Understanding the experience of treatment for anorexia nervosa : the perspective of patients who drop out of services

Drop-out' is a problem common to many mental health services. Within services for anorexia nervosa the issue is even more problematic given that the disorder has a potentially fatal outcome. Research suggests that approximately 50% of patients drop-out prematurely from treatment services for anorexia nervosa and there has been a concerted effort over recent years to try and understand and overcome this concerning phenomenon.;This research set out to investigate the possible reasons for drop-out from services for women diagnosed with anorexia nervosa. An additional aim was to investigate the personal significance of anorexia nervosa and the impact that treatment has on changing this.;This research investigated the reported experiences of 8 women who had previously attended a local specialist eating disorders service. The participants were asked to provide a narrative account of their experiences of treatment which was then followed up in an interview. One participant was only able to provide a narrative account and 3 participants preferred to be interviewed without providing a written narrative.;The information obtained from the narratives and interviews was analysed using a social constructionist revision of grounded theory.;A central theme of control emerged which was affected by interactions with the wider social system. The accumulative battle for control between the anorectic and others (such as family, friends and professionals) appeared to result in the act of dropping out as the treatment approach, timing and context recreated the setting conditions of lost control.;The orga.nisational and clinical implications of this model are discussed in the light of existing conceptualisations of drop-out and anorexia nervosa.