Il vento della crisi

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Il vento della crisi

• Per un pugno di riso
• Ho perso la calma
• E il sorriso

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Le reti degli interventi

• Think big
• And act locally
• Il senso del contesto e la singolarità
  dellevento
• Il mito dellintervento perfetto
• The quest for grahal

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Dai progetti allintervento

• Il master planning e il lavoro di team
• Il team diffuso e il team confuso
• Il team convivente e il team ricomposto
• Il team efficace e il team efficiente

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Il sistema cliente

• La persona e i suoi attributi
• La coppia
• La famiglia
• Il gruppo
• Sistemi allargati

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Il sistema osservante

• Il cliente e il terapeuta
• I clienti e i terapeuti
• Il coupling strutturale
• La forma e la struttura del processo terapeutico

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Il sintomo che costruisce il team

• No symptom no party!
• so thin so big!
• so fat so small
• No anorexia no team
• Building teams around
• Il significato relazionale

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La spiegazione psicodinamica

• A
• B
• C
• D
• E

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La spiegazione sistemica

• A
• B
• C
• D
• E

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La spiegazione cognitivo comportamentale

• A
• B
• C
• D
• E

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Il trattamento

• Biologico
• Psicologico
• Sociale

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Gli obbiettivi

• Stabilizzazione
• Comprensione
• Cambiamento

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Gli schemi

• Obbiettivi a breve
• Obbiettivi medi
• Obbiettivi strategici
• Strumenti terapeutici correlati agli obbiettivi

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Le nuove narrative

• Ascolto
• Decostruzione
• ancoraggio
• ricostruzione

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Stili di vita

• Dicotomie
• Ambienti
• Correlazioni
• Da pensiero monopolare a
• Pensiero dicotomico
• A pensiero complesso

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Emozioni e sentimenti

• Ascolto emozionale
• Nominare le emozioni
• Riconoscere le emozioni
• Narrare le emozioni
• Le emozioni triadiche
• I sentimenti triadici

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La diagnosi

• Lineare
• Relazionale
• La meta-gnosi
• La sun-gnosi

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La crisi

• Ascolto
• Contenimento
• ridefinizione

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Cura relazionale

• Mutuo aiuto
• Psicoeducazione sistemica
• Terapia gruppale
• Terapia familiare
• Terapia individuale
• Counselling
• mediazione

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I fogli informativi della Mayo Clinic

• Per la cura dei disturbi alimentari

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Psychotherapy An overview of the types of
therapy

• Many types of psychotherapy are available. Some
  focus on changing current behavior patterns and
  others focus on understanding past issues.
• Psychotherapy is a general term for a way of
  treating mental and emotional disorders by
  talking about your condition and related issues
  with a mental health professional.

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Through psychotherapy sessions, you may

• Learn about the causes of your condition so you
  can better understand it.
• Learn how to identify and change behaviors or
  thoughts that adversely affect your life.
• Explore relationships and experiences.
• Find better ways to cope and solve problems.
• Learn to set realistic goals for your life.
• Psychotherapy can help alleviate symptoms caused
  by mental illness, such as hopelessness and
  anger, so that you can regain a sense of
  happiness, enjoyment and control in your life.

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Psychotherapy can be short-term

• with just a couple of sessions, or it can
  involve many sessions over several years.
• It can take place in individual, couples, family
  or group sessions.
• Sometimes psychotherapy is combined with other
  types of treatment, such as medication

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Art therapy

• Art therapy, also called creative art therapy,
  uses the creative process to help people who
  might have difficulty expressing their thoughts
  and feelings. Creative arts can help you increase
  self-awareness, cope with symptoms and traumatic
  experiences, and foster positive changes.
  Creative art therapy includes music, dance and
  movement, drama, drawing, painting and even
  poetry.

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Behavior therapy

• Behavior therapy focuses on changing unwanted or
  unhealthy behaviors, typically using a system of
  rewards, reinforcements of positive behavior and
  desensitization.
• Desensitization is a process of confronting
  something that causes anxiety, fear or discomfort
  and overcoming those responses. If you have a
  fear of germs that triggers you to excessively
  wash your hands, for instance, you might be
  taught techniques to stop your excessive washing.

