Treatment of Anorexia
Although anorexia has a much lower incidence than other psychiatric diseases such as depression and schizophrenia, it is more likely to prove the most fatal.
Successful treatment comes through a five step model.
Step 1: Have all influential members of the person’s life attend sessions
Generally we involve spouses, siblings, parents and other relatives. In the initial consultation with the individual our therapists identify everyone who should be asked to attend the session. The participation of all these people is important as their interactions during the session can help us assess the issues in the individual’s life and conflict avoidance being maintained.
We stress the seriousness of the situation to everyone in the session. Our experts aim to motivate all the participants in the session.
Step 2: Generate goals and plan treatment
We assess the pressures in the individual’s life, the relationships they have with the members, look back at the individual’s history with conflict and determine the interactions that need to be changed.
Step 3: Address the issues
Typically sessions last one hour and are held once to twice a week based on the individual’s needs. During sessions the interaction patterns that are maintaining the anorexic behaviours are revealed. We challenge the family to change these patterns and to view the issues underlying the anorexia not just existing in the individual but one that exists in the family.
Step 4: Establish and maintain new positive behaviours
The old patterns of interaction are challenged in sessions and family members are left to establish new patterns in the session and at home. We teach individuals how to address their conflict directly. We create certain measurable goals for the individuals that need to be met and reinforced by the family. We give the individuals a greater sense of empowerment over their lives and at the same time over their anorexia.
Step 5: End therapy
In most cases of anorexia, when the individual has gained a satisfactory amount of weight treatment is completed. NZ Eating Disorder Specialists also see the point where change has occurred in the family, as when therapy can safely end. It is also important that the family recognise that they own the change and not us.
The door is left open for further consultation. Regular follow-ups by our therapists also reassure the family that help is available if further intervention or support is needed.
Next: the treatment of bulimia