Eating Disorder Program - South Vancouver Island - Grace Van Horn, Team Lead Claire Winterton, Clinical Counsellor Carol Tickner, Registered ...

Eating Disorder Program
                South Vancouver Island

Grace Van Horn, Team Lead
Claire Winterton, Clinical Counsellor
Carol Tickner, Registered Dietitian
Ministry of Children and Family Development: Eating Disorders Program

Eating Disorder Program
                      South Vancouver Island

• Is part of the Ministry of Children and Family Development
• Is located at #302‐2955 Jutland Road, Victoria
• For referral, phone 250‐387‐0000
• Can be accessed by anyone including clients, youth, parents,
  school counsellors
          counsellors, physicians and other professionals in the
  South Vancouver Island area
• Serves adults and children, youth and their families AT NO COST.

Program Philosophy
“We understand eating disorders to be complex conditions that
can affect anyone. While people may share a diagnosis of an
eating disorder, we approach each individual and family as
unique, resourceful and resilient. We approach people in a
holistic manner that acknowledges the physical, social, spiritual
and familial dimensions of recovery and health. We strive to
provide optimal client care by collaborating with the client to
identify significant relationships and other supports in their lives.”

   Regardless of our therapeutic intervention, our fundamental
               belief is that recovery is attainable.”

EATING DISORDERS PROGRAM
MULTI-DISCIPLINARY MENTAL HEALTH
          TEAM MEMBERS

Evidence Based Treatments
For children and adolescents:
• Best practice is family based treatment (FBT). This   focuses on
    coaching the parents/family to help their child overcome the
    eating disorder.
•   Focus is parental empowerment and weight restoration of the
    child
     hild
•   There is good evidence in Anorexia (65% improve) and some
    evidence in bulimia.
•   Treatment involves three phases over approximately 6 months
         1. Re‐establish healthy eating (weekly x 10 sessions)
         2. Gradually return control of eating to child
                      (biweekly x 4‐6 sessions)
         3 Address adolescent developmental issues
         3.
                   (2‐ 3 sessions over 1‐2 months)

Other Evidence Based
               T
               Treatment
                    t    tO
                          Options
                            ti
• For low weight individuals re
                             re‐feeding
                                feeding is necessary to be able to engage in
  psychotherapy due to organic brain syndrome of starvation.
• Cognitive Behavioural Therapy has limited effectiveness in anorexia,
  h
  however,  there
             h    iis llots off research
                                       h to support CBT
                                                    C with
                                                        i h Bulimia
                                                              li i and
                                                                     d Binge
                                                                        i
  Eating
• Dialectical Behavioural Therapy (evidence based practice for adults with
 Bulimia and Binge Eating)
• Interpersonal Therapy (to address co‐morbidity of depression)
• Traditional family therapy
• Medical monitoring (recommended for all clients at EDP)
• Nutritional counselling/ education (in conjunction with individual therapy)

Nutrition Treatment Goals,
     Objectives and Strategies

Overall goal of nutrition therapy is to help
develop a healthier relationship with food
and body.

Approach is to meet client where they are
at in
   i motivation
        i i based
                b d on Prochaska’s
                          P h k ’ stages
of change model

Attempt to shift motivation through education.
  • Works well with early stage, young clients
  • Understanding metabolism,
                   metabolism symptoms and stages of
    hunger, set point theory, calorie requirements, normal
    amounts of food, balanced meals, etc

Attempt behavior change by appealing to desire
for symptom reduction
  • i.e. binge/purge

Attempt
      p to decrease fears of weight
                                g ggain
through the use of experiments
  • i.e.
    i e add 1 serving of grain and check weight

Attempt to achieve a regular eating pattern
through the use of “mechanical
                    mechanical eating”
                                eating
  • Start with set times of day
  • Helps alleviate clients constant internal debate and helps
    them to get back in touch with hunger
  • Gradually work at improving nutrient balance and calories

Monitor weight
           g
  • Work on decreasing frequency of weighing through
    education on normal weight fluctuations and body
    composition
  • Ask for removal of scale from the home
  • Weigh with back to scale

Work with parents
  • Empower them
  • Help support
  • Teach feeding relationship (Ellyn Satter)

Get a Family Physician

Consider possible other resources
(EAP, lay counselling, organizational resources, private therapy, etc.)

Other eating disorder resources
(Online Support Group through the Looking Glass Foundation; Phone In
Support ‐ Anorexics and Bulimics Anonymous; or Overeaters anonymous)

Other relevant mental health agencies
(Adult Mental Health; Addiction Services)

C id other
Consider h self
             lf care activities
                        i ii

Recovery
   is
P ibl
Possible

Questions???