by Cosette Dawna Rae

City University

A comprehensive approach in the treatment of eating disorders

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

ReferencesAmazon.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.

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