“<scp>FBT</scp> Is for the Rich”: A Qualitative Study Examining Clinicians' Experiences and Perceptions of Treatment Access and Engagement for Diverse Families in Family‐Based Treatment
Bibliographic record
Abstract
OBJECTIVE: Family-based treatment (FBT) is the leading evidence-based treatment for adolescent eating disorders, but research exploring access and engagement in FBT is sparse. This paper focuses on findings from a broader study, specifically addressing the social determinants of health (SDH) impeding access and engagement in FBT for diverse families (i.e., families belonging to identity groups subject to systemic barriers and prejudices). METHODS: Forty-one FBT clinicians were recruited globally using purposive and snowball sampling. Clinicians participated in individual interviews or focus groups, discussing their experiences engaging diverse families in FBT. Qualitative data were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS: The findings underscore the pervasive impact of SDH on equitable access to FBT, specifically, the critical need for tailored approaches by clinicians to enhance access and engagement in FBT for diverse families experiencing practical, resource, and systemic barriers. Recommendations include broader dissemination of FBT knowledge, telehealth options to mitigate geographical barriers, community resource collaborations, and sensitivity to cultural and systemic factors impacting treatment engagement. DISCUSSION: Results of this study may inform future FBT planning (tailoring treatment approaches to address barriers), clinician training, clinical decision-making tools, and opportunities for supporting under-resourced families within the model, leading to more equitable FBT treatment access and engagement for diverse families.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".