Eating Disorders - fieldi

10
The Nurse’s Role in a Pilot
Program Using a Modified
Cognitive-Behavioral
Approach
phyllis roloff
Cognitive-behavioral therapy (CBT) and high-dose fluoxetine
(Prozac) have both been proven to benefit patients with bulimia. In
spite of that, only a small fraction of bulimic patients actually
receive these treatments, as they have been limited to certain psychiatric
settings. Many people do not have such facilities in their
area or lack the insurance or finances to use them or feel embarrassed
to go for psychiatric care. If these treatments could be delivered
effectively by medical doctors and nurses in primary care settings,
then they would be available to vastly more patients.
In 1997 the National Institute of Health provided a federal
grant to study the delivery of treatments for bulimia in a primary
care setting. The principal investigators are Dr. B. Timothy Walsh,
professor of psychiatry at the College of Physicians and Surgeons,
Columbia University; director of Eating Disorders Research Unit,
New York State Psychiatric Institute; and an expert in the use of
medication to treat eating disorders; and Dr. Christopher Fairburn,
Department of Psychiatry, University of Oxford, England, a
pioneer in the treatment of eating disorders and in the development
of CBT in treating bulimia. The co-investigator is Dr. Diane
Mickley, an authority on medical care of eating disorders and
director of the Wilkins Center for Eating Disorders. The grant
provides for four months of free treatment for two hundred
women with bulimia in a primary care setting through Glenville