What might treatment involve?
Assessment
The young person will initially attend with their family for a comprehensive assessment. This includes gaining an understanding of the history and background and undertaking physical and psychological assessment. Immediately following the assessment a care plan is made with the young person and family and the treatment is started.
Psychoeducation
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.
Outpatient treatment
Family-based approach: the most common treatment we use in our service. The aim is to explore the impact of the eating disorder on the whole family and identify how everyone in the family can support you in re-establishing a normal eating pattern. Download FBA leaflet (pdf)
Dietetic support
An individualised meal plan may be helpful to support your health and provide meal structure.
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.
Medical monitoring
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 need to record weights and monitor blood pressure.
You 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).
Individual therapy: can take many forms. Initially this may be supportive work to assist you in making changes and help to motivate you towards recovery. We generally wait until physical health has improved before offering regular formal individual therapy.
In some cases 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 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.
Cognitive Behavioural Therapy for Eating Disorders (CBT-E): this is a specialised form of CBT focused on recovering from an eating disorder. Download CBT-E leaflet (pdf)
Adolescent-focused treatment (AFT): an individual therapy based on a formulation of the young person’s needs.
Multi-family therapy: a four-day intensive course for families with one-day follow-up, based on evidence and designed to support families to make changes to assist in recovery.
Further information
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.
Download MFT leaflet (pdf)
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.
Parent groups: these are groups for parents of young people with eating disorders and are held monthly. 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.
One-day carers’ workshops: these are held three times a year jointly with adult service and provide a context to share ideas, develop skills and receive support.
Higher intensity treatment
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 or Crisis team 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 the family in advance.
Enhanced Care Pathway
The Enhanced Care Pathway (ECP) is a new, intensive service within the Oxfordshire CAMHS Eating Disorder team. Most young people respond to our community interventions, however some will need more intensive treatment, most commonly at the start of their journey towards recovery. The ECP will also be used as a ‘step-down’ for people being discharged from inpatient admission.
Inpatient treatment
If a young person’s physical health is at risk or if their mental health deteriorates and they are not able to access 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.
Care Programme Approach
The young person will be treated within a CPA framework. This is a structured approach to care, involving the allocation of a care-coordinator, creating a care plan and having regular reviews. The GP may be invited to join CPA reviews, particularly at the time of discharge. If the GP is unable to attend the review, a clinician from the ED service may approach the GP for an update or to share information.
Length of treatment
This 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 for the last few months), but 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.
Page last reviewed: 14 February, 2023