What is it about?

This article reviews the many challenges that practicing psychologists face when navigating stepped-care for their patients with eating disorders. Using the APA Ethics Code, this paper provides psychologists with guidance and resources to show how we can provide ethical care, recommendations, and bridge gaps between levels of care. Two hypothetical examples are provided to illustrate how this guiding framework can improve decision-making in the interest of patient wellbeing.

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Why is it important?

The stepped-care treatment model was designed to maximize patient autonomy and minimize costs. Given the known barriers to treatment that individuals with eating disorders often face in the U.S. healthcare system, stepped-care has the potential to increase access through efficiency. Unfortunately, there are many structural and systemic barriers that impede people from accessing the level of care that they need. As practicing psychologists, helping patients move through these systems can be daunting. Hopefully, by using our professional Ethics Code to guide us, we can improve treatment experiences for patients with eating disorders.


Importantly, we (the authors) wrote this paper from academic (and therefore limited) perspectives - practicing psychologists with primarily patient-facing roles will have more direct everyday experience with these systems. The intention of this article is to increase awareness and empower practicing psychologists across disciplines to use ethics to guide how they move through the treatment structures in the U.S. for the benefit of patients. Undoubtedly, many, if not most, already do this! Hopefully, having this article to point to is useful for them as well. Finally, while we provide individual-level recommendations for practicing psychologists, there is a dire need for structural change that is not addressed in this article. The second case example illustrates this critical issue, and the necessity of identifying change that we can all work toward at the policy, public health, and system-level.

Samantha Bedard
University of Wyoming

Read the Original

This page is a summary of: Ethical challenges in the provision of stepped care for eating disorders in the United States: Current status and a guiding framework for clinician implementation., Professional Psychology Research and Practice, April 2024, American Psychological Association (APA),
DOI: 10.1037/pro0000574.
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