Training on the treatment of EATING DISORDERS

Transcription

1 Training on the treatment of EATING DISORDERS A comprehensive training on the latest evidence based treatment models for Eating Disorders 27/28/29/30 April 2018 The Smallville Hotel Badaro, Beirut, Lebanon

2 DAY 1 Friday April 27, 2018 MEDICAL INTERVENTIONS FOR EATING DISORDERS 9:00 10:30 Session 1 Physiology Dr Carole Wehbe Chidiac Session 2 Medical Approach Dr Carole Wehbe Chidiac 1.1 Physiology of hunger and satiety 1.2 Physiology of restricting and dieting 1.3 Physiology of binging 1.4 Physiology of purging (being vomiting or laxatives) 1.5 Physiology of exercise 1.6 Physiology of excessive exercise 1.7 Physiology of the weight set point 1.8 Pathophysiology of eating disorders This section will help the practitioner understand the disease and educate the patients and the caregivers. It will help motivate patients to engage in treatment by explaining to them what starvation does to their body and how restriction can increase the risk of putting on weight. Many myths about diet and exercise will be challenged as well. 2.1 The doctor s approach: straightforward, non-judgemental, empathetic and motivational 2.2 Medical sssessment: history, complaints and investigations 2.3 Education of patients and caregivers 2.4 Support (not therapy) for patients and caregivers 2.5 Medical complications in adults, teens, children, pregnant and athletes 2.6 Weight goal from a health perspective and a therapeutic perspective 2.7 Exercise and ED (physiological and psychological perspectives) 2.8 What should an MD know about transdiagnostic approach and goals 2.9 What is his/her role reaching these goals in a multidisciplinary team 2.10 What should an MD know about nutrition rehabilitation 2.11 What should an MD know about evidence based therapies 2.12 Levels of care and inpatient medical interventions 10:30 10:45 Lunch Break 10:45 Session 3 Workshop and Role Play Dr Carole Wehbe Chidiac 17:15 Session 4 Psychiatric Interventions Pr Janet Treasure 17:15

3 DAY 2 Saturday April 28, 2018 PSYCHOLOGICAL INTERVENTIONS FOR EATING DISORDERS 9:00 Session 1 Introduction / Pr Janet Treasure Lunch Break 1.1 Presentation of the different disorders: Diagnosis Clinical presentations Prevalence and prognosis 1.2 Common core psychopathology and migration between different disorders 1.3 Causal and maintaining factors 1.4 Comprehensive psychiatric assessment 1.5 Focused ED assessment 1.6 Clinician stance 1.7 Evidence and recovery 1.8 Presentation of evidence based practices: Enhanced Cognitive Behavioural Therapy for the treatment of Eating Disorders (CBT-E) MANTRA (Pr Janet Treasure) The New Maudsley Approach (Pr Janet Treasure) Family Based Treatment (FBT) 1.9 Nice Guidelines Session 3.1 Psychological Interventions for Aneroxia Nervosa CBT-E Protocol Personality and social-emotional factors in AN The typical development of AN The anorexic mindset Features of starvation Stages of treatment of CBT-E for underweight: Assessment Step 1: stage 1 of CBT- E protocol - Deciding to change Step 2: stage 3 of CBT-E protocol Regaining weight to a BMI of 19 Treatment of the underlying core ED psychopathology Step 3: stages 3 and 4 of CBT-E protocol - Mindsets and Setbacks - Maintaining progress and minimize the risk of relapse 11:15 11:15 11:30 11:30 Session 2 Psychological Interventions for Bulimia Nervosa/Binge-Eating Disorder CBT-E Protocol 2.1 Personality and cultural factors in BN 2.2 Treatment goals 2.3 The typical development of BN 2.4 Reasons for binge-eating 2.5 Bulimic values, the bulimic mindset and clinical presentation 2.6 CBT-E treatment map 2.7 Stage 1 : start well: psycho-education, shared formulation, regular eating, real-time self monitoring, collaborative weighing. 2.8 Stage 2: taking stock and deciding what to tackle in stage Stage 3 : treatment of the underlying core ED psychopathology: events, mood and eating; over-evaluation of shape and weight and their control; dietary restraint; mindsets and setbacks 2.10 Stage 4: ending well: relapse prevention 17:15 17:15 Session 3.2 Psychological Interventions for Aneroxia Nervosa and Relapse Prevention Binge-eating in AN Usual mid-treatment challenges with AN Relapse prevention for AN Broad treatment goals for AN Relapse prevention for all eating disorders

