Main Category: Eating Disorders
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South London and Maudsley NHS Foundation Trust (SLaM) has just launched an innovative new intensive treatment program for adolescents suffering from anorexia nervosa.
The new day programme combines a range of group and family-based therapies, as well as time for the young person to continue their education with the support of a teacher and teaching assistant. Staff and young people will eat together, to provide support at meal times.
A specialist national service, it is open to young people diagnosed with anorexia aged between 11 and 18 years, and from anywhere across the United Kingdom.
Jo Fletcher, Deputy Director of CAMHS National and Specialist Service, said the intensive programme would treat more serious cases of anorexia and use family based treatment to overcome the need for hospitalisation.
"As a team, we are confident that committed participation in the programme offers young people and their families' real hope of overcoming their illness and beginning recovery."
The programme is designed to be therapeutic, fun and creative, and includes a range of activities. Activities and groups on offer include cognitive behaviour therapy, mindfulness and managing your relationships, groups about nutrition, relaxation and the effects of anorexia on mind and body.
Each young person and their family will be allocated a key worker who will be their main point of contact for the duration of their time in the programme. Their ongoing care coordinator will also be involved in the treatment.
The day programme will follow a similar pattern to school, with patients attending from 8:00 am to 8:00 pm Monday to Thursday, with a shorter day on Friday. After attending the programme for a period of six weeks, patients will then begin multi-family therapy.
Unlike inpatient care, the programme allows young people to spend evenings and weekends with their families in order to put into practice the skills they have learnt during the week. Families are encouraged to give feedback after the weekend and strong family involvement is fundamental to the success of the programme.
Ms Fletcher said most treatments for children and adolescents suffering anorexia involve long hospital stays, averaging between six months and a year.
"Unfortunately, dedicated specialist services for young people with anorexia are limited across the United Kingdom. At the Maudsley, we are at the forefront of developing family-based treatments for children and young people with anorexia nervosa."
The National Institute for Clinical Excellence (NICE, 2004) recommends that whenever possible adolescent patients should be treated for anorexia on an outpatient basis by a service that has expertise both in the psychological aspects of the treatment and in assessing the physical risk associated with eating disorders.
NICE also emphasises the importance of family interventions, and age-appropriate facilities for children and adolescents including educational activities.Ms Fletcher said SLaM's child and adolescent Eating Disorders Service has been developed through many years of research and clinical experience.
"SLaM's research is internationally recognised. The 'Maudsley Family Therapy', also known as 'Family-Based Treatment' or the 'Maudsley Approach', was pioneered at at SLaM in the mid 1980's to treat anorexia nervosa in adolescents. It is now used across the world to treat a wide-range of mental health conditions."
The Maudsley Approach is an intensive outpatient treatment method where parents play an active and positive role. Instead of blaming the family situation for contributing to the development of eating disorders, it uses parents as an essential resource in treating anorexia.
Today, 90 to 95 per cent of children and adolescents treated for eating disorders at SLaM are treated on an outpatient basis. Young people requiring hospitalisation for eating disorders at SLaM is around 20 per cent of the national average.
"The new day care programme is aimed specifically at those remaining 20 per cent of chronically ill patients who are likely to end up in hospital. Through this new intensive approach, we hope to work closely with their family to put them on a path to recovery and keep them out of hospital."
The day care programme is located with in the current at SLaM's Michael Rutter Centre for Children and Young people, and compliments SLaM's other outpatient and inpatient national specialist eating disorder services for children and adults.
Feedback from former patients and family
"Bringing out daughter to the Eating Disorders Service helped to turn things around by empowering us and involving us as collaborative partners in her regaining her health in a way that we had not been made to feel with our previous local service. We are very pleased with the help we received!" Parent of a former patient
"Taking part in the multi-family group treatment helped me to realise just how anorexia had robbed me of the life I wanted; in that sense I got better quickly. With whole days in a row of non-stop anorexia bashing talk, I couldn't continue to bury my head in the sand, could I?" Former patient, age 16
A typical day in the Intensive Treatment Programme:
All young people participating in the programme will attend from 8am to 8pm and participate in all groups. All meals and snacks will be provided, and the young people will eat alongside staff members.
8:15 - 9:00 Breakfast
9:00 - 10:00 Education
10:00 - 11:00 CBT for worries
11:00 - 11:30 Snack break
11:30 - 12:15 Physical checks
12:15 - 13:00 Mindfulness
13:00 - 14:00 Lunch
14:00 - 15:00 Education
15:00 - 15:45 Managing emotions
15:45 - 16:15 Snack break
16:15 - 17:00 Art group
17:00 - 18:00 Physical healthcare group
18:00 - 18:45 Dinner
18:45 - 20:00 Family time
Notes
- For more information on SLaM's CAMHS Eating Disorder Services visit here.
- SLaM's eating disorder treatment is provided mainly on an outpatient basis and includes the Multi-family Therapy (MFT) programme, for which we received the Positive Practice Award from the National Institute for Mental Health in England, in 2004.
- SLaM's CAMHS services are renowned both in the UK and internationally, with clinical practice that thrives on links with the Institute of Psychiatry (IoP) and the Medical Research Council Child Psychiatry Unit.
- SLaM's Eating Disorder Service for children and adolescents is located within the Michael Rutter Centre for Children and Young People at the Maudsley Hospital, Denmark Hill, London SE5 8AZ.
Source:
SLaM
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