Eating Disorders: A Comprehensive Approach

A comprehensive approach in the treatment of eating disorders by Cosette Dawna Rae City University

Over the course of ten years, she was hospitalized
26 times
for anorexia nervosa.
Her first hospitalization was at the age of 15
(Sargeant, 1999)
“ Her Story”

“ The punitive behavior modification program she underwent ( family visits were denied if she failed to gain weight ) foreshadowed years of hospitalizations that she contends did nothing to ease her condition.” (Amazon.com, 2006)

In America today, 10 million men and women have an eating disorder (NEDA, 2006)

Eating disorders have the highest mortality rate of any mental illness (Costin, 1996)

Clients need help in understanding the disorder and in changing behaviours
Immediate assistance
Comprehensive approach
Family systems theories are dominant (Maiolo, 2006)

Assessments are made an individual treatment plan is created
Psychiatrist Intake and Assessment
Inpatient versus outpatient treatment
Individual treatment plan

Desired treatment goals by eating disorder (NIMH, 2006)

Anorexia Nervosa
Restore weight lost
Healthy body image
Recovery or remission
(NIMH, 2006)

Bulimia Nervosa
Eliminate purging and binge eating
Healthy eating
Exercise
(NIHM, 2006)

Binge-Eating Disorder
Eliminate binge eating behaviors
Healthy eating
Exercise

Intensive Outpatient Program (IOP) the Moore Center Approach
Stage One IOP : is a twelve week process
Stage Two IOP : meet weekly
One is not “cured” by the 12-week program, recovery is a life-long choice aided by the IOP program (Maiolo, 2006)

A variety of techniques are used in assisting the client with recovery
Behavioural Modification & Management
Interpersonal, Group, and Family Therapy
Psychopharmacology
Psychological Testing

Cognitive Behavioural Therapy (CBT) Behavioural Modification & Management
Developed by Albert Ellis and Aaron T. Beck
Behaviour, emotions and cognitions interact
A variety of methods and approaches to CBT

Sample CBT Session
Session Structure*
Greet Patient
Perform a symptom check
Set agenda
Review homework
Conduct CBT
Teach basic CBT
Develop new homework
* (Wright, Basco& Thasem, 2006)

Schemas, automatic thoughts, cognitive distortions
All or Nothing
Magical Thinking
Generalization
Overgeneralization
Minimization
Personalization
Magnification
Dichotomous Thinking
* (Maiolo, 2006)

Sample Thought Change Record (TCR) *
Situation: Describe the event that led to the emotions or physiological sensation.
Automatic Thoughts : Identify the thought that preceded the emotion or feeling.
Emotion(s): List the emotion(s), e.g., sad, happy, frustrated, angry, irritated.
Rational Response : List the cognitive error and the identify rational response.
Outcome: Subsequent emotion
* (Wright et al. 2006)

Are these techniques effective in helping clients recover?
According to the Eating Disorder Sourcebook: (Costin, 1996)
Only 30-40 percent ever fully recover
Only 50 percent report being cured
5 to 10 percent of anorexics die
(within ten years from onset)
20 percent will be dead after twenty years

A comprehensive treatment approach has been shown to be effective
No specific form of therapy seems to be more effective than another
(Healthy Place, 2006)

Her Recovery
Currently
In
Remission

References
Amazon.com (2006) Editorial Review. Retrieved 03/13/2006 from http://www.amazon.com/gp/product/1880823195/102-0852111-3308911?n=283155
Costin, C. (1996) Eating Disorder Sourcebook , RGA Publishing Group, Los Angles, CA.
DeAngelis, T. (2002). Promising treatments for anorexia and bulimia: Research boosts support for tough-to-treat eating disorders. Monitor on Psychology. 33(3 ).
Healthy Place (2006). APA treatment guidelines for eating disorders. Healhtyplace.com Retrieved Februrary 6, 2006 from http://www.healthyplace.com/Communities/Eating_Disorders/treatment_guidelines.asp
Maiolo, C. (2006). Personal communication. The Moore Center.
Meads, C., Gold, L. & Burls, A. (2001). How effective is outpatient care compared to inpatient care for the treatment of anorexia nervosa? A systematic review. European Eating Disorders Review. 9(4) 229-241.
Moore, M. (2006). The Moore Center. A comprehensive treatment program for eating disorders. Retrieved February 28, 2006 from http:// www.moorecenterclinic.com
NEDA (2006). National Eating Disorders Association. Retrieved February 13, 2006 from http:// www.nationaleatingdisorders.org/p.asp?WebPage_ID =320&Profile_ID=95634
NIMH (2006). Eating Disorders Facts about eating disorders and the search for solutions. National Institute of Mental Health. Retrieved February 15, 2006 from http:// www.nimh.nih.gov/publicat/NIMHeatingdisorder.pdf
Sargeant, J. (2006) Anorexia Nervosa: Judy’s story. Retrieved February 12, 2006 from http:// www.angelfire.com/ms/anorexianervosa/index.html .
Wright, J. H., Basco, M. R, Thase, M. E. (2006). Learning Cognitive Behavior Therapy . American Psychiatric Publishing, Inc. Arlington, VA.
Heavensfield Design © 2006 Photographs used with permission and may not be reproduced without written authorization.

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