The Nature of the Therapeutic Alliance between Nurses and Consumers with Anorexia Nervosa in the Inpatient Setting: A Mixed Methods Study

About this resource

Aims and Objectives: To develop a greater understanding of the nature of the inpatient therapeutic alliance between nurses and consumers with Anorexia Nervosa (AN). Background: Consumers with AN value interpersonal relationships with nurses, finding these relationships meaningful and therapeutic. It is established that the therapeutic alliance enhances outcomes for consumers with AN. However, establishing the therapeutic alliance in the inpatient setting is considered challenging. Design: This study employed a two-phase mixed method explanatory sequential design. An initial quantitative survey, phase one, was followed by the collection and analysis of qualitative data, phase two. Methods: Phase one employed validated survey instruments, measuring the perceived degree of therapeutic alliance and elements of ward milieu. Phase two involved semi-structured interviews that focused on therapeutic relationships between nurses and consumers, with specific exploration of the results from phase one. Data collection commenced May 2014 and concluded February 2015. Results: The therapeutic alliance involved interpersonal engagement and a balanced application of authority. In a therapeutic alliance, nurses cared for consumers with interpersonal finesse, whilst maintaining clear distinction between the consumer as an individual and AN as an illness. Nurses also developed a therapeutic alliance by occupying their position of power with consistent yet individualised expectations, and by maintaining appropriate professional boundaries. Conclusions: The therapeutic alliance between nurses and consumers with AN is not developed through negotiation of equal partners. Rather, the therapeutic alliance is dependent on nurses’ capacity to maintain their position of power, whilst demonstrating their trustworthiness to the consumer. In trusting nurses, consumers felt safer in investing in a new concept of wellbeing.

AuthorZugai, Joel S.; Stein-Parbury, Jane & Roche, Michael
JournalJournal of Clinical Nursing

See also

Neuromodulation in eating disorders and obesity: a promising way of treatment?

The Bar-BED and BED groups reported comparable levels of overall eating-disorder and depressive symptoms, and these levels were significantly higher than those levels reported by the OW/OB and Bar-LOC Only groups.

Read more

Biological therapies for eating disorders

OBJECTIVE: To provide a comprehensive review of pharmacotherapy and other biological treatments for eating disorders.

Read more

Perceived confidence, competence and training in evidence-based treatments for eating disorders: a survey of clinicians in an Australian regional health service.

OBJECTIVES: Eating disorders (EDs) are challenging to treat and contribute to considerable morbidity and mortality.

Read more

A comparison of stigma toward eating disorders versus depression

The goal of this study was to compare the degree of stigma associated with anorexia nervosa (AN), bulimia nervosa (BN), and depression.

Read more

Help us improve!

Give us feedback!

We will continue throughout 2020 to update and improve the NEDC website and welcome any feedback you may have on the site.

Provide feedback