4 DAY 3 Sunday April 29, 2018 PSYCHOLOGICAL INTERVENTIONS FOR EATING DISORDERS 9:00 10:30 Session 1 Typical Eating Disorders in Children Session 3 ARFID (Avoidant-Restrictive Food Intake Disorder) 1.1 Numbers 1.2 Signs 1.3 Prevention 1.4 Recovery rates 1.5 Clinical presentations 1.6 Family Based Treatment (FBT) 1.7 Adaptation of CBT-E for the younger underweight population 1.8 General adaptation of treatment 3.1 Diagnosis 3.2 Prevalence 3.3 Causes 3.4 ARFID vs picky eating? 3.5 Assessment 3.6 Family meals 3.7 Stages of treatment: FBT-ARFID, CBT 3.8 Referrals 10:30 10:45 10:45 12:45 Session 2 Collaborative Care in the Treatment of Eating Disorders Pr Janet Treasure Session 4 Conclusion 12:45 Coaching families: The New Maudsley Approach 4.1 Conclusion on the psychological interventions of ED 4.2 A clinical perspective on normal eating 4.3 Role play: psycho-education and design of a formulation for BN Lunch Break

5 DAY 4 Monday April 30, 2018 NUTRITIONAL INTERVENTIONS FOR EATING DISORDERS 9:00 Session 1 Nutrition Counseling Mrs Hala Abu Taha Session 3 Nutritional Therapeutic Approaches Mrs Hala Abu Taha 11:15 11:15 11: Overview of nutrition and EDs Eating disorders in details The multi-disciplinary team involved in the treatment of EDs Characteristics of an ED dietician International guidelines for nutrition and ED 1.2 Nutrition counseling Course of treatment The process of counseling Counseling interventions Exercise and EDs 3.1 Role of dietician in FBT and CBT-E 3.2 Weight loss after ED resolving Genetic set point When to start the weight loss journey Lifestyle modifications Session 4 Nutrition Counseling for Avoidant Food Intake Disorder (ARFID) and Practicum Mrs Hala Abu Taha 11:30 12:45 Session 2 Nutrition Tools and Treatment Mrs Hala Abu Taha 4.1 ARFID in details 4.2 Workshop: case studies for AN, BN, BED & ARFID 2.1 Tools and meal planning Food planning: Rule of 3, exchange list, myplate 2.2 Treatment Assessing weight: protocol, frequency Nutritional risk assessment Treatment objectives for AN, BN & BED (2 phases each) Treatment of AN, BN & BED Challenges facing the ED dietician Problem solving with resistance 18:00 Q & A 12:45 Lunch Break

