Table 2.

Themes and subthemes identified in interviews with staff from specialist eating disorder inpatient settings:

Theme 1: ‘The Punisher’ – Delivering treatment against consent

a. From ‘helper ‘to ‘punisher’

b. Helping or hurting? Uncertainty about treatment approaches for complex presentations

c. ‘It’s bloody traumatising’ – The impact of contributing towards treatment on staff

Theme 2: ‘The Abused’ – Casualties of the system

a. Violence and aggression when the eating disorder fights back

b. ‘Bottom of the ranks’ – 'no one cares about you'

c. Insufficient support and training

Theme 3: Nurturing ‘a core of hopefulness’ – Coping with the work

a. Managing your mindset and ‘holding hope’

b. The ‘virtuous cycle’ of relational work

c. 'Listen and take action' – what clinicians need to maintain wellbeing at work