Patient satisfaction with treatment in eating disorders:: Cause for complacency or concern?

The present study explored treatment satisfaction among eating disorder patients participating in a Swedish multicentre study (N=469) who had been followed up 36 months after initial assessment. Satisfaction was measured using a questionnaire focusing on initial reception at the treatment unit, suitability of treatment, ability of staff to listen and understand, confidence in the unit and agreement on treatment goals. After 36 months, 38% of patients were 'highly satisfied' with treatment, while 39% were 'satisfied' and 23% were 'unsatisfied'. Satisfaction was predicted by treatment interventions focusing on support and increased control of eating problems. Although unsatisfied patients were characterized by significantly higher levels of eating disorder psychopathology and psychiatric symptoms as well as more negative interpersonal profiles at follow-up, these patients had been virtually indistinguishable from the other groups at initial assessment, with a few notable exceptions. Unsatisfied patients had previously been less prepared to change their eating habits, had higher levels of conflict with their fathers, had a lesser degree of present weight acceptance and tended to expect less from treatment interventions focusing on control of eating problems. It is concluded that, although we may be successful in engaging and satisfying patients who are predisposed to therapeutic strategies focusing on support and control of eating problems, we may be less successful with those who have a greater number of interpersonal problems and who are not as focused on their symptoms of disordered eating. Copyright (C) 2004 John Wiley & Sons, Ltd and Eating Disorders Association.