OT's Role in Treatment of Anorexia Nervosa by Jessica Brown

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Level III: Treatment of Chronic Anorexia Nervosa: A 4 year follow-up of Adultpatients treated in an acute inpatient setting.Evidence from a number of studies have determined that nearly 50% of patientswith anorexia nervosa eventually make a full recovery. However, there is still a lack ofresearch in treatment methods for anorexia nervosa. The reason for the lack of research isattributed to the rarity of the condition, medical complications that may require inpatientmanagement, the extended period of treatment that is necessary for a full recovery, patientswho do not want treatment, the nature of the disorder and the attitudes about the diseaseand the recovery. Cognitive behavior therapy is the most used treatment for the disease.The treatment setting in this study was at a 12 bed purpose built eating disorder unitand the staff consisted of: a consultant psychiatrist, consultant psychologist, consultantphysicians, assistant psychologist, dietician, nursing staff, occupational therapists,teachers, physical education staff, physiotherapist and a social worker. The requirementsfor the patients in this study were: body mass index (BMI) below 17.5, very rapid weightloss, life threatening physical complications, suicide risk, and chronic failure to benefitfrom outpatient treatment.Treatment included; active patient involvement and in depth case reviews every 6weeks, a structured goal setting approach that translates the problems associated withanorexia into concrete steps or short term goals, interaction with the outside worldincluding the involvement of family and partners, and directive therapy.The elements of the treatment program included; weight restoration, normalization ofeating habits, modification of weight control measures (ex: excessive exercise, purging),Cognitive behavioral therapy to address anorexic attitudes, body image problems andsocial problem solving and improve family and social functioning. The inpatient programwas followed up by outpatient care. The study concluded that Cognitive behavioral therapyeffectively treated weight restoration and helped reduce a relapse risk. Although the studyis lacking the benefits of CBT on adolescents the results show that 44% of adult patientscan be classified as being in remission. Patients completed a follow up 4 years after leavingoutpatient treatment and results showed the comparison is consist of long term follow ups(12 years) of anorexia nervosa patients.Level III: The current status of Treatment for Anorexia Nervosa and BulimiaNervosa.Effective treatments for eating disorders such as anorexia nervosa and bulimianervosa are being under used. And though no research has been diagnosed as being themost effective treatment for anorexia nervosa, there have been successful therapies fortreating anorexia nervosa.These successful treatments for anorexia nervosa and bulimia nervosa include;cognitive-behavioral therapy, drug therapy, and group therapy. anorexia nervosa evenmore than with bulimia nervosa. Results determined that 60% of clinicians do not believethere is one specific treatment that would effectively treat patients with anorexia nervosaand about two-thirds of clinicians use talk therapy (a combination of psychodynamic andcognitive-behavioral therapy) to treat anorexia nervosa more so than bulimia nervosa. Inboth surveys, neither group therapy or cognitive behavioral therapy were promoted moreoften for bulimia nervosa than anorexia nervosa(Keller, 1990).
What was also determined is that patients play an important role in determining the typeof treatment they receive(Keller & Lavori, 1988). . Patients have been known to seek out aspecific clinician who practices the treatment they are interested in receiving. This in turnmay help in the possibility of long term remission because the patient is seeking a treatmentthat is of interest to them.Level V: The role of Art in the therapy of Anorexia Nervosa.This article discusses the common themes of four patients of having a disturbedself-image, inner emptiness/loneliness and concern over control. This article discusses thecombination of behavioral therapy, individual and family psychotherapies, and the use ofart therapy. The positive aspects to art therapy in the treatment of anorexia nervosastimulates the patient’s feelings, the acknowledgement and ownership of feelings beingproblematic in this illness. The study characterizes the art into three conflict areas for thepatients; self-image, self-esteem, and control. Art work represents a less threatening formof therapy and a means of expression for the patient. A variety of therapies along with arttherapy were part of the therapy for the individuals that include individual and familypsychotherapy, goals of working through denial and physical therapy to restore musclemass and improve cardiac performance as well as building endurance and strength. It isalso shown in this study that patients were the least hesitant in participating in art therapythan the other therapies involved in their treatment.What was found in this study is that art serves as a good indicator of the issues andconflicts of the patient and helps patients deal with the conflict of the disease. Art can be aconcrete self-object with the potential of definition and clarification in a way which otherobjects cannot be clarified. Treatment of anorexia nervosa combines a variety of differenttreatments that focuses on the physical and psychological aspects and while adding anothermodality to the treatment of these patients this article expresses the positive aspects that arttherapy had on these patients.Level V: Rationale for the application of Exposure and response prevention to thetreatment of anorexia nervosa.This article suggests the intertwining of anorexia nervosa and anxiety disorders.For example the anxiety of the amount of food intake an individual with anorexia nervosaexperiences as well as managing eating and avoidance behaviors around meal timesdisplays the intertwining of anxiety with anorexia nervosa. This article suggests that thesame treatments used for anxiety disorders may also be useful in the treatment of anorexianervosa. Using exposure and response prevention in the treatment of anorexia nervosa mayalter a patient’s flexibility around food, calorie consumption which will in turn helpmaintain the patient’s weight and prevent relapse.Level V: Anorexia nervosa: Identification, main characteristics and treatment.Anorexia nervosa occurs mainly in women, with about 5-8%of patients being male.This article discusses the best treatment for patients with anorexia nervosa ismultidisciplinary with a team of medical, nutritional, mental health and nursingprofessionals with experience in eating disorders.Physical characteristics of patients with anorexia nervosa include; BMI below 17.5,
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OT's Role in Treatment of Anorexia Nervosa by Jessica Brown

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