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Cognitive therapy

• Cognitive therapy is designed to help you
  identify and change distorted thought (cognitive)
  patterns that can lead to feelings and behaviors
  that are troublesome, self-defeating or
  self-destructive. It's based on the premise that
  how you interpret your experiences in life
  determines the way you feel and behave. If you
  have depression, for instance, you might see
  yourself and your experiences in negative ways,
  which worsens the symptoms of depression. Like
  behavior therapy, cognitive therapy focuses on
  your current problem, rather than addressing
  underlying or past issues or conflicts. Unlike
  behavior therapy, however, your experiences are
  an important part of the cognitive therapy
  process.

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Cognitive-behavior therapy

• Cognitive-behavior therapy combines features of
  both cognitive and behavior therapies to identify
  unhealthy, negative beliefs and behaviors and
  replace them with healthy, positive ones.
• It's based on the idea that your own thoughts
  not other people or situations determine how
  you behave. Even if an unwanted situation doesn't
  change, you can change the way you think and
  behave in a positive way.

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Dialectical behavior therapy

• Dialectical behavior therapy (DBT) is a type of
  cognitive-behavior therapy. Its primary objective
  is to teach behavioral skills to help you
  tolerate stress, regulate your emotions and
  improve your relationships with others. It was
  originally designed for people with borderline
  personality disorder, who often have suicidal
  behavior. But DBT has been adapted for people
  with other conditions, too, including eating
  disorders and substance abuse.

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Dialectical behavior therapy

• is derived, in part, from a philosophical process
  called dialectics, in which seemingly
  contradictory facts or ideas are weighed against
  each other to come up with a resolution or
  balance. For instance, you might learn about
  accepting who you are while at the same time
  making changes in your thoughts and behaviors.

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Exposure therapy

• Exposure therapy is a form of behavior therapy
  that deliberately exposes you to the very thing
  that you find upsetting or disturbing.
• It's especially useful for people with
  obsessive-compulsive disorder or post-traumatic
  stress disorder. Under controlled circumstances,
  exposure to the event or things that trigger your
  obsessive thoughts or traumatic reactions can
  help you learn to cope with them effectively.

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Interpersonal therapy

• Interpersonal therapy focuses on your current
  relationships with other people. The goal is to
  improve your interpersonal skills how you
  relate to others, including family, friends and
  colleagues.
• You learn how to evaluate the way you interact
  with others and develop strategies for dealing
  with relationship and communication problems.

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Play therapy

• Play therapy is geared mainly for young children
  at specific developmental levels. It makes use of
  a variety of techniques, including playing with
  dolls or toys, painting or other activities.
• These techniques allow children to more easily
  express emotions and feelings if they lack the
  cognitive development to express themselves with
  words.

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Psychoanalysis

• In psychoanalysis, you examine memories, events
  and feelings from the past to understand current
  feelings and behavior. It's based on the theory
  that childhood events and biological urges create
  an unconscious mind that drives how you think,
  feel and behave. In this type of therapy, you
  explore those unconscious motivations to help
  make changes to improve your life. You might also
  do dream analysis and free association talking
  about whatever happens to come to mind.

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Psychoanalysis

• is a long-term, intensive therapy that often
  involves several sessions a week with a
  psychoanalyst for several years. In formal
  psychoanalysis, you lie on a couch and the
  therapist sits unseen behind you. The practice
  evolved out of theories developed by Sigmund
  Freud.

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Psychodynamic psychotherapy

• Psychodynamic psychotherapy, based on the
  theories of psychoanalysis, focuses on increasing
  your awareness of unconscious thoughts and
  behaviors, developing new insights into your
  motivations, and resolving conflicts to live a
  happier life.
• It's one of the most common types of
  psychotherapy. It's less intense than
  psychoanalysis and is usually done sitting face
  to face with a therapist.
• It's also less frequent usually once a week
  and is shorter term, usually a year or less.

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Psychodynamic psychotherapy

• includes a variety of therapeutic techniques,
  such as exploring your past, confronting your
  beliefs and actions, offering support, and
  interpreting your thoughts and behavior.
• That process allows you to become aware of and
  acknowledge the link between a feeling, thought,
  symptom or behavior and an unconscious meaning or
  motivator.
• With that new understanding, you can modify
  unwanted behavior or thoughts.

