The Women's Recovery Group for Individuals with Co-occurring Substance Use and Eating Disorders: Feasibility and Satisfaction in a Residential Eating Disorders Program

Mental health facilities with eating disorder treatment programs and substance use disorder treatment in the United States

Eating disorders (EDs) and substance use disorders (SUDs) often co-occur. However, not all providers that treat persons with an ED provide SUD treatment. Using the National Mental Health Services Survey, this study examined 1,387 ED treatment providers in the U.S. Facilities were categorized according to whether they provided SUD treatment. Differences based on facilities' profit status, available treatment settings, payment options, and treatment services were examined. Most ED facilities in the sample offered SUD treatment services (67.2%). Differences in proportions of the facility type, availability of outpatient treatment, sliding fee scale payment option, whether the facility had a program for individuals with co-occurring mental health and SUD, couples/family therapy, dual disorders treatment, and if the facility provided telemedicine/telehealth were identified. Although most facilities in this sample offered SUD services, more should be done to increase such facilities' capacity to provide treatment for co-occurring ED and SUD nationwide.

Integrated treatment for comorbid eating disorders and substance use disorders: a scoping review protocol

OBJECTIVE

This review will identify and summarize the literature on the integrated treatment of comorbid eating disorders and substance use disorders, focusing on clinical practice guidelines and treatment studies.

INTRODUCTION

Eating disorders and substance use disorders are the deadliest psychiatric conditions, frequently co-occur, and are linked to greater symptom severity and poorer treatment outcomes. Despite repeated calls for their integrated treatment, such an approach has rarely been empirically evaluated. To advance the development of integrated treatments for comorbid eating disorders and substance use disorders, a critical first step is to describe existing treatment guidelines and summarize research evidence for this approach.

INCLUSION CRITERIA

This review will consider all peer-reviewed and gray literature describing the integrated treatment of comorbid eating disorders and substance use disorders, focusing on i) clinical practice guidelines; and ii) treatment studies. We will not place limitations on populations, types of eating disorders, types of substance use disorders, or other contextual factors.

METHODS

Databases to be searched will include MEDLINE (Ovid), Embase, CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and clinical practice guidelines databases identified by CADTH Grey Matters. No date or language limits will be applied to the search. At the screening stage, we will only consider literature in English or French. Two independent reviewers will screen studies at the title/abstract and full-text levels, and extract relevant studies. Disagreements will be resolved through discussion. Findings will be presented in tabular format and a narrative summary.

REVIEW REGISTRATION

Open Science Framework https://osf.io/za35j/.

A Qualitative Assessment of the Treatment Needs of Women with Concurrent Eating and Substance Use Disorders in a Residential Setting

Objectives: Eating and substance use disorders (SUD) are generally treated separately, leaving eating disorders (ED) overlooked within substance use treatment. The frequent co-occurrence of SUD and ED is well documented. Despite their many similarities and frequent co-occurrence, these two disorder types continue to be largely treated separately-either sequentially, with the most severe disorder addressed first, or concurrently but in separate programs. Our study, therefore, responds to this lacuna of data on patient and provider treatment needs for integrated ED and SUD treatment, centering the perspectives of women with lived experience of ED and SUD to support the development of therapeutic groups for women in treatment programs. Methods: This study was designed as a needs and assets assessment to determine the needs and priorities of women with concurrent ED and SUD for developing group programs. Participants for the needs assessment included both staff members (n = 10) and women receiving treatment (n = 10) who were recruited from a 90-day residential treatment program for women with SUD in British Columbia, Canada. Interviews and focus groups conducted with participants were audio-recorded and transcribed verbatim. Data were thematically analyzed and coded using Dedoose software. Results: Six key themes emerged from the qualitative data and were organized into sections with sub themes. An overarching premise from both staff and program participants was the need for concurrent therapeutic programming, nutritional support, and medical monitoring. The six discrete themes that were elicited included the similarities between ED and SUD, gaps in treatment, community support, family involvement, program participant treatment suggestions, staff treatment suggestions, and family involvement. Conclusions: Throughout this qualitative study, the need for screening and assessment of both disorders along with integrated treatment was stressed by participants, both program participants and staff alike. These findings complement current literature and suggest that pursuing concurrent treatment design may be helpful in addressing unmet program participant needs and could provide a more holistic framework for recovery.

A systematic review of gender-responsive and integrated substance use disorder treatment programs for women with co-occurring disorders

Background: Integrated and gender-responsive interventions, designed to target co-occurring substance use and psychiatric disorders in women, may be effective in addressing gender-specific challenges.Objectives: This systematic review aims to identify integrated gender-responsive substance use disorder treatments for women, summarize evaluations of these treatments, and address gaps in the literature.Methods: We searched PsycINFO, PubMed, and MEDLINE on September 24, 2021, and March 10, 2022. Included articles were randomized-controlled trials, secondary analyses of naturalistic studies, or open-label studies of integrated and gender-responsive treatments from any year that assessed both substance use and mental health/trauma outcomes.Results: We identified N = 24 studies (participants = 3,396; 100% women) examining Seeking Safety, Helping Women Recover and Beyond Trauma, A Woman's Path to Recovery, Modified Trauma Recovery and Empowerment Model (TREM), Breaking the Cycle, VOICES, Understanding and Overcoming Substance Misuse, Women's Recovery Group, Female Specific Cognitive Behavioral Therapy, and Moment by Moment in Women's Recovery. Across treatments there were significant improvements over time; Seeking Safety, Helping Women Recover, and TREM were associated with significantly better substance use and mental health outcomes relative to the comparison groups.Conclusions: Integrated gender-responsive treatments are a promising approach to treating women with co-occurring substance use and mental health concerns, and broad clinical implementation stands to benefit women. However, there remains a lack of studies evaluating substance use treatments in women with severe mental illness (e.g., psychotic-spectrum disorders) who differ in their needs and capacity.