Extended assessment
If after the assessment it is felt that treatment from our service may be useful to you but we remain unsure, we will usually offer you an extended assessment. These are 6 sessions, lasting around an hour. This will give you an opportunity to talk about your eating disorder symptoms and to start making small changes if you feel able. It also allows some space for you to discuss the impact the eating disorder may be having on the rest of your life.
After the extended assessment, we will be in a better position to direct you into the most appropriate course of treatment. Either within our service, within other NHS services or outside agencies where appropriate.
Treatment pathways
There is currently a waitlist for both treatment and assessment in the service.
All clients we are accepted for treatment into our service will need to complete our Food for Thought course before one-to-one therapy is offered or commenced.
This course runs weekly for 6 weeks and provides 6 modules of 2 hours each and offers psycho-education around eating disorders and dietetics. It sets the stage for prioritising your health and recovery and lays the foundations for further treatment within the service.
There are a number of treatment options available within our service thereafter. Not all of them will be suitable or beneficial for every client. We will discuss the right options for you following assessment.
Possible treatment pathways that may be offered to you after the Food for Thought Group could include the below.
Support from a dietitian
You may be offered individual appointments with a dietitian. Initially the dietitians will offer a dietetic assessment to determine the nutritional adequacy of your diet and offer guidance as required. Following this, you may be offered ongoing dietetic sessions, whereby you will be provided with tailored nutritional support to help you improve your relationship with food and help support your recovery.
These sessions may include developing meal plans, establishing regular eating patterns, and exploring psychoeducation around nutrition and the body.
Physical health monitoring appointments
Our service does not routinely offer physical health monitoring. Most of our therapy pathways include mandatory weighing as part of the recovery journey.
Outside this, we have a physical health team who are commissioned to provide time limited physical health monitoring appointments for client's presenting with serious high risk of physical health complications for approximately 40 clients at any one time. These appointments are usually weekly, but can be more frequent depending on presentation and include weighing, ECG, and bloods taking to support physical health recovery.
Client's who do not meet the criteria for high risk monitoring will need to visit their GP for physical health monitoring.
Cognitive behaviour therapy
Cognitive behaviour therapy (CBT) has some adaptations such as CBT-10, designed specially to support some adults with eating disorders. You could be offered 10 to 40 sessions on this pathway.
CBT is a structured, goal-oriented therapy by supporting the change of negative thought patterns and behaviours. CBT is the first line one to one therapy recommended for clients with eating disorders.
Cognitive analytic therapy
Cognitive analytic therapy (CAT) brings together understandings from cognitive psychotherapies (such as CBT) and from psychoanalytic approaches into one integrated, user friendly and effective therapy.
CAT is a collaborative programme of looking at the way you think, feel and act and is tailored to meet your individual needs.
Maudsley model of anorexia nervosa treatment
MANTRA is a specialist integrative therapy which was developed for the treatment of anorexia nervosa. It typically consists of 20 to 40 sessions which aim to address the cognitive, emotional, relational and biological factors which tend to maintain anorexia by working out what keeps people stuck and helping them find alternative and more appropriate ways of coping.
Family therapy
Therapy which involves the client who has an eating disorder and their family. It is aimed at helping and supporting the family. This is usually a 1 hour and 30 minutes and can be a one off session or a series of sessions over a period of time.
Specialist supportive clinical management
Combines 2 therapeutic components:
- Clinical management prioritising normal eating.
- Weight restoration.
It also provides psycho-education and advice about eating disorders, eating, weight and shape concerns.
Mental health interventions
Our mental health wellbeing practitioners are trained in a number of mental health interventions to support good mental health and recovery. These interventions are based on CBT theory and can support with eating disorder recovery, sleep, anxiety and/or depression, emotional regulation, body and shape concerns and more.
Occupational therapy
Occupational therapists use specialist assessments to identify how an eating disorder is affecting an individual's occupational performance.
Eating disorders can affect all areas of occupational functioning, such as:
- meal preparation
- food and clothes shopping
- managing difficult emotions
- work or study demands
- socialising with friends and family
During occupational therapy, you will identify areas of your life that you wish to make changes in and work collaboratively with the occupational therapist to achieve these goals.
Occupational therapy can be provided on either a one-to-one basis or as part of a group.
Peer support
A relatively new intervention offered by the service. It recognises the role and value of lived experience when offering support to those with mental health difficulties.
We currently offer a range of peer-based interventions, including:
- sharing recovery stories
- supporting clients to create recovery plans and decide on recovery goals.
- attending community appointments or activities together
- signposting to resources, activities, and opportunities
- community interventions such as attending coffee shops together or completing weekly food shopping.
- supporting with clinical groups by offering a lived experience perspective
- individual support offered before and after initial assessments
The interventions are person-centred and designed to meet the client where they are at, offering a non-clinical space in which to reflect on possible ways toward recovery.