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Psychoeducation

• Psychoeducation focuses on teaching you and
  sometimes family and friends about your
  illness.
• Psychoeducation explores possible treatments,
  coping strategies and problem-solving skills for
  your condition. You might learn about resources
  in your community, such as support groups or
  housing options. You can also learn about
  symptoms that might indicate a potential relapse
  so that you can take steps to get appropriate
  treatment. Psychoeducation can be especially
  useful for people with chronic or severe
  illnesses, such as schizophrenia.

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Family therapy Healing family conflicts

• Families can be torn apart by illness, divorce or
  other problems that create conflict and stress.
  Family therapy can help families identify and
  resolve problems.

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Your family can be your greatest source

• of support, comfort and love. But it can also be
  your greatest source of pain and grief. A health
  crisis, mental illness, work problems or teenage
  rebellion may threaten to tear your family apart.
  

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Family therapy can help

• your family weather such storms. Family therapy
  can help patch strained relationships, teach new
  coping skills and improve how your family works
  together. Whether it's you, your partner, a child
  or even a sibling or parent who's in crisis,
  family therapy can help all of you communicate
  better and learn to get along.

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What is family therapy?

• Family therapy is a type of psychotherapy. It
  helps families or individuals within a family
  understand and improve the way family members
  interact with each other and resolve conflicts.
• Family therapy is often short term. You usually
  attend one session a week, typically for three to
  five months. In some cases, though, families may
  need more intensive treatment. The treatment plan
  will depend on your family's specific situation.

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Family therapy

• is usually provided by therapists known as
  marriage and family therapists. These therapists
  provide the same mental health services as other
  therapists, simply with a specific focus family
  relationships.
• Family therapy is often short term. You usually
  attend one session a week, typically for three to
  five months. In some cases, though, families may
  need more intensive treatment. The treatment plan
  will depend on your family's specific situation.

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Who can benefit from family therapy?

• In general, anyone who wants to improve troubled
  relationships can benefit from family therapy.
  Family therapy can help with such issues as
• Marital problems
• Divorce
• Eating disorders, such as anorexia or bulimia
• Substance abuse

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Who can benefit from family therapy?

• Depression or bipolar disorder
• Chronic health problems, such as asthma or cancer
  
• Grief, loss and trauma
• Work stress
• Parenting skills
• Emotional abuse or violence
• Financial problems

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Your family may do family therapy

• along with other types of mental health
  treatment, especially if one of you has a serious
  mental illness that also requires intense
  individual therapy. Family therapy isn't a
  substitute for other necessary treatments. For
  instance, family therapy can help family members
  cope if a relative has schizophrenia. But the
  person with schizophrenia should continue with
  his or her individualized treatment plan, such as
  medication and possibly hospitalization.

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Your family may do family therapy

• .
• In some cases, family therapy may be ordered by
  the legal system. Adolescents in trouble with the
  law may be ordered into family therapy rather
  than serving jail time, for instance. Violent or
  abusive parents are sometimes spared jail if they
  enter family therapy. Divorcing couples may also
  be required to attend family therapy.

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How does family therapy work?

• Family therapy often brings entire families
  together in therapy sessions. However, family
  members may also see a family therapist
  individually. Family therapy can even include
  nonfamily members, such as teachers, other health
  care providers or representatives of social
  services agencies.

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Working with a family therapist

• , you and your family will examine your family's
  ability to solve problems and express thoughts
  and emotions. You may explore family roles, rules
  and behavior patterns in order to spot issues
  that contribute to conflict. Family therapy may
  help you identify your family's strengths, such
  as caring for one another, and weaknesses, such
  as an inability to confide in one other.

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For example

• , say that your adult son has depression. Your
  family may not understand the roots of his
  depression or how best to offer help. Although
  you're worried about your son's health, you have
  such deep-seated family conflicts that
  conversations ultimately erupt into arguments.
  You're left with hurt feelings, decisions go
  unmade, and the rift grows wider.

