INTRODUCTION S. Who are Therapy Partners? Who am I and what do I do?

Transcription

1 INTRODUCTION S Who are Therapy Partners? Who am I and what do I do?

2 Therapy Partners are a Team of Specialists that work together with one goal in mind, to help support young People that have developed an Eating Style that, if not treated, may in the long run, have a negative impact on their health and the choices they may wish to make in the future. We are:- Cognitive Behavioural Therapists, Family Therapists, Specialist Counsellors and a Specialist Nutritionist.

3 ME? Sallie Kemp Specialist Counsellor Eating Disorders Partner, Mum, Sister, Daughter, Friend

4 Eating Disorders What are they? Who gets them? Why do they develop? How can they affect us? How can they be treated? 4

5 What do you Know? Anorexia Nervosa Bulimia EDNOS

6 Anorexia nervosa Definition(Criteria) ( 3 features need to be present ) ICD-10 /DSM 5 Over evaluation of shape and weight and control, Judging self worth largely and even exclusively in terms of shape and weight and the ability to control Active maintenance of an unduly low body weight ( typically defined as maintaining a body weight less than 85% of that expected or a body mass index of 17.5 or below). Amenorrhea in post pubertal females ( not helpful with males) (Fairburn 2008)

7 Bulimia Nervosa Criteria - 3 features present ICD Over evaluation of shape and weight and their control, as in AN Recurrent binge eating. A binge is an episode of eating of which an objectively large amount of food is eaten given the circumstances and there is a sense of loss of control at the time. Extreme weight control behaviour ( e.g. sustained dietary restriction, recurrent self induced vomiting or laxative misuse. In addition there is an exclusionary criterion namely that the diagnostic criteria for AN should not be met. This criterion ensures that it is not possible for patients to receive both diagnosis at one time.

8 Eating Disorder Not Otherwise Specified EDNOS This is a residual category for eating disorders of clinical severity That do not meet the diagnostic criteria for Anorexia Nervosa or Bulimia Nervosa (ICD )

9 Possible indicators of an eating disorder e.g. what to look out for? Increased social isolation Diminishing levels of concentration and performance within the classroom- almost seeming switched off as the brain needs 500 calories a day to function Appear tired on a regular basis Not eating with family and friends Irritability Mood changes Weight loss or gain Excessive exercise

10 Who gets an eating disorder and why?

11 Young People? Middle Aged People? Children? Old People? Girls? Boys? Women? Men? Actors? Supermarket Assistants?

12 Research has found that anyone can get an eating disorder Eating disorders don t discriminate, and occur in females and males, across all age groups, across all socioeconomic groups and cultural backgrounds. It is often not possible to tell if a person has an eating disorder simply by looking at them. The Butterfly Foundation have estimated that about one in 20 Australians has an eating disorder: Both men and women get eating disorders 11 percent men (NICE 2017)

13 WHY?

14 Reality? There is no single cause of an eating disorder developing but there are a number of risk factors which may trigger disordered eating patterns to develop (BEAT 2017) Developing an ED can often be seen as a coping mechanism to help the individual manage challenging emotional states. Risk factors :- Body Image Pressures through the power of the media and social network sites Trauma, Bullying, Family/ relationship difficulties, stress, puberty, Abuse, Perfectionism, etc.

15 Body Image Video

16 Impact of eating disorder (the hard hitting stuff) People with eating disorders have the highest standardised mortality ratios among psychiatric disorders times that of their peers. Anorexia Nervosa (AN) has the highest mortality rate of any psychiatric disorder in adolescence ( BEAT 2017) Currently, of those surviving, 50% recover whereas 30% improve and continue to live with an eating disorder and 20% remain chronically ill and require on-going interventions (BEAT 2017). Only 46.9% of AN patients were classified as cured. Early intervention results in the best possible recovery outcome (NICE 2017). Not providing children and young people with the resources to recover means that their illness may not be cured and that they go into adulthood with enduring Anorexia Nervosa.

17 Psychological Impact Food obsession- calorie counting etc. Depression anxiety Irritability Fatigue Social isolation Obsessive thoughts/ paranoia

18 Physical Impact Anaemia Intestines- bloating, constipation Muscles and joints-bone loss, Kidneys- failure Skin-bruise easily, dry, develop fine downy hair, yellow tinge, nails brittle. Hormones- periods may stop in females- which could lead to infertility.

19 How does it effect relationships/family/carers Self blame Depression Shame Sense of loss Confusion and hopelessness Isolation Anxiety And these are feelings that can be experienced by the people that are close to the Person who has the Eating Disorder.

20 How can we help? Work with clients on a 1:1 basis using CBT-E Fairburn 2007 model Work with families- 1:1 and group Offer peer support Promoting awareness in schools

21 How We Promote Change

22 CBT-E has 3 goals To remove the Eating disorder psychopathology (We work to challenge the belief system that is holding the young Person within the Disordered Eating Style) To correct the mechanisms that maintain this psychopathology ( By Challenging beliefs that may have been developed ie reality checking!) To ensure that the changes are lasting ( Setting goals and making changes that are sustainable and achievable)

23 Peer support groups Weekly support groups are offered to our Young People once they have completed their one to one therapy. The aim of these groups is allow them to meet with other young people that may have experienced a similar relationship with food. Allowing them to talk in a Non-judgemental environment and work together to continue their road to recovery.

24 Family work its important to recognise that an Eating Disorder doesn t just affect the Person, but it also can have an impact on those around them. Support groups Weekly sessions are offered to the Parents/Families of the young person that has been through 1 to 1 Therapy. These are facilitated by our Specialist Therapists and often Guest Speakers are invited along to help offer advice and support.

25 Rewrite your story: video tdatp234

26 Useful go to websites Therapy Partners UK ED sites BEAT Eating disorders Victoria

27 The New Maudsley Method

28 Questions?