Abstract

Objectives: 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. Methods: 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 (n = 10) and women receiving treatment (n = 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. Results: 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. Conclusions: 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.

摘要

目标：饮食和物质使用障碍（SUD）通常分开治疗，而在物质使用治疗中饮食障碍（ED）被忽视。SUD 和 ED 频繁同时发生是有据可查的。尽管它们有许多相似之处并且经常同时出现，但这两种疾病类型在很大程度上仍然是分开治疗的——要么依次治疗，首先解决最严重的疾病，要么同时治疗，但在单独的项目中。因此，我们的研究针对患者和提供者对 ED 和 SUD 综合治疗需求的数据空白做出了回应，以具有 ED 和 SUD 生活经验的女性的观点为中心，以支持治疗计划中女性治疗小组的发展。方法：本研究旨在进行需求和资产评估，以确定同时患有 ED 和 SUD 的女性制定团体计划的需求和优先事项。需求评估的参与者包括工作人员 ( n  = 10) 和接受治疗的妇女 ( n  = 10)，她们是从加拿大不列颠哥伦比亚省针对 SUD 妇女的 90 天住院治疗计划中招募的。对参与者进行的访谈和焦点小组进行了录音并逐字转录。使用 Dedoose 软件对数据进行主题分析和编码。结果：六个关键主题从定性数据中出现，并被组织成带有子主题的部分。工作人员和项目参与者的首要前提是需要同时进行治疗规划、营养支持和医疗监测。得出的六个独立主题包括 ED 和 SUD 之间的相似之处、治疗方面的差距、社区支持、家庭参与、项目参与者治疗建议、工作人员治疗建议和家庭参与。结论：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疾病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，并表明追求同步治疗设计可能有助于解决未满足的计划参与者的需求，并可以提供更全面的康复框架。