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Family therapy

• can help you pinpoint your specific concerns and
  assess how your family is handling them. Guided
  by your therapist, you'll learn new ways to
  interact and overcome old problems.
• You'll set individual and family goals and work
  on ways to achieve them. In the end, your son may
  be better equipped to cope with his depression,
  you'll understand his needs better, and you, your
  partner and your son may all get along better.

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What questions should you ask when choosing
a family therapist?

• Before choosing a family therapist, you can ask
  lots of questions to see if he or she is the
  right fit for your family. Consider asking
  questions like these
• Are you a clinical member of the AAMFT or
  licensed by the state, or both?
• What is your educational and training background?
  
• What is your experience with my type of problem?
• How much do you charge?

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Are your services covered by my health insurance?

• How long is each session?
• How often are sessions scheduled?
• How many sessions should I expect to have?
• What is your policy on canceled sessions?
• How can I contact you if I have an emergency?

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Starting therapy

• with a family therapist can be one of the best
  things you do when your family is torn apart. You
  can heal emotional wounds, come to understand one
  another better and restore a sense of harmony you
  may not have felt for a long time.

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I

• Consigli alla spettabile clientela da parte del
  Dipartimento USA per la salute mentale

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There are over 400 schools of psychotherapy

• , each claiming a distinct theory and set of
  treatment technique. Psychodynamic and
  cognitive-behavioral therapies probably represent
  the most widely used. There is no one
  definitive form of therapy recommended for eating
  disorders. Often the therapist will evaluate
  where the patient is. For some individuals, they
  may be very knowledgeable and have had experience
  with some intervention. For others, it is a
  totally new experience.

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Most often a supportive psycho-educational

• format launches the process. Most therapists will
  either combine or progress to a
  cognitive-behavioral or psychodynamic approach. A
  variety of professionals may collaborate to make
  sure that medical, dental, and nutritional
  components are addressed. If this sounds pretty
  complex, you are correct. Now just to add
  confusion to the entire picture, assume all these
  therapies can be done in individual, group,
  family, couples, and maybe even the Internet!
  Don't panic. That's why there are professionals
  out there to help sort out what will work for
  you.

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But who gets what and why?

• There are several treatments that hold promise
  and should be strongly considered. Many
  therapists will take an eclectic approach and
  combine different forms of therapy in order to
  develop your treatment plan. Some will work
  together with a treatment team with professionals
  providing an area of specialization, such as
  medication, nutritional counseling, family, or
  group therapy. Your therapist, however, may have
  a certain philosophy or be trained in a specific
  approach. Make sure you ask and understand the
  goals in treatment. Remember your treatment
  should always be individualized to meet your
  needs.

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the therapeutic alliance

• Above all, one of the most important things in
  therapy is what we callthe therapeutic alliance.
  It's the key to any successful therapy. Some
  studies have suggested that this therapeutic
  relationship maybe as important, if not more so,
  than the specific technique in determining
  outcome. People get well in many ways but one
  thing for sure the relationship of trust and
  mutual respect serves as a foundation for
  treatment. You be the judge!

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What happens in therapy

• Often individuals have an image in their mind
  regarding what happens in therapy. Below is a
  partial list of terms and some additional
  comments that might be helpful in understanding
  the various approaches. This list is by no means
  complete or comprehensive, but it may help you be
  a more informed consumer in order to select an
  approach that fits you.

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It works?

• It is important to note that formal psychotherapy
  may be ineffective with starving patients and
  should not be used alone to treat severely
  malnourished patients. It may help the patient to
  become motivated and gain weight, but medical,
  nutritional, and supportive treatment should be
  initiated during this stage. Once malnutrition
  has been corrected and weight gain is starting to
  occur and the patient no longer acutely medically
  compromised, various forms of psychotherapy can
  be very helpful

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Understanding the Language

• The Bio-psycho-social model Since the causes
  of eating disorders seem multiple, this
  philosophy approaches eating disorders as an
  interactive process which involves genetic and
  biological factors, psychological factors
  androecia-cultural and family factors. This might
  seem like a shot gun approach- and it is. Eating
  disordered patients are complex, and often have
  serious and chronic conditions that require
  various treatments at different stages.

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The B.P.S.

