(P25-045-25) Building Rapport via Telehealth in Adults With Eating Disorders: A Qualitative Study

Objectives: Clinician-client rapport improves clinical outcomes. Building rapport in adults with eating disorders (ED) is challenging due to the highly personalized and sensitive nature of ED care. Despite its increased utilization, telehealth ED care (e.g., online video conferencing visits (OVCV), text-based messaging (TBM), etc.) can increase rapport-building challenges. This qualitative study explored adult participants’ experiences with rapport building in ED telehealth care via OVCV and TBM.

Methods: In this qualitative study, 40 adults (ages 19–52 years) with ED completed 24 individual weekly 50-minute telehealth OVCV with a Registered Dietitian. Participants also utilized TBM as needed. After visits, participants were interviewed about experiences with rapport building during OVCV and as-needed TBM. Additional data collected included participant age, sex, specific ED diagnosis, and self-reported duration of ED. Descriptive statistics were calculated, and interviews were analyzed using thematic analysis.

Results: Participants were on average 30 ± 5 years, 95% female (n = 38), and had a mean self-reported ED duration of 11 ± 4 years. ED diagnoses included binge eating disorder (n = 18), other specified feeding or eating disorder (n = 17), anorexia nervosa (n = 2),  avoidant/restrictive food intake disorder (n = 2), and bulimia nervosa (n = 1).

Themes that improved rapport building included clinician eye contact during OVCV, same-day responses to TBM, clinician punctuality during OVCV, and the clinician providing unconditional acceptance, welcoming body language, supportive empowerment, validation, active listening, use of a trauma-informed approach, willingness to discuss difficult topics, genuine interest, and safety. Themes deemed as hindrances included distractions in the participants’ telehealth environment, unexpected lapses in connection, software difficulties, and participant unfamiliarity with telehealth experiences.

Conclusions: As telehealth becomes more widely utilized in ED care, improving rapport building efforts during OVCV and TBM grows in importance. Clinicians can utilize traditional rapport-building techniques, such as using a trauma-informed approach and emphasizing person-centered care, while also balancing limitations of OVCV software to potentially improve clinical outcomes.

Funding Sources: None