<scp>Cognitive‐behavioral</scp> therapy in the time of coronavirus: Clinician tips for working with eating disorders via telehealth when face‐to‐face meetings are not possible

TLDR

The COVID‑19 pandemic has forced eating‑disorder therapists to shift abruptly to telehealth, leaving many clinicians feeling ill‑equipped to deliver evidence‑based care. This article seeks to synthesize clinicians’ experiences of challenges and solutions for providing cognitive‑behavioral therapy for eating disorders via telehealth. The authors emailed 70 colleagues, gathered 22 clinicians’ online suggestions over 96 hours, and collated these into timely guidance for peers. The discussion revealed broad themes—patient and therapist concerns, technical issues, environmental changes—and specific CBT‑ED recommendations, offering a substantial set of evidence‑based telehealth practices for clinicians worldwide.

Abstract

Abstract Objective The coronavirus pandemic has led to a dramatically different way of working for many therapists working with eating disorders, where telehealth has suddenly become the norm. However, many clinicians feel ill equipped to deliver therapy via telehealth, while adhering to evidence‐based interventions. This article draws together clinician experiences of the issues that should be attended to, and how to address them within a telehealth framework. Method Seventy clinical colleagues of the authors were emailed and invited to share their concerns online about how to deliver cognitive‐behavioral therapy for eating disorders (CBT‐ED) via telehealth, and how to adapt clinical practice to deal with the problems that they and others had encountered. After 96 hr, all the suggestions that had been shared by 22 clinicians were collated to provide timely advice for other clinicians. Results A range of themes emerged from the online discussion. A large proportion were general clinical and practical domains (patient and therapist concerns about telehealth; technical issues in implementing telehealth; changes in the environment), but there were also specific considerations and clinical recommendations about the delivery of CBT‐ED methods. Discussion Through interaction and sharing of ideas, clinicians across the world produced a substantial number of recommendations about how to use telehealth to work with people with eating disorders while remaining on track with evidence‐based practice. These are shared to assist clinicians over the period of changed practice.