• This approach often allows the therapist to
  bring a variety of different theories and
  approaches to treatment. Within this broad model,
  however, treatment can still vary widely. Ask if
  the therapist has a specific approach and whether
  there has been training using this approach with
  eating disorders.

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Medical Model

• Mood disturbances and anxiety states are quite
  common in eating disorders. The need for
  nutritionally and medically stabilizing
  individuals is seen as important first steps.

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In anorexia

• the assessment for antidepressant medication is
  often done following weight gain since starvation
  itself can worsen the symptoms of depression. In
  addition, there is some evidence that medication
  should be considered for prevention of relapse
  for patients who have restored their weight or
  who continue to show signs of depression or
  obsessive compulsive problems.

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In bulimia nervosa

• antidepressant medications are effective for
  many patients as one component of the initial
  treatment in combination with therapy. They
  appear to help with some of the psychological
  symptoms and also directly to decrease the
  binge/purge cycle. There are a number of other
  medications that may be useful in the treatment
  of eating disorders. One should not rely on the
  treatment of eating disorders solely with
  medication.

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Cognitive Behavior Therapy (CBT)

• CBT has been used increasingly in recent years.
  It is a very directive and time limited therapy.
  The therapist and patient work together to
  identify irrational beliefs and illogical
  thinking patterns associated with body image,
  weight, food, and perfectionism. There is a focus
  on the behavioral components of the illness such
  as binge eating, purging, dieting, and
  ritualistic exercise. Outcome studies show that
  it compares favorably with antidepressant
  medication and is often considered the treatment
  of choice for bulimics. Its short-term structure
  with the availability of manuals has made it a
  useful resource.

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Psychodynamic Therapy

• This is based on the idea that people can
  achieve greater understanding of the
  psychological forces that motivate their actions.
  Insight through psychological exploration then
  opens up the possibility for change in
  personality and behavior. The assumption is that
  the present is shaped and governed by the past.
  This approach is frequently used for eating
  disorders when the person is at the appropriate
  stage to benefit from this type of intervention.

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Feminist Psychodynamic Psychotherapy

• The feminists model is based on the assumption
  that social conditioning of women results in
  repression of certain needs and aspects. The
  therapist engages the patient in dialogue that
  encourages her to find her own truths and have
  one's own voice. The importance of interpersonal
  relationships and intimacy are a focus. The
  therapist acts as a resource and doesnt claim to
  know all the answers and encourages the open
  exchange of ideas and fosters the development of
  self.

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Interpersonal Therapy

• This is a short-term therapy that was initially
  used to treat depression and modified to treat
  eating disorders. Individuals are taught to
  evaluate their interactions with others with an
  understanding that interpersonal conflicts may
  not have caused the eating disorder per se but
  may indeed maintain the disorder. Problem areas,
  other than the eating disorder, are identified
  and a treatment contract is formulated. The focus
  is here and now with less attention paid to the
  eating disorder behavior and symptoms.

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Interpersonal 2

• If a patient replied in therapy that her eating
  was terrible, the therapist would not focus on
  the details of the disturbed eating behavior but
  rather the importance of understanding why this
  had happened. The patient would be asked if it
  could be related to one of the identified
  interpersonal problem areas. The expectation is
  that as one improves interpersonal function,
  there is improvement of the eating disorder.

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Family Therapy/Marital Therapy

• There are a variety of approaches to family
  therapy. Some will view therapy as treatment WITH
  the family, others as treatment OF the family.
  Certainly family therapy should be considered
  whenever possible, especially for adolescents
  who still live with their parents, patients still
  with ongoing conflicts or marital discord. Some
  have suggested the younger the patient the more
  significant the use of family therapy. In
  addition, if the eating disorder patient is a
  mother, special help should be paid to mothering
  skills to decrease the risk of transmitting an
  eating disorder.

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Psychoanalysis

• In its true form this is the couch therapy.
  Sessions are usually held 4-5 times a week, and a
  completed analysis may take 3-5 years. The focus
  is aimed on self-understanding and correction of
  developmental lags so that there can be
  reorganization of the personality. Free
  association and dream analysis occur in this type
  of therapy. Analysis is not for everyone, being
  more suitable for individuals at the healthier
  end of the spectrum.

