The Short-Term Allocation Tool for Eating Disorder Treatment

Imagine, you are struggling with an eating disorder and know that you need support but are overwhelmed and confused by the numerous types of treatment available. Maybe you don’t have to imagine this at all. But, what if there is a short-term allocation tool to help those in eating disorder treatment.

Please know that you are not the only one. Even professionals in this area often have differing opinions on what symptoms indicate an individual’s need for varying levels of care.

Researchers and eating disorder professionals alike recognized the confusion within the community and are working to create a more streamlined and uniform approach to treatment level recommendation.

For this reason, the Short-Term Allocation Tool for Eating Disorders (STATED) was created.

What is the STATED for Eating Disorder Treatment?

This assessment is a “new evidence-based algorithm developed to match patients to the most clinically appropriate and cost-effective level of care [1].” The algorithm uses three patient dimensions to determine this: medical stability, symptoms severity/life interference, and readiness/engagement.

The first two are likely unsurprising, as most in the field can agree that a medically unstable individual needs hospitalization or that an individual with severe symptoms or daily life interference will need a higher level of care.

However, the STATED is unique in its inclusion of consideration of an individual’s readiness, IE: “an individual’s internal motivation to engage in symptoms reduction goals of action-oriented treatment [1].”

This aspect is included based on “a robust literature showing that readiness and motivation to recover is one of the strongest predictors of clinical outcome [1].” The STATED is “trans-diagnostic and represents all patient presentations across the developmental spectrum [1].”

Is it Effective?

Any treatment method or assessment tool described as evidence-based is considered “legit” in that research has supported its effectiveness. As such, the STATED is definitely “legit,” but, if you want to understand more about how one study in 2018 examined it to determine just that.

The study intended to “examine the extent to which current practices are in alignment with the STATED [1].” That is, do the results of the STATED match what most educated professionals in this area would refer their patients to?

The study found that 22 out of 24 comparisons were statistically significant, meaning the STATED recommendations matched the current practice recommendations. Even so, it was found that, when looked at more stringently, there was inconsistency related to the readiness dimension.

Researchers hypothesize that this is a result of a lack of understanding of the implications of low readiness [1].

They also believe that patients with low readiness were assigned higher levels of care (recovery-focused intensive day, residential, or inpatient care) in an effort to relieve the distress of their family and providers “likely due to the universal recognition of the critical need to assess medical stability and to prevent de-compensation [1].”

Translated, they think that professionals are being “better safe than sorry” in putting low-readiness individuals in higher levels of care because it is better they receive more intense care than needed and become medically stable than to not receive enough care.

All-in-all, the study determined that the STATED is off to a great start in including readiness in assessing treatment needs. However, more research needs to be done to further understand how to measure and consider readiness in treatment protocols.

Rebuttal Consideration:  A highly esteemed clinician and treatment program founder recently contacted Eating Disorder Hope to share additional insights to broaden the considerations of this new tool.  She expressed concern that the STATED may have a serious problem.  It may encourage insurance companies not to cover treatment for those who are seriously ill with anorexia, bulimia, binge eating disorder, etc. unless they are demonstrating enthusiasm to pursue recovery.  Unfortunately, eating disorders have the highest death rate of all behavioral health issues.  If we were to wait until all individuals struggling with serious eating disorders wanted or felt ready to pursue treatment, we would likely have even more deaths from this disease.

We welcome other thoughts/comments on this new resource of the STATED.

~ Eating Disorder Hope Team

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Resources

[1] Geller, J. (2018). The short-treatment allocation tool for eating disorders: current practices in assigning patients to level of care. Journal of Eating Disorders, 6:45.

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About the Author:

Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published April 2, 2020, on EatingDisorderHope.com
Reviewed & Approved on April 2, 2020, by Jacquelyn Ekern MS, LPC