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Degree

Doctor of Philosophy, Miami University, Psychology, 2011.

Abstract

This study strove to enhance our understanding of the effects of compulsion and coercive experiences in eating disorder treatment by interviewing 18 recovering women about their prior experiences of involuntary treatment and informal coercion. Interpretative Phenomenological Analysis, a comprehensive, qualitative research methodology, was used to analyze the transcripts. The analysis produced 28 themes that reflected how participants’ experiences of perceived coercion impacted aspects of their sense of control, choice, and recovery from eating disorders. These themes were grouped into six domains: (1) Varied Impact of Perceived Choice on Treatment: Based on the amount of perceived choice, women’s response to treatment ranged from active treatment resistance and internal rebellion to satisfaction with the amount of choice granted and relief over having the choice made for them; (2) Harmful and Unhelpful Coercive Experiences: Participants identified specific negative emotions, actions perceived as unnecessarily coercive, and unintended consequences of coercive experiences; (3) Necessary and Helpful Coercive Experiences: Participants highlighted acceptable types of coercion, the factors contributing to positive outcomes, and, for some, retrospective gratitude following coercive experiences; (4) Views on Compulsory Treatment: Participants clarified their views on when compulsory treatment was acceptable for minors and adults; (5) Interpersonal Dimensions Impacted by Family Dysfunction and Coercive Practices: Participants’ autonomy, agency, and positive connection to others were adversely impacted by the level of family dysfunction, personal psychiatric symptomatology, and extremity of the coercion experienced, and (6) Meaning-Making of Past Treatment and Coercive Experiences on Recovery: Participants offered their retrospective reassessment on how choice, control, and coercion impacted their recovery. These results suggest the importance of understanding choice, control, and coercion in relation to treatment response and recovery. Implications for clinical practice are discussed with respect to both the life saving function of coercive treatment as well as the damaging ramifications which can lead to a ruptured therapeutic alliance and treatment setbacks or failure.

Subject Headings

Clinical Psychology

Keywords

Eating disorders; involuntary treatment; coercion; client attitudes, Interpretative Phenomenological Analysis; qualitative research

Committee / Advisors

Margaret O'Dougherty Wright, Ph.D. (Advisor)
Terri Messman-Moore, Ph.D. (Committee Member)
Vaishali Raval, Ph.D. (Committee Member)
Marie Elise Radina, Ph.D. (Committee Member)

Pages

78p.

Document number: miami1301781198
Permalink: http://rave.ohiolink.edu/etdc/view?acc_num=miami1301781198

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