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Focal psychoanalytic psychotherapy

• This is a short-term approach where the
  therapist takes a non-directive approach. No
  advice is given regarding the eating behavior,
  symptoms or problems. The focus is on the meaning
  of the symptoms in terms of the patient's history
  and experiences with their family.

74
Dialectic Therapy (DBT)

• Although DBT is a cognitive behavioral treatment,
  it differs from standard CBT. There is a focus on
  helping patients to observe and label their
  emotional reactions to trauma, validation and
  acquiring a balance between acceptance and
  change. This is a fairly new type of approach
  whichs being modified for the treatment of
  bulimia and binge eating disorder. It holds
  promise especially for those who have experienced
  post-traumatic stress or exhibit chronic or
  severe suicidal behavior because of lack of basic
  skills for self-regulation

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Supportive Psychotherapy

• Most forms of therapy will have a supportive
  component. It is different from exploratory work
  because the goal is not insight- it is lessening
  of anxiety. Usually this is done through
  reassurance, advice, bolstering the individual's
  personal strengths and encouraging more adaptive
  defenses.

76
Nutritional Therapy

• Nutritional rehabilitation and counseling often
  will help patients gain weight and stabilize
  their eating patterns. Depending on the level of
  training, interest, and expectations by the
  treatment team, the dietitian often deals with
  body image, education about nutrition, risk
  regarding the eating disorder, concerns about
  weight and irrational fears related to the eating
  disorder. Some dietitians will shop, help
  prepare, and eat meals with patients and their
  families.

77
Psycho-educational Therapy

• Usually this is included in most treatment so
  that there is understanding of the definition of
  the illness, why individuals develop the illness,
  what predisposes them and what might precipitate
  the illness. Aspects of nutrition, medical
  issues, socio-cultural issues such as the drive
  for thinness in our society, etc. are often
  covered.

78
Addiction Model

• There is a high prevalence of substance abuse
  among persons with eating disorders and the
  likelihood that either condition may precipitate
  the other. There is much debate as to whether
  eating disorders are true addictions. There is
  also a great deal of variability from chapter to
  chapter and sponsor to sponsor.

79
Substance abuse

• The presence of a currently active substance
  abuse does have implications for treatment.
  Ideally, treatment which focuses concurrently on
  both the eating disorder and the substance
  disorder should be attempted in a setting where
  the staff is competent to treat both.

80
Substance and anorexia

• For patients with anorexia nervosa, treatment
  which focuses only on a narrow and zealous
  application of the 12 step, or other approaches
  which exclusively call for the need for
  abstinence without addressing nutritional,
  cognitive, or behavioral problems are of concern
  when used as the sole approach. Many addiction
  programs, however, will attempt to offer a
  blended model incorporating the medical model and
  cognitive behavior.

81
no single treatment approach works for everyone

• Although an old adage in the eating disorders
  field warns,, an interesting new treatment worth
  considering is developing in the eating disorders
  field. While traditional treatment of eating
  disorders has concentrated on individual
  psychotherapy, Christopher Dare and Ivan Eisler
  at Maudsley Hospital in London have developed an
  original family-centered approach. Instead of
  being criticized as a dysfunctional social unit,
  the family of the sufferer assumes responsibility
  for making the patient eat. No one is blamed for
  having triggered the illness rather, the illness
  is treated as a medical condition and the family
  must care for the sick child.

82
Maudsley

• This family-centered treatment progresses in
  three distinct phases, in which power shifts from
  the family back to the patient after she/he
  reaches an acceptable weight. The first phase
  focuses on empowerment and eating.

83
A therapeutic bind

• The family separates the patient from her/his
  illness and learns strategies to successfully
  battle the disease. Placed in the position of a
  therapeutic bind, the family is urged to take
  immediate action, which provokes anxiety yet
  this anxiety is balanced by the therapists
  acceptance and expertise.

84
Maudsley Method

• Food functions as medicine in the Maudsley
  method, and the parents act as doctors who
  administer the feared remedy. For this method of
  re-feeding to succeed, the parents must establish
  an alliance and agree to enforce consistent food
  rules. In order for the patient not to feel like
  an enemy of the food-wielding parents, she is
  encouraged to turn to siblings for support.

