Empowering Families Skills for Carers Workshops. Susan Ringwood Chief Executive Beat

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1 Empowering Families Skills for Carers Workshops Susan Ringwood Chief Executive Beat

2 Empowering Families Overview of presentation Beat The New Maudsley Method Parenting styles- the animal metaphors Communication Skills How Carers can cope Carer & Sufferer comments Discussion

3 Beat We believe that eating disorders will be beaten Our aims are: to change the way everyone thinks and talks about eating disorders to improve the ways services and treatment is provide to help anyone believe they can beat their eating disorder

4 What we do Help-lines, and text Website, forums and live chat Support groups Literature and publications Share perspectives with professionals Media work and campaigning

5 The Beat Team

6 Norwich- our fine city

7 ...Ancient and modern

8 Empowering Families Skills Workshops Supporting Carers of Loved Ones with Eating Disorders Beat in collaboration with the Maudsley Hospital and King s College, London Material drawn directly from: Skills-based Learning for Caring for a Loved One with an Eating Disorder. The New Maudsley Method (2007), Treasure, Smith and Crane Thanks to Janet Treasure, Gill Todd and the Team.

9 Session outlines 1 understanding eating disorders 2 Maintaining factors, personality & animals 3 Stages of change & communication skills 4 Motivational interviewing 5 Challenging Behaviours 6 Problem eating 7 Supporting yourself 8 Review and planning ahead

10 Understanding Eating Disorders Exact cause of Eating Disorders unknown but many different risk factors... NO evidence family are the cause of Eating Disorders

11 Why Skills Training? The Collaborative Care Ethos Caring for a loved one with an eating disorder Impact on family and friends Family involvement in treatment Family members lack information and skills for this role Collaborative Care ethos sees carers as a Valuable Resource

12 Collaborative Care Ethos Curious Caring Consistent Compassionate Coaching Calm

13 Shared Personality traits of Eating disordered individuals and Carers Perfectionism black and white thinking - Missing the Oh Sod It! Gene All polarised thinking Nothing Rigidity - Difficulty in changing thinking. Rules learnt are difficult to shift. Flexible Focused Detail vs Global bias Not seeing the wood for the trees Detailed Global

14

15 Maintaining Factors Interpersonal Biological Social Environmental

16 Animal Analogies Style of Involvement Too much sympathy & micromanagement Just enough direction & support Emotional Response Too much criticism & hostility Too little emotion Head in the sand Just enough calmness, compassion & consistency Too much emotion Can t cope: Sad & Mad

17 Expressed Emotion: Overprotection The Vicious Cycle of Kangaroo Care Anxious about Edi Fear of death Fear of saying the wrong thing Worsen how they feel Unhelpful behaviours Become overly supportive Don t allow any space/ personal responsibility Worsen Problems No opportunity to master challenges Gives message world is a threat Stifles and frustrates. Suffocating Emotionally draining for both

18 Expressed Emotion: Over-directedness The Vicious Cycle of Rhinoceros Care Anxious about her/ fear of her death Want to take control/ sort things out Make her see reason Worsen how they feel Unhelpful behaviours Shout/try to control Ban from going out Argue and try to win Worsen Problems Edi feels rejected/unloved - no trust Anger/upset: I won t give in! Emotionally draining for all

19 The Balance of Direction Too much control & direction Just enough Subtle direction Too much sympathy & micro-management

20 Think about your loved one- What are their personality traits? Have any of them appeared or increased since they ve developed an eating disorder?

21 So what are the perceived benefits of an eating disorder for someone with these personality traits?

22 The Stages of Change Model Relapse Precontemplation Exit through Maintenance to Recovery Maintenance Contemplation Action Preparation

23 Motivational Interviewing Aesop The Battle of Wind and Sun

24 Discover tools to: Communication Skills Express yourself in a way your loved one can understand Understand what your loved one is trying to communicate Improve your relationships

25 Communication Skills Listen skills build trust & mutual respect Empathise understand what is really going on Share non-eating disorder activities Support create a safe and calm atmosphere is More

26 Reflective Listening It sounds to me like So you re saying From your point of view Let me check I ve understood. you re feeling

27 Roadblocks to Listening Dis/agreeing Being distracted Suggesting Too much Empathising Rehearsing Dis/approving Arguing Reassuring Judging Feeling upset

28 Antecedents for Challenging Behaviours Intense negative thoughts about self and world The Hidden emotions Low self-worth Teenage hormones Starved (/unbalanced) brain High Expressed Emotion environment Carer refuses to Accommodate/Enable Fear about change/leaving safety of Eating Disorder behaviour.

29 Addressing Challenging Behaviour with ABC A Antecedent B Behaviour C Consequence What were the emotions and illness-based reasons underlying the behaviour? What was their behaviour? What was your response? Understanding the underlying causes for their behaviour, & the vicious cycles that maintain them, how could your response be different in the future?

30 Carer Coping Good Enough Caring Mistakes are a treasure! Oxygen mask

31 What did you find most useful about the workshops? Just telling us over and over again that we need some breaks and time for ourselves, as we always feel guilty if we do take some time off... I have learned to give myself my life back

32 Carer Comments I think it is absolutely essential for carers of loved ones with eating disorders, the sooner the better...it made me hopeful that I could do something useful Our relationship has improved massively I know that we re just at the beginning of a really difficult road of recovery but for the first time feel like it s going to be OK I strongly recommend to any family facing a similar problem, please do attend the workshops if you can, both parents if possible I really can t recommend the workshops highly enough, I almost feel like a different person now

33 Sufferers Comments If she hadn t had the teaching and support and stuff like that then I might not have got better as well or as quickly as I have I feel it really helped and the main thing that helped was her staying calm it really, really helped...when she stays calm, I sort of stayed calm myself and just got over it She recognises that I have AN, it s not just my personality and it s the AN she hates... I like that she sees it as separate in one way because it makes me know that she doesn t hate me I think mainly the confidence thing before they felt panicked; they didn t know what to do...

34 Further Information: Skills-based Learning for Caring For a Loved One with an Eating Disorder. The New Maudsley Method Janet Treasure, Grainne Smith, Anna Crane 2007, Routledge

35

36 Thank you

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