What is Intensive Treatment for Anorexia?
What is Intensive Treatment for Anorexia?
Although the majority of people with eating disorders can be treated through outpatient therapy, for those with a more severe illness, inpatient treatment will be necessary.
Inpatient treatment for anorexia usually takes place in eating disorder centres, often located far from the individual's home, and can last as long as six to nine months. This means a long period of disconnection from home, family, community and friends.
Specialist eating disorder centres have recently introduced intensive treatment programmes for anorexia.
Unlike the traditional approach, known as standard recovery, intensive treatment takes place over a fixed period, usually lasting eight weeks.
"We recognise that it is not realistic to suggest anorexia can be fully treated within eight weeks," explains Professor Hubert Lacey, Medical Director of Newbridge House. "However the intensive treatment programme is based on having agreed, achievable goals for the inpatient unit and equally, a clear role for local NHS community mental health services following discharge from inpatient care."
The intensive treatment programme consists of family work and family involvement, group work, individual therapy and occupational therapy. Supported meal times are at the heart of the programme, with the aim that all individuals will accept three meals a day. Specific weight gain and BMI goals will be individually based.
Family work and involvement is key feature of intensive treatment. A long period of inpatient treatment can be disempowering for parents of young people with eating disorders, who effectively hand over' responsibility for food and nutrition to the specialist unit.
Under the intensive treatment programme, families are normally invited to the unit, often for the first two weekends of treatment. They work with dietician, occupational therapist and specialist nurses, supporting family members with key skills such as meal preparation and managing conflict. After the first two weekends, the young people will normally return home on a Saturday and Sunday, enabling families to assist in the process of recovery and build their own skills in order to do so.
One of the major differences between the intensive treatment programme and standard recovery is the role of local mental health services. Under the traditional model, it is the inpatient unit which carries out the whole process of treating the patient and working with them through to recovery. The intensive treatment programme is based on the inpatient unit having a defined role, but equally, allocating a clear role to local services. For example, the inpatient unit's role may be based on stabilisation, some weight gain and acceptance of three meals a day. The role of local services thereafter may be to oversee longer term psychological change through interventions such as family therapy and individual therapy.
The intensive treatment programme offers a new way for developing the partnership between the specialist eating disorder centre and local NHS community mental health services, reflecting the strengths of both and allowing for them to work together more closely. Also, as the intensive treatment programme is based on a fixed term of treatment, it provides a potential option for private patients, whether via their insurance schemes or on a self-pay basis.
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