Community-based mealtime management for adolescents with anorexia nervosa: A qualitative study of clinicians' perspectives and experiences.

BACKGROUND AND OBJECTIVE: Community-based mealtime management is an intensive, focused, and time-limited intervention for young people with an eating disorder which aims to support refeeding at home and thus prevent hospital admission. Little is known about clinicians' experiences of delivering this intervention. We aimed to explore mental health clinicians' perspectives on community mealtime management with children and adolescents diagnosed with an eating disorder.

METHODS: A qualitative design was used. Semistructured interviews were conducted with six mental health clinicians with experience of delivering or referral for the intervention. Interview recordings were transcribed and subjected to a thematic analysis.

RESULTS: Analysis resulted in identification of three themes: (a) technical aspects of mealtime management, (b) emotional aspects of mealtime management, and (c) a mixed zone of uncertainty around the use of dietary supplements. Overall, participants believed mealtime management to be a valuable intervention.

CONCLUSIONS: Findings highlight the perceived need for more formal training for clinicians undertaking mealtime management, and the positive impact this could potentially have on their practice. Clinicians' emotion regulation during intervention delivery was perceived to be important. There was a perceived need for greater adherence to protocols but an acceptance that flexibility was also required.