Final Presentation Notes on Treatment for Eating Disorders in Children and Adolescents - Thin Documentary PDF

Preview

Summary

These were notes on the final presentation for Professor Ellen Halpern's class about treatment for eating disorders in children and adolescents....

Description

Amanda Scheuer | Treatment for Eating Disorders in Children and Adolescents | 12/13/2016

 Thin Documentary  Thin takes place in The Renfrew Center in Coconut ● Lauren Greenfield’s 2006 documentary Creek, Florida for the treatment of women with eating disorders. The film features four women in the facility who are struggling to recover from anorexia and/or bulimia nervosa: Shelly (25), Polly (30), Alisa (30), and Brittany (15) ● Brittany Robinson ○ Brittany was admitted to Renfrew (ED Center) at age 15 having lost 88 lbs in less than 1 year; she had a dangerously low BP and heart rate, liver damage, and hair loss ○ She was a compulsive overeater at 8 which led to compulsive dieting and anorexia by 12 ○ She said she had “a bad body image,” and wanted to be accepted by her peers ○ Her mother also had an eating disorder; they would “have the greatest time” by buying bags of candy, chewing it, and then spitting it out without swallowing ○ She says she just wants to lose “another 40 lbs” and she “just wants to be thin” ○ Her insurance runs out and she relapses before she is forced to leave treatment ○ She falls back on restriction after being discharged and quickly loses weight, but her insurance would not cover any more treatment ○ She considered going to rehab a few years later for heroin addiction ● Group Therapy ○ Renfrew utilizes group therapy called “community group” ■ One patient explains it as a place for confrontations and support ■ There is a talking stick that is passed around to whoever wants to share ■ It is a confidential room - nothing anyone says leaves the room - but nothing can be said about weight, calories, numbers, etc. and no curse words can be used ■ Brittany asks for support because she is having a hard time with recovery ■ Polly tells her it’s hard to offer support because Brittany wants “to be the sickest one” there; Brittany leaves therapy out of frustration and insecurity ○ The other women have their own form of group therapy on the smoke porch, where they can discuss weight, calories, and numbers; cursing is allowed and they can talk badly about the other patients and staff as well ○ After Brittany’s insurance runs out, the other girls express their concern for her in group therapy; she breaks down about her fears of gaining weight ■ She says she doesn’t want treatment anymore, and the other women tell her that they wish they could go back to being 15 and just accept the treatment ■ Brittany tells them she doesn’t want anyone to be mad at her or concerned about her, and that she just wants everyone to let her die ● Family Therapy ○ Brittany repeatedly calls her mother for help because she doesn’t want to be there anymore; when her mother does actually visit, her own disordered eating habits show ■ It is clear that Brittany does not have the support from her family that is needed to get her help

Some of the other girls also have their families come, but they are more supportive and willing to help Nutrition Therapy ○ The nutritionist educates patients on their caloric and fluid needs, while asking them about how their recovery is going as far as eating ○ Brittany tells her nutritionist she has purged 12 times since entering Renfrew because she does not want to gain weight; the nutritionist tells her she must be honest if she wants to continue getting help ○ The other girls show an open and trusting relationship with the nutritionist, but there are still patients breaking the rules and relapsing in their recovery ○

●

Cognitive Behavioral Therapy for Weight Management and Eating Disorders in Children and Adolescents ● “(CBT) emphasizes the process of changing habits and attitudes that maintain psychological disorders” ● Interventions should start young because this is when the disordered habits form; “children and adolescents are more likely to respond to treatment” then ● “CBT is the most established psychological treatment for [bulimia nervosa] and [binge eating disorder]” ● It has been more difficult to research anorexia nervosa patients in CBT (due to difficulties in recruitment and retention), but family-based therapy has shown to be significantly effective in treating adolescents Position of the American Dietetic Association: Nutrition Intervention in the Treatment of Anorexia Nervosa, Bulimia Nervosa, and Other Eating Disorders ● “Nutrition intervention...is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders” ● “The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists” ● Nutritionists are necessary to provide nutrition counseling, recognize eating disorder signs, and assist in medical monitoring ● They can also educate patients with eating disorders on proper nutrition to help prevent future dieting and disordered eating habits Brittany Robinson ● At the time of Brittany’s stay at Renfrew, she would have benefitted most from continuing group therapy sessions, one on one therapy with her nutritionist, and most importantly, the support from her mother in family-based therapy ● The recovery program would have been more successful if her mother was there to support her; Brittany was feeling very alone throughout her stay there and this was also due to her insecurity with the other girls ● If her insurance continued to cover her treatment, she would have had the ability to form a support system with the other girls and possibly begin to recover...