Eating Disorder Management
The positive side to the story of eating disorders is often lost in the complexity of these illnesses.
Person-centred care, tailored to suit the person’s illness, situation and needs, is the most effective way to treat someone with an eating disorder.
Recovery from an eating disorder is a long-term process, lasting on average for seven years but affecting up to 25% of people as a severe and enduring illness.
Early detection and intervention is critical to successful outcomes. People who have had an eating disorder for less than 2 years are likely to respond more quickly to treatment and experience a shorter duration of illness with fewer physical health consequences. When delivered early in illness by health professionals with appropriate knowledge and skill in eating disorders, this treatment can lead to full clinical recovery and improved quality of life for about 75% of people with eating disorders.
(source: Butterfly National Agenda)
According to the National Agenda for ED (Butterfly Foundation, 2017), “eating disorders occur in the context of a person’s life and the life of their family.
An eating disorder will have an impact on every aspect of life. People need to receive treatment and support that is based on an integrated understanding of their lives that can equip them for the long journey of recovery.
Person-centred care, tailored to suit not just the person’s illness but their life situation and needs, is the most effective way to treat someone with an eating disorder. The perspective of the individual provides a vital framework
for recovery as it is the individual who decides how to engage in treatment and recovery.
To move towards recovery, it is critical that people with eating disorders feel consulted and engaged in their treatment. The loss of identity and self-worth, lack of control and sense of connectedness experienced during an eating disorder are exacerbated by treatment that is not person-centred and recovery-oriented.
Recovery is a process that may take an extended period of time, both during and after participation in treatment.
Relapse and recurrence are significant issues, with rates of relapse ranging from 22% to 51% across studies of people with anorexia nervosa and bulimia nervosa.
These setbacks are a common part of the process of recovery. With access to treatment and support setbacks do not have to be major obstacles to recovery.
People with eating disorders need access to recovery support services and re-admission treatment plans to support sustainable recovery. Families and carers play a vital role supporting treatment and recovery.
Without family support, there is likely to be a need for higher levels of intensity in treatment and more frequent episodes of illness.
A severe and enduring eating disorder can be life threatening.
Safe treatment for eating disorders addresses all of the aspects of illness assisting people to meet their psychical, psychological, behavioral, nutritional, occupational and social needs. Treatment is provided by a multi-disciplinary team who work in partnership with the person, their family and other health and support providers, including treatment of co-morbid issues (National Framework, 2012).
It is recommended to consider SSCM for that support. SSCM is a combination of clinical management and supportive psychotherapy. See treatment option HERE.
SSCM combines clinical management like giving information, advice and encouragement with a supportive therapeutic style. The aim of the therapy is to help the individual make a link between their symptoms and their eating behaviour and weight, and to support them in a gradual return to normal eating and weight (NZ ED Clinic).
Aims Of SSCM Treatment
According to the Clinician Guideline – Managing Severe and Enduring Anorexia Nervosa (Touyz, Le Grange, Lacey & Hay, 2016), the SSCM three phase approach (page 114 of the guideline) for individual outpatient care include; collaborative patient-led stance, psychodynamic and psychoeducation, goal setting, symptom checklist, and ending the program phase. Notable SSCM modified goals approach for improved quality of life over weight, is a flexible approach, and promotes patient autonomy. For more information on the SSCM, see chapter seven of the Clinician Guideline – Managing Severe and Enduring Anorexia Nervosa (Touyz, Le Grange, Lacey & Hay, 2016).
More specifically, aims may include the following:
- Keeping people in services
- Self harm minimisation
- Manage neuro-cognitive complications
- Avoidance of further failure experience
- Increasing motivation levels and sense of future direction
- Managing co-morbidity
(i.e. one or more additional disorders co-occurring with the primary disorder)
- Encourage engagement with life, relieve boredom and experience enjoyment
Through a positive therapeutic SSCM relationship with an ED professional or ‘coach’, the person with the eating disorder is more likely to stick a treatment plan.
The relationship can be seen as a collaborative partnership between the therapist and the person with the eating disorder, who is considered an expert in their own care.
Through this partnership, an exploration of practical steps is used to initiate change in daily life. This is done in an organised manner with manageable time-framed strategies towards agreed-to specific behavioural goals.
With this said, flexibility must be applied when needed.
The therapist provides a sense of hope, along with consistency, reassurance, encouragement, and patience. Ultimately, sessions aim to help individuals reach their fullest potential in life.
Predictors of therapeutic alliance in two treatments for adults with severe and enduring anorexia nervosa
Therapeutic alliance (TA) has been found to be a significant predictor of outcome for patients with severe and enduring anorexia nervosa, accounting for more variance than treatment type. To better understand how to promote TA for this population, this study aimed to investigate predictors of TA in adults with SE-AN.Read More Here
Anorexia nervosa is one of the earliest psychiatric illnesses to be described in the medical literature with well documented accounts made in the 19th century by both Gull  and Lasègue . They both expressed optimism about the eventual outcome of treatment.Read More Here
If you need help, reach out.
If you need assistance, or are interested in any eating disorder services, get in touch.
We can help with more information, referrals and/or arrange an assessment appointment.
You can also contact us through Eating Disorders Queensland
Eating Disorders Queensland 89 Sherwood Road, Toowong Qld 4066