ABSTRACT
This chapter concludes the treatment manual with information about training, dissemination, implementation in clinical settings, financial challenges, therapist attitudes and experiences, and current challenges and future needs in terms of research. Chapter 21 emphasizes that because R4R draws from several different theoretical perspectives and addresses a difficult-to-treat population, the R4R therapist requires training in the psychopathology and treatment of eating disorders, as well as their impact on the family system. Experience with family and/or group psychotherapy, Motivational Interviewing principles, Stages of Change Theory, and Relational-Cultural Theory serve as important preparation for learning R4R. The challenges in obtaining training in eating disorders, family therapy and specifically, multifamily therapy training, are noted. This chapter also examines the various ways R4R could be disseminated so practitioners can effectively implement it in their clinical settings. It outlines possible barriers to effective dissemination and implementation and offers possible solutions. Asynchronous and synchronous learning models are discussed with an emphasis on utilizing telementoring (e.g., Project ECHO®) and online education. The chapter then addresses the importance of treatment fidelity and adherence and reviews factors that promote these processes. It also explores some of the financial challenges related to offering and paying for R4R, as well as the essential values and orientation of an R4R therapist. The chapter ends with suggestions about R4R research directions including involvement of patients and families in all aspects of research endeavors and much needed additional quantitative and qualitative research.
