# Clinician’s Experience of Working with an Intensive Outpatient Programme for Child and Adolescent Eating Disorders—A Reflexive Thematic Analysis

## TL;DR

This study explores how clinicians experience working with an intensive outpatient program for eating disorders in children and adolescents.

## Contribution

The study provides new insights into clinicians' perspectives on the structure and effectiveness of IOPs in the UK context.

## Key findings

- Clinicians identified tri-directional collaboration as a key strength of the IOP.
- The program helped create space for thoughtful planning and arrested rapid deterioration.
- Transitions were seen as turning points requiring further evaluation for long-term success.

## Abstract

Although intensive outpatient programmes (IOPs) are becoming more prevalent, the evidence base, particularly within the UK, remains limited. Given clinicians’ central role in developing, delivering, and adapting these emerging models of care, their perspectives are essential to understanding how IOPs function in practice. This study therefore aims to address a significant gap in the literature by exploring clinicians’ experiences of working with an IOP and the strengths and opportunities arising from this. Fifteen experienced clinicians participated in individual semi-structured interviews after working with the IOP. Open-ended questions guided the discussions, which were recorded and transcribed verbatim. Data were analysed using the six stages of reflexive thematic analysis. The analysis generated three key themes: (1) Tri-directional Collaboration, (2) Creating Space for Change, and (3) Transitions as Turning Points. Clinicians felt that the IOP provided a structure that strengthened and reinforced the therapeutic alliance between parents and clinicians, helped arrest rapid deterioration, and created space for thoughtful planning. Embedding IOPs within stepped-care frameworks may offer an effective and scalable means of expanding system capacity while delivering enhanced, flexible support during periods of heightened risk. However, longitudinal, mixed-methods evaluations are needed to clarify the sustainability of progress post-IOP and to identify predictors of positive transitions.