"A sense of making a difference": staff experiences of residential treatment for eating disorders

Residential facilities for eating disorders provide recovery-oriented care in less restrictive home-like treatment environments compared to traditional inpatient hospital treatments. These services also frequently integrate staff members with a lived experience of eating disorder recovery-lived experience practitioners-within their treatment frameworks. However, limited research has examined staff experiences of working in these settings. This study explores employee experiences of an Australian residential eating disorder facility using a fixed mixed-methods approach with an independent convergent parallel design. Sixty-five percent of employees consented to participation, with 50% identifying as lived experience practitioners. Findings highlight employees' strong sense of purpose and critical role as facilitators of recovery. Participant narratives positioned staff as, in the words of one participant, the "heart and soul" of the facility. While experiences were predominantly positive, employees also identified ideological challenges, including navigating tensions between standardised, phase-based treatment protocols, and person-centered, recovery-oriented care (e.g. adapting structured approaches to meet individual patient needs). Given the centrality of the clinician-patient relationship in treatment outcomes and the interconnection between staff wellbeing, patient safety, and care quality, further research is needed to explore how residential organizations can balance structured protocols with individualized care and employee wellbeing to sustain a skilled and resilient workforce.