6 Carine el Khazen DESS, DEA Carine el Khazen is a clinical psychologist. She has a Masters Degree in Clinical and Psychopathological Psychology (University of Saint Joseph, Lebanon, 2000), postgraduate degree (DESS) in Clinical and Psychopathological Psychology (University of Sorbonne, Paris V, France, 2002), and diploma in Profound Studies (DEA) in Clinical Psychopathology (University of Jussieu, Paris VI, France, 2004). Carine has joined the American Center for Psychiatry and Neurology in Dubai in 2011 and as an eating disorders and obesity specialist (Practitioner s Skills diploma in eating disorders, training in the treatment of obesity and training in nutrition from the National Center for Eating Disorders- NCFED- accredited by the British Psychological Society, training in Enhanced Cognitive-Behavioral Therapy for the treatment of Eating Disorders -CBT-E and training in The Maudsley Model of Anorexia Treatment in Adults- MANTRA), she has set up and is the director of a specialized multidisciplinary out-patient eating disorders program based on evidence-based models. The program is currently under the supervision of Dr Riccardo Dalle Grave (Department of Eating and Weight Disorder, Villa Garda Hospital, Italy) co-developer of CBT-E. Along with her team they have successfully helped children, adolescents and adults recover from their eating disorders (anorexia, bulimia, binge-eating, ARFID, picky eating, ) and overcome their obesity. Carine is the Vice-President and head representative for the UAE of the non-profit association MEEDA (the Middle East Eating Disorders Association) and dedicates her free time to raising awareness and training the general public and professionals on the subject of eating disorders in multiple schools, universities and general medical practices across the UAE. Dr Carole Wehbe Chidiac MD, Family Medicine Specialist Dr Carole Wehbe Chidiac is a Family Medicine Specialist and an Eating Disorder Practitioner (Practitioner s Skills for eating disorders diploma from The National Center For Eating Disorders - NCFED) with more than 10 years experience in the treatment of eating disorders and obesity. As an active member of MEEDA board of advisors since 2013, Dr Chidiac has been a consultant and a lecturer for health care professionals, schools, companies and the general public. As a member of the international academy of eating disorders AED since June 2017, Dr Chidiac is part of two of its special interest groups, educating health care professionals, and increasing awareness via the distribution of its purple book. Dr Carole participated as well in the training of the American Centre of Psychiatry and Neurology staff in November 2016 before starting the first intensive outpatient unit for Eating Disorders and Obesity in the Middle East at ACPN in December She is still an active member of the unit, undergoing supervision for CBT-E treatment by professor Ricardo Dalle Grave. She did a similar training for doctors and nutritionists at GMCCLINICS Dubai in November Dr Chidiac will be completing a training in hospital refeeding for anorexics and severe medical complications of eating disorders at Boston Children Hospital, Adolescent Medicine Department, Harvard Medical School in April 2018.

7 Hala Abu Taha Dietician Having graduated in 2004 from Hashemite University, Jordan, with a Bachelor of Science in Clinical Nutrition & Dietetics; Hala then went on to train in post-obesity surgeries in Leeds, United Kingdom. In 2006, she attended a program of Diabetes Education Specialist along with working as clinical dietician at the National Center of Diabetes & Endocrinology in Amman, Jordan. Hala has been working in Dubai for the past several of years counseling individuals on weight loss, diabetes, pregnancy, childhood obesity among other health-related conditions. Then moved to Abu Dhabi to explore a new experience with bariatric surgery to be able to provide her patients with the full support pre and post surgeries along with working on homecare set patients to assess and tailor make the required nutritional plan for different cases. Finally, after a long experience in the nutrition field, Hala chose to join the American Center for Psychiatry and Neurology Eating disorders team to work closely with her clients building a solid & trustful relationship and helping them achieve long-term dietary habits and encouraging a balanced and healthy lifestyle. She works with patients with Binge-Eating Disorder, Bulimia Nervosa, Anorexia Nervosa and ARFID confidently after getting supervision sessions with international leaders in the ED world such as Marcia Herrin and Dr. Riccardo Dalle Grave (CBT-E). In addition to that role, Hala is keen to training other dieticians in the field of ED s and in that perspective she participated as a speaker in the International Conference for Eating Disorders (ICED 2017-Prague June 2017) and was part of an expert panel of dieticians designing worldwide nutritional guidelines for the treatment of ED s. Professor Janet Treasure OBE PhD FRCP FRCPsych Professor Janet Treasure has specialised in the treatment of eating disorders at the South London and Maudsley Hospital and also has had an academic career Kings College London for the majority of her career. The unit is one of the premier European academic centres for eating disorders. We have co-produced interventions with recovered patients and carers using some of the newest technologies including ipod, DVDs and web based as part of our interventions. She was made a Professor of Psychiatry in In 2013 she was given an OBE for her work in eating disorders. Her research has led to greater understanding of, and better treatments for, anorexia and bulimia. As well as editing professional texts, Janet has written several self help books for people with eating disorders (Schmidt & Treasure, 1993; Treasure, 1997). Guided self-help using books such as these are recommended in the NICE guidelines as a first stage of treatment. She works with Prof K Ishmael to manage people with diabetes and eating disorders in particular those that require inpatient care. She was on the NICE guideline for eating disorder in 2005 and She is a trustee of the charity Diabetes with Eating disorders (DWED) and medical advisor for BEAT and student minds Hala has interest in media as a dietitian she appears regularly on televisions shows and radio stations highlighting the importance of nutrition on our overall health and well-being.

8 For more information