Getting it right, right from the start, begins with an assessment of an individual’s insight into their illness and readiness to change. How much the individual is changing for themselves versus how much they are 'doing treatment' for others indicates both the investment they have in recovery and the perceived degree of control have over their life. Individuals often fear that if they are honest about both their intent and feelings of ambivalence toward recovery, that others will take control. It is imperative therefore that treatment professionals listen with compassion in order to build a relationship of trust by encouraging the individual to speak honestly, even if it is not what we (families and professionals) want to hear. This is the beginning of effective communication and opens up the opportunity to further explore the intent of the illness.

Assessment must always explore the specific characteristics of the illness, symptoms, eating disorder behaviours and make an initial determination about readiness to recover but only after a environment of trust and mutual respect has been established. It should also refer an individual on at the earliest possible time if the treatment on offer is not going to be a good fit. In an ideal situation (essential with children and young adolescents) families should be involved in the information gathering and sharing of thoughts, feelings and expectations, after all, it is the family who will be there throughout the recovery process and long after the professionals have become redundant.

A medical doctor needs to be involved in every stage of the assessment as it is his/her expertise that will ultimately determine the risks to an individual's physical wellbeing and whether the treatment on offer is appropriate and safe. Where possible, the prospective treatment professional should liaise directly with the consulting doctor however families can also facilitate this dialogue effectively.

A prospective treatment provider should always explain their approach to treatment, clarify expectations and answer all questions whilst demonstrating the utmost respect for the individual and family. Families, don't be afraid to ask to tough questions; Professionals, don't feel threatened by seemingly difficult questions, working through this together is how trust and partnership is born.

Assessment should cover impact of Illness on the life of the individual and the lives of those who love and care them. Whilst it is important to determine level of motivation and readiness to change, this must be balanced against the fears and concerns held by both the individual and their family.


Importantly, assessment must determine core medical, nutritional and behavioural imperatives. This process takes time and cannot be achieved in a single session.

The assessment process has been successful when the individual, family and professional feel at ease with one another, can speak honestly, expressing fears and concerns, hope and expectations and a plan, (written and agreed to by all parties) sits at the centre of the pathway forward. It is this plan, rather than the professional or family, that should guide everyone. A Professional who elevates themselves (with authority) above the family or individual will ensure that the alignment between the individual and their eating disorder is strengthened, eroding trust and the sense of partnership. Families, if you encounter a professional with this approach; keep looking. Take the Charter for patient and carer rights a with you, sit it in the middle of your assessment and question the treatment you are considering against your rights and expectations.

As an outcome of your assessment you should, as a minimum, have agreed upon a reason for treatment to commence and a treatment plan (as described earlier) including a set of guidelines that everyone involved in treatment (including professionals and family) will respect. Where an individual is an inpatient and will be transitioning to outpatient, then plans must be developed (following along the guidelines explained earlier) well in advance of discharge.

Professional Resources: The Bronte Foundation developed a comprehensive range of documents, detailing a step by step approach to assessment (including forms and checklists) that professionals can use to guide themselves through this process. The Bronte Centre makes these documents freely available to all professionals. To access these simply follow the contact us link and request copies.

Family Resources: The Bronte Foundation has many resources for families to help them understand their rights, what they should reasonably expect, and increase their knowledge and understanding of eating disorders and recovery. To access these simply follow the contact us link and tell us your needs. We are here to help.