85
Despite these remarkable outcomes

• .there are still some crucial factors to examine.
  Data from Maudsley studies indicates that this
  treatment is less effective for older adolescents
  and for adults, along with chronically ill
  patients, and those who binge and purge. In
  addition, some families may not be able to put in
  the enormous time and effort that is required to
  supervise meals and settle the accompanying food
  battles. Another variable to consider is the
  enmeshed parental relationships that eating
  disordered patients are often involved in.

86
Maudsley treatment

• The highly involved parentalrole in the Maudsley
  treatment may further exacerbate these
  dysfunctional patterns. The patient may also
  experience more difficulty in gaining a sense of
  autonomy following treatment.Despite these
  possible drawbacks, the Maudsley therapy is now
  gaining popularity with researchers in the United
  States. Currently, psychologists at the
  University of Chicago, University of Michigan,
  Columbia University and Stanford University are
  testing this treatment

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The second phase of treatment

• starts when the patient complies with the
  parents food guidelines and makes steady weight
  gain . At this point, the parents help their
  child assume increased responsibility for eating.
  According to the Maudsley model, once the patient
  maintains a stable weight of near 95 of his or
  her ideal weight without substantial parental
  supervision, the patient should begin individual
  therapy.

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Maudsley

• At this point in their recovery, they can focus
  on issues and anxieties surrounding adolescence,
  a life phase that they have avoided by having an
  eating disorder. They can explore their identity
  and independence and learn to construct clearer
  family boundaries.

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Maudsley

• Despite its unconventional approach of enlisting
  the family as the primary player in the recovery
  team, the Maudsley treatment offers some definite
  benefits.  Parents are more likely to resist food
  manipulation by their child, since they take on
  active roles in treatment and are instructed by
  therapists not to tolerate resistance. They are
  encouraged to offer incentives and support for
  cooperation. Moreover, since their childs life
  is in imminent danger, they will expend an
  enormous amount of energy to successfully coax
  their child to eat and regain health.

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bulimia nervosa

• For patients with bn, considerable controversy
  exists regarding the role of the 12 step programs
  or other approaches that focus exclusively on the
  need for abstinence when theyre the only
  intervention and do not address nutritional,
  psychological, or behavioral problems.
  Self-Help Self-help may be a valuable first
  step for treatment. The major goal is to provide
  support and communication between individuals who
  are at different stages of recovery. Sometimes
  family and friends are invited or they may have
  their own support group. Usually leaders are
  recovered or volunteer professionals who offer
  their service at a no cost basis.

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Self help

• This group becomes a safe place where you can
  learn about the disorder, share feelings, find
  someone who has had similar experience, and
  realize that recovery is possible. With an
  informal structure, one can attend as needed. For
  more information, please visit ANAD's section
  nonsupport groups. In addition, there are now
  some self-help manuals, on-line web sites, news
  groups, and chat rooms focusing on the treatment
  of eating disorders. In the prevention area,
  there is an on-going study of an on-line self
  help form that may help students reduce the risk
  of developing an eating disorder. While a
  substantial amount of worthwhile information and
  support are available, it is important to
  critique the content.

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Expressive Therapy

• The expression of oneself through the arts is
  another form of therapy which is useful,
  particularly when there is difficulty of putting
  feelings into words. Whether it is dance,
  movement, art, drama, drawing, painting, etc.,
  these avenues allow the opportunity for
  communication that might otherwise remain
  repressed.

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Light Therapy

• Many individuals with SAD (seasonal affective
  disorder) also have dysfunctional eating. Recent
  studies have shown that light therapy has
  improved mood and decreased bingeing and purging.
  The positive effects can last for about 4
  weeks.

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EMDR

• Eye Movement Desensitization and Reprocessing ()
  EMDR is a unique form of psychotherapy. It was
  originally developed in the 80s to help patients
  with traumatic experiences, recovering memories
  of past trauma and post-traumatic stress. At
  present there is little efficacy that this had
  been helpful with patients with eating disorders
  and may even prevent or delay the use of other
  types of therapy that may be effective.

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