Child and Adolescent Mental Health Services

Eating Disorder Service

Information for young people

What might treatment involve?

Treatment may involve different therapeutic approaches, depending on your need. It will be overseen someone called a care coordinator. They will likely be the person you see the most in the team. They will also help you understand who else is involved in your care.a

Psychoeducation is usually the starting point as it is a chance for you 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 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 life.

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 and your parents to be seen 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 your recovery.

In the first phase your parents will support you to get back to normal eating. As time goes on you will take back responsibility for eating and begin to get on with other aspects of your life.

For details, please read our FBA leaflet (pdf).

This will be an important part of your 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 you and take your blood pressure.

You may also be asked to have a blood test with your GP or go to the hospital to have an ECG (which assesses how your heart is functioning).

An individualised meal plan may be helpful to support your health and provide meal structure for you and your family.

The meal plan may be drawn up by your family, with guidance from the team as necessary, or the meal plan may be drawn up collaboratively with the dietitian, taking into account usual family patterns of eating.

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 you and 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 you in making changes and help to motivate you more towards recovery. Often we would wait until your physical health has improved before offering regular individual therapy. This is because therapy is much more effective when you have gained some weight and are healthier.

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 Adolescent-focussed therapy (AFT).

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.

For details, please read our CBT-E leaflet (pdf).

MFT workshops run four times a year alongside individual family-based treatment for anorexia nervosa. MFT offers a unique opportunity for you and 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 you, 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 you are also very low in mood or very anxious, medication may be considered.

The length of treatment will usually depend on the severity and history of the eating disorder. Normally we would expect treatment to last nine months to a year (this may be around 20 sessions, spaced out over the last few months), but it may take longer to achieve a full recovery.

Generally, treatment will be more intensive at the start and appointments will become further apart as recovery progresses.

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

Your parents will be offered time on their own and in a parent group so that they can feel more confident to help you and supported in the process. There is also a Carer workshop where parents can learn about eating disorders and how to help.

Last updated: 11 March, 2019