, incorporating person-centered elements of the recovery process. Future research should validate these constructs and develop instruments (or tools) that integrate the lived experiences into a measurement of recovery from an ED.
BACKGROUND: An extensive literature exists describing treatment interventions and recovery from eating disorders (EDs); however, this body of knowledge is largely symptom-based and from a clinical perspective and thus limited in capturing perspectives and values of individuals with lived experience of an ED. In this study, we performed a systematic review to coproduce a conceptual framework for personal recovery from an ED based on primary qualitative data available in published literature. METHODS: A systematic review and qualitative meta-synthesis approach was used. Twenty studies focusing on ED recovery from the perspective of individuals with lived experience were included. The studies were searched for themes describing the components of personal recovery. All themes were analyzed and compared to the established connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (CHIME) and Substance Abuse and Mental Health Services Administration (SAMHSA) frameworks of recovery, which are applicable to all mental disorders. Themes were labeled and organized into a framework outlining key components of the ED personal recovery process. RESULTS: Supportive relationships, hope, identity, meaning and purpose, empowerment, and self-compassion emerged as the central components of the recovery process. Symptom recovery and its relationship to the personal recovery process are also significant. DISCUSSION: Individuals with lived experience of EDs noted six essential elements in the personal ED recovery process. This framework is aligned with several of the key components of the CHIME and SAMHSA frameworks of recovery, incorporating person-centered elements of the recovery process. Future research should validate these constructs and develop instruments (or tools) that integrate the lived experiences into a measurement of recovery from an ED.
Authors: Yasmina Silén; Pyry N Sipilä; Anu Raevuori; Linda Mustelin; Mauri Marttunen; Jaakko Kaprio; Anna Keski-Rahkonen Journal: Eur Eat Disord Rev Date: 2021-05-18