Unified Treatment Model Shows Long-Term Symptom Gains in BIPOC Patients With Eating Disorders

A new study found that the Unified Treatment Model (UTM), a transdiagnostic cognitive-behavioral protocol used in residential eating disorder care, produced statistically significant and durable reductions in eating disorder, depressive, and anxiety symptoms among Black, Indigenous, and people of color (BIPOC) adults.¹

The UTM, implemented at the Renfrew Center in partnership with the study's Florida Atlantic University (FAU) research team, adapts principles from the Unified Protocol for transdiagnostic treatment of emotional disorders. Rather than treating eating disorder symptoms, depression, and anxiety as separate diagnoses, the model targets shared underlying mechanisms—emotional avoidance and maladaptive coping—and is integrated across therapy, nutrition counseling, and psychiatric services.

Led by Kelly Emelianchik-Key, PhD, LMHC, LMFT, NCC, ACS, of FAU's Department of Counselor Education, the research team analyzed data from 470 BIPOC adults who received residential eating disorder treatment at the Renfrew Center between 2016 and 2023. Participants self-identified as female, non\binary, transgender, or another gender identity. Outcomes were measured with the Eating Disorder Examination Questionnaire (EDE-Q), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Overall Anxiety Severity and Impairment Scale (OASIS) at admission, discharge, and 6-month follow-up.

The study was published in Counseling Outcome Research and Evaluation.

Study Results

Three one-way repeated measures ANOVAs showed statistically significant change across all 3 measures. Eating disorder symptoms declined with a large effect size (F[2,330]=96.321; P<.001).1 Depressive symptoms also improved significantly (F[1.91,292.79]=63.191; P<.001), as did anxiety symptoms (F[1.838,306.937]=23.984; P<.001). Gains achieved during residential treatment were maintained at the 6-month follow-up assessment across all 3 domains.

"Our findings provide encouraging evidence that a transdiagnostic approach can be effective for clients from a range of backgrounds," said Emelianchik-Key. "The UTM's emphasis on emotional awareness and adaptive coping may help sustain recovery beyond the treatment setting."²

Broader Implications

The investigators noted that eating disorder research has historically centered on a narrow demographic, leaving gaps in understanding of how eating disorders present and respond to treatment across cultural backgrounds. They recommend that counselor education and clinical supervision programs incorporate training in transdiagnostic, culturally informed approaches. The authors suggest the UTM—now expanded with modules addressing factors that influence emotional avoidance and eating disorder symptomology—may offer a scalable model for improving outcomes across treatment settings.¹

Insights From an Expert

Gayle Brooks, PhD, CEDS-C, the vice president and chief clinical officer at the Renfrew Center, shared the following thoughts exclusively with Psychiatric Times:

“Eating disorders do not discriminate, yet misconceptions about who develops these illnesses continue to influence how they are recognized, studied, and treated. For many individuals from Black, Indigenous, and People of Color (BIPOC) communities, eating disorders may be overlooked due to longstanding stereotypes, cultural stigma, provider bias, and inequities in access to specialized care. Too often, these illnesses are still viewed through a narrow lens that does not reflect the diversity of those affected.

As clinicians and researchers, we have a responsibility to challenge these assumptions with evidence. At the Renfrew Center, our recent research examining outcomes among BIPOC patients receiving residential eating disorder treatment found that eating disorder symptoms decreased by 34% from admission to discharge and remained 26% lower than admission levels at six-month follow-up. These findings reinforce that when individuals receive evidence-based, culturally responsive care, meaningful and lasting improvements are possible.

Greater representation in eating disorder research is essential because it helps us better understand how these illnesses affect diverse populations, identify barriers to treatment, and ensure that the care we provide is effective for all individuals. Historically, BIPOC communities have been underrepresented in eating disorder research, limiting our understanding of their experiences and contributing to disparities in diagnosis and treatment.

Evidence-based and culturally responsive care should go hand in hand. Research that reflects the diversity of our communities allows us to strengthen clinical practice, reduce inequities, and ensure that more individuals are recognized, supported, and connected with the treatment they need.”

References

1. Emelianchik-Key K, Labarta AC, DeDonno M, Gill CS. Long-term effects of the unified treatment model for eating disorders and comorbidity with BIPOC clients. Couns Outcome Res Eval. 2025;17(1).

2. Fennimore A. Unified treatment model shows lasting impact on eating disorder recovery. News release. Florida Atlantic University College of Education; October 23, 2025. Accessed July 30, 2026. https://www.fau.edu/education/newsevents/eating-disorders/