Oxford Health NHS Foundation Trust

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Child and Adolescent Mental Health Services

Eating Disorder Service

Information for family and friends

What might treatment involve?

Treatment may involve different therapeutic approaches, depending on your child’s need. Treatment will be overseen by the care coordinator who will see you regularly, coordinate the care from other members of the team and set up review meetings.

Psychoeducation is usually the starting point as it is a chance for you and your family to understand more about eating disorders. We will discuss with you what an eating disorder is, how it develops and gets maintained and what might be the effect on your child’s physical and mental health.

We will answer any questions you have about the eating disorder or the treatment and may give you information leaflets which you can take away and read. This can help you and your family gain greater understanding of the way eating disorders can impact on your child’s life and on the family. Sometimes this can also help to reduce feelings of guilt or blame.

A family-based approach (FBA) is the most common treatment we use in our service.

We generally see the whole family together, but make sure there is time for you to have some time as parents on your own if needed.

The aim is to explore the impact of the eating disorder on the whole family and identify how everyone in the family can support the recovery of your child.  As part of the treatment you will be supported to assist your child in re-establishing a normal eating pattern.

This will be an important part of the care plan, as there can be considerable risk to physical health when someone has an eating disorder. It will include regular measurement of weight, blood pressure and pulse in addition to an assessment of general health.

This will be generally by done by the medical or nursing staff within the team, although other clinicians may weigh your child and monitor blood pressure.

Your child may also be asked to have a blood test with your GP or go to the hospital to have an ECG (to assess heart functioning)

An individualised meal plan may be helpful to support your child’s health and provide meal structure for your child.

The meal plan may be drawn up by parents, with guidance from the team as necessary, or the meal plan may be drawn up collaboratively with the team, taking into account usual family patterns of eating. We also have standardised meal plans which can be adapted for your individual needs.

The predictability of the meal plan may help to reduce anxiety before eating and can make mealtimes easier to manage. When weight restoration is necessary the meal plan will be increased with appropriate dietary advice.

During the first stage of treatment your family may be invited to have a supported meal in the clinic to help the family and professionals work together to understand the eating disorder.

Individual therapy can take many forms. Initially this may be supportive work to assist your child in making changes and help to motivate him/her towards recovery. We generally wait until physical health has improved before offering regular formal individual therapy.

However, in some instances, individual therapy for an eating disorder may be recommended early on in the treatment. This is usually specialist cognitive behavioural therapy (CBT-E) or another model of therapy, depending on your child’s needs.

The service can also offer individual psychological therapy for other mental health difficulties, for instance, anxiety, depression or obsessive-compulsive disorder, should these need addressing alongside the eating disorder.

It is widely recognised that caring for someone with an eating disorder can be challenging. Parent/Carer support groups and workshops are held on a regular monthly basis. These groups are facilitated by clinicians in the team and aim to provide an opportunity to meet other parents, share experiences and gain an understanding of eating disorders and how to help as a parent.

Two or three times a year we hold a one-day skills workshops for carers to help parents/carers learn skills in how to help their child/young person.

When your child is referred for treatment, your E mail address will added to the mailing list for these groups (if you are happy with this).

MFT workshops run four times a year alongside individual family-based treatment for anorexia nervosa. MFT offers a unique opportunity for your family to work intensively alongside other families to better understand and overcome the eating disorder. Each family attends four consecutive days with three follow-up days.

A range of family members can attend with the young person, including parents, grandparents and siblings across the age range.

Families who have attended these workshops report that it can be helpful gaining support from other families and learning how other families manage similar problems.

Medication is not routinely used in the treatment of eating disorders. However, if the young person is also very low in mood or very anxious, medication may be considered.

Medication is not routinely used in the treatment of eating disorders. However, if the young person is also very low in mood or very anxious, medication may be considered.

Some young people with eating disorders find it very difficult to make the changes needed in order to get better. If a higher intensity of support is needed, the Outreach Service for Children and Adolescents (OSCA) home treatment team in Buckinghamshire or crisis team in Oxfordshire may become involved.

The home treatment team can provide intensive and home-based support, for example around mealtimes. Sometimes, this can be a way of avoiding a hospital admission. The need for higher intensity support will always be discussed with families in advance.

If your child’s physical health is at risk or if their mental health deteriorates and they are too unwell for community-based care, it is sometimes necessary to refer a young person to a paediatric ward or an inpatient adolescent facility for a short period of inpatient care either locally or further afield, depending on bed availability.

Last updated: 12 March, 2019