Beyond traditional models: a content analysis exploring the applicability of harm reduction in eating disorder care.

BACKGROUND: Eating disorders can place an individual at significant risk of physical harm. Despite this, there is minimal guidance on how to empower individuals to recognise and minimise potential harms to their physical safety. This paper explores the recommendation to incorporate harm reduction strategies within eating disorders care by an eating disorder consultation service to clinicians working with individuals who have eating disorders. The aim of this paper was to examine how often, and in what contexts, HR approaches were deemed applicable during eating disorder specific public mental health case consultations. METHODS: Adult case consultation records from an eating disorder consultation service in Australia were retrospectively analysed to examine the frequency at which harm reduction approaches were considered applicable to the consultation question. Content analysis was performed to examine the context in which the potential utility of harm reduction was discussed. RESULTS: Out of 45 adult secondary case consultation records accessed, almost three-quarters reported that a harm reduction framework was discussed as part of the secondary consultation. Content analyses revealed that 33.33% of consultations recommended harm reduction in the context of treatment engagement, 21.21% in the context of treatment ambivalence, and 45.45% in the context of concerns for physical safety whilst an individual was engaged in eating disorders care. CONCLUSIONS: Our results give preliminary indication that harm reduction approaches may have utility in supporting individuals with eating disorders to reduce their risk of physical harm across the spectrum of motivation and treatment engagement. Given the high incidence of physical harms associated with eating disorders, further studies examining the application and effectiveness of harm reduction approaches for eating disorders would likely be of benefit to the field.