The Therapeutic Team
Due to the complex nature of eating disorders, treatment can often mean working with a multidisciplinary team of practitioners.
Some people will benefit from stand-alone therapies, which involve working with only one professional, while others will need to be treated for the physical, psychological, nutritional and functional aspects of their eating disorder.
These four components of treatment must work together, with progress in one domain enabling and supporting progress in each of the other domains. A person with an eating disorder therefore often needs a multidisciplinary response to their immediate presenting health problem and to the full spectrum of the eating disorder.
A therapeutic's team capacity to work collaboratively in assessment, treatment planning, and treatment review is essential for safe treatment.
Multidisciplinary professions include:
GPs and local doctors
Although General Practitioners (GP) may not be formally trained in distinguishing the presence of an eating disorder, they are a good ‘first base’ if you have concerns about yourself or someone you care for.
Talk through the signs and symptoms of the eating disorder with you
Provide you with additional information about the eating disorder
Refer you to an eating disorder specialist for further help, diagnosis and treatment
Paediatricians are often involved in the treatment of children and adolescents suffering from eating disorders. Paediatricians can:
Speak to children and adolescents at their level
Talk to you as a carer or parent and help you understand what is happening to your child or loved one
Decide on a treatment or refer you to another specialist who will be able to help you
Psychologists are commonly involved in the treatment of eating disorders. Psychologists will generally:
Conduct assessments to diagnose mental illnesses or conditions
Develop treatment plans that specifically address mental and emotional issues associated with the eating disorder (e.g. body image or weight issues)
Provide counselling for other problems not directly related to the eating disorder (e.g. family situations, social problems)
All psychologists should be tertiary qualified; in addition, clinical psychologists need to have completed postgraduate training in order to gain expertise in treating mental illnesses.
A psychiatrist is a medical practitioner who specialises in the diagnosis and treatment of mental, emotional and behavioural disorders. Psychiatrists can:
Assess someone with an eating disorder to diagnose various disorders
Develop treatment plans that help to treat the disorder
Prescribe medication and monitor its effectiveness
All psychiatrists will have completed medical training and additional supervised psychiatric practice.
Dietitians often play a significant role in the treatment of eating disorders. Dietitians can:
Translate scientific information into practical advice surrounding food and healthy eating
Prescribe dietary treatments for people suffering from eating disorders
Teach people with eating disorders how to eat and how to buy appropriate foods (e.g. in a supermarket)
Provide medical nutrition therapy services
A nutritionist is a tertiary qualified professional who can provide general support to people with eating disorders in relation to nutrition education and community health. Nutritionists can:
Offer general advice to people with eating disorders
Provide basic advice on nutrition, eating plans and motivations for eating well
Address fears and concerns about food and weight
Social workers are tertiary qualified and are often involved with treatment, if the person presents with additional social and mental health issues. Social workers can:
Provide individual, couple and family counselling for people with eating disorders and their carers
Provide case management and referrals or resources
Facilitate support groups and provide links to other community resources
Social workers can be found in hospitals and health services, government programs such as Centrelink and community organisations.
Occupational Therapists use a client-centred approach and a range of evidence-based interventions to support eating disorder recovery in the person’s meaningful environments by:
- Assessing the impact of an eating disorder on the daily life of a person living with an eating disorder and their family.
- Developing the person’s ability to engage in meaningful and important activities such as self-care, school, work, leisure activities and social interactions.
- Encouraging the person to engage in activities to enhance or re-establish important life skills and roles by supporting the development of a strong and supportive social network.
Nurses and mental health nurses form an important part of the multidisciplinary treatment team. Nurses can:
Provide practical medical and mental health care during hospitalisation or treatment, via the health systems as well as within schools
Conduct medical or mental health assessments
Consult to ensure needs are being met
If a person with an eating disorder is admitted to hospital or a similar community setting, either as part of an outpatient or inpatient program, nurses and mental health nurses will become involved in the treatment of that patient and their eating disorder on a daily basis.
Choosing a therapist
When choosing a therapist, it is important to remember that the relationship you have with your therapists and clinicians is vital. At the heart of a good therapeutic relationship lies:
- Understanding – your therapist understands your disorder and your emotions and feelings, and you also understand their role in the treatment and recovery process
- Trust – you trust your therapist and your therapist trusts you; give time for trust to develop
- Rapport – you can talk openly and be heard without judgement
- Collaboration – you and your therapist work as a team, developing mutual understanding, setting goals and following through on objectives
Stages of Change
The Stages of Change model is a guide to understanding the five different stages on the way to recovery, although some people may skip back and forth between these stages, especially in cases where relapse is common.
Barriers to Care
Vital access to treatment and recovery can be hampered by a limited availability of care or lack of care in remote areas, by stigma, poor professional skills and poor understanding of the pathways to care.
It's different for everyone, but recovery from an eating disorder involves overcoming physical, mental and emotional barriers in order to restore normal eating habits, thoughts and behaviours.
Relapse & Recurrence
Relapse can be a common part of the recovery process; many people with eating disorders experience a relapse or recurrence as they recover from their disorder and learn to manage their eating habits.