The Eating Disorders Unit (EDU)

Not all Akeso clinics have an Eating Disorder Unit.

Introduction

An eating disorder is a complicated and debilitating psychiatric illness that results in pain, confusion and anxiety both for the sufferer and their family. By the time the decision is made to admit a patient, a family has often been in turmoil for months, and the decision to admit the patient is painful. The Eating Disorders Unit provides comprehensive and specialised treatment programmes for:

Anorexia

Anorexia Nervosa is an illness which presents with weight loss and changes in eating habits.

Bulimia

Bulimia presents with a chaotic eating pattern of bingeing with vomiting or some other compensatory behaviour.

Binge Eating Disorder

Underlying the above is a severe psychological illness with many features of emotional disturbances. Through regular review, the programme continually incorporates current international trends as well as components that are found to be effective to many of the patients that have attended since our inception.

Treatment is designed to:

• Reverse weight loss
• Normalise the eating pattern
• Achieve stabilisation at a normal weight
• Encourage a healthy attitude towards food
• Challenge eating or distorted beliefs and behaviours

The success of treatment will depend ultimately on the patient's ability to cope with these difficulties and emerge from the grip of emotions that may, in the early stages of treatment, feel overpowering.

The inpatient programme involves a group structure that focuses on food and weight management, as well as prompting psychological growth. The groups included are therapy-based and practical skills-based. The programme is reviewed at regular intervals. The aim throughout the group programme is to encourage patients to make healthy choices about their bodies and lives.

Family involvement in the treatment process is very important as this promotes a greater understanding of the illness and will help the patient to recover. Families can be involved through information sessions and family therapy.

The continuation of care is important to support the psychological changes that have taken place during the period of inpatient and day patient treatment. This is usually arranged on an out-patient basis according to individual needs.

The staff on the Eating Disorders Unit work as members of a multi-disciplinary team. This team is led by consultant psychiatrists who all have special interests and extensive experience in the management of patients with eating disorders. There is also a dietician, occupational therapists and a psychotherapist who work exclusively for the Unit. Family therapists and psychotherapists also work for the Unit on a sessional basis.

The Team

The EDU has a dedicated and committed team of professionals who have extensive experience in working with eating disorders. This multi-disciplinary team liaises constantly and meets for a formal ward round every week.

The Programme

The programme is varied and addresses the multi-factorial complexity of an eating disorder. It is important that the multi-disciplinary approach is followed, allowing the patients to explore those factors that have led to the development of the disorder. The programme includes the following:

Psychotherapy

Patients follow an individualised psychotherapy programme with the consultant psychologist. An interactional systemic approach is followed in which patients are encouraged to explore their significant relationships, coping skills and interactional style.

Family Therapy

Family therapy forms an important part of the recovery process, as patients will return to their family of origin. The focus and purpose of family therapy is not to apportion blame, but to restructure the family dynamics in such a way that the patient no longer needs to communicate through an eating disorder.

Occupational Therapy

These groups form the bulk of the therapeutic programme and focus on life skills and coping skills. This takes place through a variety of activities, ranging from conversational groups to activity-based groups. Each week covers a specific topic addressing a skill that is required for functioning in a modern society. Although the topics discussed are serious by nature, the activities are also fun and creative. The extensive use of art therapy encourages creative expression in a safe environment that allows patients access to their emotional world. In these sessions, patients will also be taught practical skills such as healthy meal preparation. By taking patients on outings to restaurants, normal eating is encouraged in a relaxed environment. All outings are fully supervised and permission is obtained from the parents/guardians prior to the outing.

Nutritional Therapy

In consultation with the dietician, the patient will learn a more informed approach to food and nutrition. Many of the problems experienced by our patients are the result of misinformation. The dietician will consult with the patient prior to discharge and be available for consultations thereafter.

General Practitioner Groups

In these groups, the general practitioner discusses the medical implications of eating disorders and answers many of the questions that have arisen from misinformation. As most of our patients are in adolescence, it is helpful to be able to answer queries about the normal changes that take place in the body, as it is the transition into adulthood that is often key in the development of an eating disorder.