Scholarlink

<p>Premature discontinuation from eating disorder (ED) treatment is commonly interpreted through adherence, motivation, ambivalence, treatment fit, or symptom change. Wade and Schmidt make an important contribution by identifying seven strategies intended to improve retention and by moving beyond explanations located solely within the patient. They explicitly frame retention as a route through which people may obtain greater therapeutic benefit. This commentary argues that continued participation does not, by itself, establish benefit, safety, acceptability, treatment quality, or recovery. Some discontinuation may reflect treatment non-response or circumstances unrelated to care. In other cases, it may communicate poor treatment fit, coercion, relational rupture, cultural or identity-related misattunement, or iatrogenic harm. These possibilities cannot be distinguished reliably when adverse effects are poorly defined, inconsistently monitored, and inadequately reported, or when patient accounts of iatrogenic harm are discounted. We propose an expanded framework in which retention is evaluated alongside collaboratively defined benefit, treatment safety, reasons for staying and leaving, and patient-reported experiences during treatment and follow-up. Mixed-methods research, informed consent about potential negative effects, repeated confidential feedback, repair-oriented responses to reported harm, and lived experience-led co-production are required to determine whether care is safe and worth continuing. Retention records participation. Its clinical value depends on the care in which people are retained.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Iatrogenic harm and premature treatment discontinuation in eating disorders: a lived experience response to Wade and Schmidt (2026)

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月30日

查看全文
  • Laurence Cobbaert,
  • Rosiel Elwyn

摘要

Premature discontinuation from eating disorder (ED) treatment is commonly interpreted through adherence, motivation, ambivalence, treatment fit, or symptom change. Wade and Schmidt make an important contribution by identifying seven strategies intended to improve retention and by moving beyond explanations located solely within the patient. They explicitly frame retention as a route through which people may obtain greater therapeutic benefit. This commentary argues that continued participation does not, by itself, establish benefit, safety, acceptability, treatment quality, or recovery. Some discontinuation may reflect treatment non-response or circumstances unrelated to care. In other cases, it may communicate poor treatment fit, coercion, relational rupture, cultural or identity-related misattunement, or iatrogenic harm. These possibilities cannot be distinguished reliably when adverse effects are poorly defined, inconsistently monitored, and inadequately reported, or when patient accounts of iatrogenic harm are discounted. We propose an expanded framework in which retention is evaluated alongside collaboratively defined benefit, treatment safety, reasons for staying and leaving, and patient-reported experiences during treatment and follow-up. Mixed-methods research, informed consent about potential negative effects, repeated confidential feedback, repair-oriented responses to reported harm, and lived experience-led co-production are required to determine whether care is safe and worth continuing. Retention records participation. Its clinical value depends on the care in which people are retained.