"I mean, it kind of saved my life, to be honest": a qualitative study of participants' views of a dialectical behaviour therapy for multidiagnostic eating disorders programme.

Background: Despite the increasing use of dialectical behaviour therapy (DBT) as a treatment for eating disorders (EDs), there is little published evidence of its effectiveness for treating restrictive eating disorders. DBT for EDs may be particularly helpful for those who live with severe and enduring eating disorders (SE-EDs) given that it targets those for whom first-line treatments have not been effective, its focus on factors thought to maintain symptoms and its focus on improving quality of life. This study sought to evaluate the experiences of participants in a comprehensive DBT programme for people with SE-EDs.

Methods: Semistructured interviews were conducted with seven participants who were treated in the 'DBT for Multidiagnostic Eating Disorders (MED-DBT)' programme at a regional eating disorders service in New Zealand. The interviews were transcribed verbatim and analysed via thematic analysis.

Results: The findings indicate that the MED-DBT programme was perceived as effective by participants. The skills learned provided participants with valuable tools that could be used to better manage emotions, crises, and tasks of daily life, which improved their quality of life and improved their management of their eating disorder symptoms. Several participants reported that the programme saved their lives. A key component of the MED-DBT programme was having access to phone coaching that supported participants with the acquisition and consolidation of skills to reduce crises and generalise learning of the skills. These skills have continued to be used by participants more than five years posttreatment.

Conclusions: The qualitative findings of the present study suggest that the MED-DBT programme is an effective and valuable treatment for participants. All participants endorsed the MED-DBT programme for ED treatment. The treatment programme was seen as a highly beneficial and feasible treatment that could provide greater options for treating complex clients with severe and enduring eating symptomology with confidence.