Barriers to Treatment in Eating Disorders

Despite the availability of evidence-based treatments for eating disorders, only a minority of individuals seek and receive professional treatment for their problems. While research over the past two decades aimed at understanding factors that prevent help-seeking (i.e., perceived barriers, demographic variables, other characteristics of treatment-seeking individuals), there is a paucity of methodologically sound studies investigating factors associated with low help-seeking. Importantly, imprecise and inconsistent definitions and measurement of these factors has limited the available research in this area. The literature to date has used terms such as barriers or perceived barriers, factors (e.g., demographic variables or characteristics of treatment-seeking individuals), help-seeking correlates, or predictors for help-seeking interchangeably and inconsistently to broadly describe factors associated with low help-seeking. Thus, in this chapter the use of clear terminology and definitions to reflect putative (i.e., factors that are likely preventing individuals from seeking help) and true help-seeking barriers is proposed. To establish a factor as a true barrier for help-seeking, precedence and a change in the factor prior to the event of help-seeking are essential criteria. Without establishing that the associated (variable) factor precedes help-seeking and changes (e.g., decreases) before the individual seeks help, it is impossible to determine whether a barrier has truly prevented an individual from seeking help. The current evidence shows that two perceived barriers, namely denial and a failure to perceive the severity of the illness as well the inability of others to provide help, have been established as correlates of help-seeking for eating disorders. However, precedence of these factors prior to help-seeking has not been established and longitudinal studies are urgently needed to advance the field and facilitate help-seeking among those who require professional help for eating disorders. describe factors associated with low help-seeking. Thus, in this chapter the use of clear terminology and definitions to reflect putative (i.e., factors that are likely preventing individuals from seeking help) and true help-seeking barriers is proposed. To establish a factor as a true barrier for help-seeking, precedence and a change in the factor prior to the event of help-seeking are essential criteria. Without establishing that the associated (variable) factor precedes help-seeking and changes (e.g., decreases) before the individual seeks help, it is impossible to determine whether a barrier has truly prevented an individual from seeking help. The current evidence shows that two perceived barriers, namely denial and a failure to perceive the severity of the illness as well the inability of others to provide help, have been established as correlates of help-seeking for eating disorders. However, precedence of these factors prior to help-seeking has not been established and longitudinal studies are urgently needed to advance the field and facilitate help-seeking among those who require professional help for eating disorders.