New Directions in Eating Disorders Treatment: Introducing Our Virtual Parent Training Course

From increases in depression and anxiety symptoms (Hawes et al., 2021) to rising rates of adolescent suicide attempts (Yard et al., 2021), youth experienced a plethora of adverse mental health effects as a result of the pandemic. Eating disorders were no exception. Treatment waitlists grew quickly (Nuffield Trust, 2022), and hotlines for organizations like the United States’ National Eating Disorders Association (NEDA) and Canada’s National Eating Disorders Information Centre were flooded with requests for support (Martinson, 2020; Kindelan, 2020). Studies confirmed that steep increases in child and adolescent eating disorders were occurring across the globe (Kuriso et al., 2022; Taquet et al., 2021), resulting in rapid increases in emergency department visits (Toulany et al., 2022; Springall et al., 2021) and eating disorder hospitalizations among youth (Haripersad et al., 2020; Otto et al., 2021; Toulany et al., 2022)

While the healthcare system as a whole is greatly overwhelmed, the eating disorders treatment landscape is especially unequipped to meet the rising demand for care. This unmet demand highlighted and exacerbated pre-existing treatment access issues in the eating disorders field including a lacked of trained eating disorder providers and significant geographic and sociodemographic barriers to specialized, evidence-based care. An unacceptable consequence of these barriers is that the majority of people who need eating disorder treatment never actually receive it (Hart et al., 2011), despite the existence of effective treatments (Costa & Melnik, 2016; Couturier, Kimber, & Szatmari, 2013; Grilo, Reas, & Mitchell, 2016; Lock, 2015). This creates a system in which patients, at best, only receive treatment when the eating disorder has significantly progressed, and, at worst, never receive treatment at all. For many, particularly BIPOC (Mikhail & Klump, 2020) and people of low socioeconomic status (Sonneville & Lipson, 2018), treatment access issues persist even as the need for care becomes critical. This is extremely problematic, because longer durations of illness are associated with worse prognoses (Pike et al., 1998; Steinhousen & Weber, 2009). Simply put, time is of the essence when it comes to eating disorder recovery, and people are being denied their best opportunity to recover. 

Fortunately, the pandemic served as a catalyst for much-needed changes to the eating disorders treatment landscape. An interstate compact allowing psychologists in the United States to practice telemedicine across state licensure lines was implemented in 30 states (psypact.site-ym.com), allowing patients in geographic regions with limited access to care to be seen by out-of-state specialists. Exclusively virtual eating disorder treatment programs were created, and many in-person programs began to offer virtual treatment options. At the UCSD Eating Disorders Center, we ran eight virtual rounds of our one-week intensive multifamily treatment program (Kaye et al., 2014; Marzola et al., 2015; Wierenga et al., 2018), allowing families to skip the travel and lodging costs and practice implementing pro-recovery behaviors in their typical environments. 

In 2020, we were granted the NEDA Feeding Hope Fund for Clinical Research as part of NEDA’s mission to advance innovative treatment development efforts. Our goal was simply to provide as many people as possible with treatment that works. To do so, we set out to create a self-guided resource that was affordable, easily accessible, and based on empirically-supported models of eating disorders treatment. With those goals in mind, we created a comprehensive virtual training course for parents of children and adolescents with anorexia nervosa. The course is based on the principles of Family-Based Treatment (FBT), the gold-standard treatment for youth with anorexia (National Institute for Health & Care Excellence, 2017), and Temperament-Based Treatment with Supports (TBT-S), which focuses on understanding temperament and personality traits to facilitate recovery (Hill, Knatz Peck, & Wierenga, 2022; Kaye et al., 2014). The course is designed to help parents better understand eating disorders and learn and implement skills to help their child recover. Unlike traditional treatment, the course content is delivered through brief videos featuring clinicians, researchers, and experts by lived experience as well as accompanying handouts to help apply material at home. While the course is not a replacement for treatment, we believe it could be particularly beneficial for parents who are not connected with a Family-Based Treatment provider. 

It is important to us to scientifically evaluate our course. If you are a parent of a child or adolescent with anorexia nervosa (diagnosed or suspected), we invite you to participate in our study.  As a study participant, you gain access to our virtual parent training course and will be asked to complete online questionnaires about your experiences with the course and your child’s weight and symptoms over time. We know parent feedback is integral to continuously improving our course, and, ultimately, helping families. If you are interested in participating in the study, please email Terra Towne, Ph.D. at ttowne@health.ucsd.edu. 

No family should have to navigate eating disorder recovery alone, but the unfortunate reality is that many families do. We could not be more grateful to NEDA for supporting our efforts to change this. While there is much more work to be done to ensure treatment access for all, we are proud to have created a resource that delivers expert knowledge with passion and empathy and provides parents with skills and strategies that are often gatekept from people without access to specialized care.