Quality statement 2: Discussion about psychological treatment options

Quality statement

People with eating disorders have a discussion with a healthcare professional about their options for psychological treatment.

Rationale

Discussing psychological treatment options with people with eating disorders (and their parents or carer as appropriate) enables healthcare professionals to tailor care to suit the person's individual needs and preferences. Patient choice is important during these discussions. However, for some people there may be an additional need for clinical opinion, for example, people with high-risk anorexia nervosa can have avoidant behaviour so may have difficulty deciding on their treatment.

Quality measures

Structure

Evidence of local arrangements to provide psychological treatments for people with eating disorders.

Data source: Local data collection, for example, service specifications.

Process

Proportion of people with eating disorders who have a documented discussion with a healthcare professional about their options for psychological treatment at diagnosis.

Numerator – the number in the denominator who have a documented discussion with a healthcare professional about their options for psychological treatment at diagnosis.

Denominator – the number of people diagnosed with eating disorders.

Data source: Local data collection, for example, local audit of electronic records. 

What the quality statement means for different audiences

Service providers (such as community eating disorder teams, primary care, secondary care, tertiary care and non-NHS units) ensure that pathways are in place for people with eating disorders to have a discussion with a healthcare professional about their options for psychological treatment. Service providers should also ensure that healthcare professionals have training in discussing these options and have supervision with monitoring of competency.

Healthcare professionals (such as therapists specialising in eating disorders) discuss options for psychological treatment with people with eating disorders and support them in making a decision.

Commissioners (such as clinical commissioning groups, NHS England and local authorities) ensure that they commission services with the capacity and expertise to deliver options for psychological treatment for people with eating disorders.

People with eating disorders (such as anorexia nervosa, binge eating disorder, and bulimia nervosa and other types of eating disorder) talk about their options for psychological treatment (talking therapy) with a healthcare professional. These options may also be discussed with their family members or carers if appropriate. Treatments aim to help people to manage their thoughts and feelings around food and to improve their mental wellbeing so that they can maintain their nutritional health and meet energy needs.

Source guidance

Eating disorders: recognition and treatment (2017) NICE guideline NG69, recommendations 1.3.4 to 1.3.17, 1.4.1 to 1.4.8 and 1.5.2 to 1.5.10

Definition of terms used in this quality statement

Psychological treatments for people with eating disorders

NICE's guideline on eating disorders gives details of psychological treatment options for children, young people and adults with anorexia nervosa, binge eating disorder and bulimia nervosa.

[NICE's guideline on eating disorders, recommendations 1.3.4 to 1.3.17, 1.4.1 to 1.4.8 and 1.5.2 to 1.5.10]

Equality and diversity considerations

Patient choice is important during these discussions. However, for some people there may be an additional need for clinical opinion, for example, people with high-risk anorexia nervosa can have avoidant behaviour so may have difficulty deciding on their treatment.

Family therapy may not be an appropriate psychological treatment option for children and young people who have been abused by family members or looked-after children and young people.