Informing the development of intensive outpatient programmes for eating disorders in children and young people: learning from service leads' experience

Introduction: The field of eating disorders (EDs) has evolved dramatically in recent years, with an increasing focus on community treatment because of better acceptability, both to children and young people (CYP) and parents/carers. Furthermore, this may provide a more cost-effective approach than inpatient care. Aim: This study aimed to explore the perspectives of service leads operating intensive outpatient programs (IOPs) for CYP with EDs. To achieve this, we convened advisory groups composed of current service leads and conducted focus group sessions. Methods: Advisory groups of service leads in established IOPs across England participated in focus group sessions to discuss initial successes and challenges in setting up IOPs for CYP with EDs. Four virtual focus groups were conducted via Microsoft Teams between December 2022 and January 2023. Sessions were recorded, transcribed and analysed using inductive thematic analysis to identify key themes. Results: Four main themes were identified for the successful running of IOPs, (1) approach, (2) team considerations, (3) patient considerations and (4) commissioning. A key sub-theme emphasised the importance of flexible and creative approaches in IOPs to supplement existing evidence-based therapies. Conclusion: IOPs for EDs appear to enable improved community treatment tailored to individual patient needs. They are flexible, equally effective and less disruptive to the young person's development than inpatient care.