There are many different ways in which an individual with an eating disorder can access help, support and treatment.
However it is important to remember that there is not one solution that suits all and it is imperative to consider and apply the perspectives of patients themselves, as they are the ones who decide whether and how they engage in treatment and work towards recovery (Yu, Agras & Bryson, 2013).
The treatment that is chosen will depend on a variety of factors, such as the type and severity of the eating disorder, along with the person’s age, family situation, relationships, mental condition, physical condition and social issues. To assist the individual in identifying an appropriate treatment strategy, which addresses these areas, individuals and their families need opportunities to discuss safe, evidence based treatment pathways, including the empirical support, research findings and expert consensus behind various treatment options (Hay et al., 2014). Treatment choices should, wherever possible, be informed decisions made with the person and their family if family involvement is appropriate (Hay et al., 2014). This type of approach is called Person-Centred care and it is the most effective way to treat someone with an eating disorder (Hay et al., 2014).
One of the ways that a person-centred approach can be integrated into the treatment process is to work from a recovery-oriented mental health model. The recovery model is described as “a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful, and contributing life, even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.” (Anthony, 1993 cited Frese et al. 2001).
In the recovery-oriented model of practice, the terms ‘recovery’ and ‘cure’ are not synonymous. Rather, recovery refers to both internal conditions experienced by persons who describe themselves as ‘being in recovery’ or ‘on a journey of recovery’ – hope, healing, empowerment and connection – and external conditions that facilitate recovery – implementation of human rights, a positive culture of healing, and recovery-oriented services (Jacobson & Greenley, 2001). The primary focus of recovery is therefore not the cessation of certain attitude(s) or behaviour(s), but rather recovery is viewed as a tool to support people in sustaining self-identified, purposeful lives and identities (Andresen et al., 2003; Anthony, 1993; Schrank & Slade, 2007).
The recovery-oriented model of practice is considered best practice in the treatment of eating disorders (Hay et al., 2014). In general, recovery-oriented modes of treatment aim to support individuals in taking responsibility for their personal journey of recovery and offer a collaborative holistic framework to work within.
More specifically, according to the Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines for the Treatment of Eating Disorders (2014) implementation of recovery-oriented practice is about providing a framework that supports the recovery of mental health consumers in the following ways:
- recognises and embraces the possibilities for recovery and wellbeing created by the inherent strength and capacity of all people experiencing mental health issues
- maximises self-determination and self-management of mental health and wellbeing
- assists families to understand the challenges and opportunities arising from their family members experiences
- provides evidence-informed treatment, therapy rehabilitation and psychosocial support that helps people to achieve the best outcome for their mental health, physical health and wellbeing
- works in partnership with consumer organisations and a broad cross-section of services and community groups
- embraces and supports the development of new models of peer-run programs and services
- maximises choice
- supports positive risk-taking
- recognises the dignity of risk, i.e. the individual’s right to make treatment choices that the treating health care team might not see as being the most effective decision
- takes into account medico-legal requirements and duty of care
- promotes safety
In the recovery-oriented model of practice recovery is considered a personal process. The Australian National Mental Health Recovery Framework, published in 2013, is based on an understanding of recovery as a personal process and defines recovery as ‘Being able to create and live a meaningful and contributing life in a community of choice with or without the presence of mental health issues’ (Commonwealth of Australia, 2013). Taking a pro-recovery perspective, personal recovery means building a better future founded on whatever the person’s present circumstances may be, which means that every experience of recovery starts from a different place and leads to a different (personally defined) concept of recovery (Dawson, Rhodes & Touyz, 2014).
Andresen, R., Oades, L. G. & Caputi, P. (2003). The experience of recovery from schizophrenia: towards an empirically validated stage model. Australian and New Zealand Journal of Psychiatry, 37: 586–594.
Anthony, W. (1993). Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16 (4): 11-23 cited in Frese, F., Stanley, J., Kress, K., & Vogel-Scibilia, S. (2001). Integrating Evidence-Based Practices and the Recovery Model. Psychiatric Services, 52: 11. http://www.nasuad.org/sites/nasuad/files/hcbs/files/44/2150/frese2001.pdf
Commonwealth of Australia. (2013). National Mental Health Recovery Framework: Policy and Theory.
Dawson, L., Rhodes, P. & Touyz, S. (2014). The recovery model and anorexia nervosa. Aust N Z J Psychiatry, 48(11): 1009-16.
Hay, P., Chinn, D., Forbes, D., Madden, S., Newton, R., Sugenor, L., Touyz, S. & Ward, W. (2014). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders.
Jacobson, N. & Greenley, D. (2001). What is Recovery? A conceptual model and explication. Psychiatric Services, 52: 4.
Schrank, B. & Slade M. (2007). Recovery in psychiatry. Psychiatric Bulletin, 31: 321-325.
Yu, J., Agras, S.W. & Bryson, S. (2013). Defining recovery in adult bulimia nervosa. Eating Disorders: The Journal of Treatment & Prevention, 17: 1.
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