Eating Disorders - fieldi

128 The Nurse’s Role in a Pilot Program
Medical Associates in Greenwich, Connecticut. All patients
receive medication (half receive placebo, half receive fluoxetine)
and medical care from the physicians in the group. Half the
patients also receive CBT working with nurses in the practice.
Wilkins Center has been actively involved in this project. The
role of the nurse is central to this study, and Phyllis Roloff RN,
director of Nursing at Wilkins Center, has played a pivotal role.
Ms. Roloff treated a series of Wilkins Center patients with CBT to
pilot the nurse’s role. Once the NIH (National Institute of Health)
study began, she helped the Glenville nursing staff to understand
and provide CBT to bulimic patients. She coordinated medical care
for the study patients at Glenville with the collection of research
data to evaluate benefits and arranged aftercare for patients from
the study who wished further treatment. In the following, Ms.
Roloff describes her experience as a nurse doing CBT.
—Diane W. Mickley, M.D.
As I approached the room to meet my first CBT patient I was both
excited about this new responsibility and apprehensive about how we
would work together and whether I was equipped to do this. As it
turned out, she was experiencing the same feelings. And thus we began.
I explained that this was a self-help program, and I was there to
guide and encourage her and to answer any questions she might have.
The following is a summary of my role, as a nurse, in a modified
cognitive-behavioral therapy program. This treatment approach is
based on a book by Dr. Christopher Fairburn (1995). This program
is suggested for very carefully selected patients, and should not, Dr.
Fairburn cautions, be used by anyone who is underweight, has a
serious physical illness or whose physical health is being affected by
bingeing (unless the physician grants permission), is pregnant, is
significantly depressed or demoralized, and, finally, who has general
problems with impulse control, such as alcohol or drug abuse
and/or repeated self-harming behavior (137). The first half of the
book is educational; the second half describes the actual program.