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Compulsory treatment in eating disorders: Control, provocation, and the coercion paradox
Author(s) -
Túry Ferenc,
Szalai Tamás,
Szumska Irena
Publication year - 2019
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.22783
Subject(s) - coercion (linguistics) , cognitive reframing , denial , psychology , eating disorders , autonomy , psychotherapist , involuntary treatment , obligation , anorexia , resistance (ecology) , anorexia nervosa , family therapy , psychiatry , clinical psychology , medicine , mental health , ecology , philosophy , linguistics , political science , law , biology
In eating disorders, the denial of the illness is a central phenomenon. In the most severe forms of anorexia, compulsory treatment may be necessary. The professional acceptance of involuntary treatment is controversial due to the fact that the autonomy of the patient is juxtaposed with the obligation of the health care practitioner to save lives. This paper discusses the major practical and ethical considerations surrounding this controversy. In addition, case vignettes are used to illustrate various strategies to diminish client resistance and enhance motivation toward treatment. Involving the family is nearly always essential for the treatment of patients with eating disorders. In some cases, parental consultation (i.e., treatment without the client) can also be an option. Home visits, though rarely used, can reframe the therapeutic relationship and provide information about family functioning. In general, a lower level of treatment coercion can be achieved through transparent client‐parent and client‐therapist communication.