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

More documents

Recommendations

Info

weight loss without evidence of any other illness explaining weight loss, and failure tomenstruate. Psychological characteristics include; obsessive concern about weight anddieting, unrealistic perception of being fat, and an extreme fear of gaining weight.Behavioral characteristics include; excessive physical exercise which patient may deny,avoidance or sharing meal times with others, cutting out foods they once enjoyed, andvomiting and laxatives.Treatment of patients is very individual based so it is best to involve the patient andfamily at 1 st contact. It is also important to be sensitive and flexible to the needs of thepatient and involve the patient in every aspect of the treatment process. Treatment goalsinclude; restoring body weight and correcting malnutrition, correcting dysfunctionalbehaviors and thinking, treat depression and obsessive thinking, restoring autonomy,prevent relapse, and support the family and partner.Level V: Anorexia Nervosa and Reynaud’s phenomenon: A case report.Reynaud’s phenomenon is a syndrome characterized by episodic digital ischemiain which discoloration of the digits follows a characteristic pattern in time from white toblue to red. Emotional stress is recognized as a trigger. This case report discusses the linkbetween Reynaud’s and anorexia nervosa are minimal. Two forms have been identified: anidiopathic form (Raynaud’s disease), which is not associated with other diseases, causesvasospasm and the second form is associated with other systemic diseases that have beenwell described causes of Raynaud’s disease.The case in this article describes a 19 year old woman, 160cm tall, her weight is 35 kg, herbody mass index being 13.6kg/m. She expressed a sign cant fear of being fat and two yearsprior with a weight of 55kg. She started a strict diet and exercise program. At first whenadmitted she was diagnosed with Anorexia Nervosa, restricted type. In accordance withher weight loss she described feeling cold and that her hands and feet turned white orpurple due to cold temperatures. This patient underwent further testing indicating she infact had Reynaud’s phenomenon.During the first 18 month evaluation the patient’s body dimorphic thoughts had subsidedtesting indicated hypogonadotrphic hypogonadism. By the third year her amenorrhea wasstill going on so transdermal estrogen replacement therapy.More research should be established on the approach of anorexia nervosa and theReynaud’s phenomenon that they may be intertwined and may help in a therapeuticapproach to the treatment of anorexia nervosa.Level V: Cognitive Behavioural Therapy for individuals with longstanding anorexianervosa: adaptations, clinician survival and system issues.Cognitive Behavioral Therapy is recognized as the treatment of choice for patientswith eating disorders. Strong evidence based research is showing the effectiveness of CBTin bulimia nervosa but it is not as strong for anorexia nervosa. Anorexia is widely known tobe the most difficult psychiatric disorder to treat and using the traditional CBT techniqueshas been found to be more of a challenge. Some of the most important skills needed to havesuccess in treating a patient with anorexia nervosa is getting the patient involved byforming a strong therapeutic alliance with an emphasis on consistency, encouragement,reassurance and patience(Bamford & Mountford, 2012).Therapists need to take into consideration they should never rush a patient into
engaging in active therapeutic tasks. Patients should also be able to feel comfortable to stayat the engaging and motivating stage for as long as required to increase the likelihood ofkeeping the patients in treatment and long standing remission(Bamford & Mountford,2012). Great emphasis on what the patient has achieved during care in the facility isimportant as well as creating plans on how to maintain and adapt to daily living outside ofinpatient therapy.Qualitative: Service Users’ feedback on cognitive training in the treatment ofanorexia nervosa: A qualitative study.This article discusses the idea of cognitive remediation therapy and that it may behelpful in treating patients with anorexia nervosa. Research has shown that individualswith anorexia nervosa have difficulty in aspects of cognitive functioning. Patients withanorexia nervosa have difficulty in set-shifting (making choices) as well as analyticalthinking.Cognitive remediation therapy is based on incorporating various exercises whichaim towards increasing a patient’s flexibility of thinking as well as increasing theirinformation processing versus detail oriented processing. This type of therapy focuses onefforts to change a patient’s activities or their daily living. Patients described CRT as fun,enjoyable, interesting, refreshing and less intense compared to other types of therapies.More evidence based practice needs to be done on CRT but patients expressed thatthey appreciated the fact that the therapy was not focused on food and eating and it helpedthem reduce their need to be perfectionists and helped patients see things more holistically.Bottom Line for Occupational Therapy Performance:Treatment should focus on restoration of normal weight, expertise on part ofclinicians, involvement of significant others and family, and nutrition training. OTpractitioners are a valuable member of the team for treating anorexia nervosa. OTaddresses various occupational roles of the patient and how to refine these roles as theycontinue healthier lives. Occupational therapy closely resembles the role of daily livingmore so than any other treatment setting therefore provides the most realistic environmentso he/she can test their skills as they develop in daily living. Anorexia Nervosa is oftentimes triggered by a traumatic event that has happened in someone’s life. It may bring upthings that have happened in the past such as sexual abuse. Patients with anorexia nervosahave a strong need for controlling themselves and others through their intake of food. Atypical patient with anorexia nervosa was controlled as a child by a controlling oroverprotective person and didn’t permit her/him to form normal experiences that lead toself assessment and the development of typical reality-based self esteem. With this, ayoung girl establishes a false ideal of low weight, and hides a feeling of emptiness and alow self esteem.Motivation should be one of the main focuses on treating patients with anorexianervosa but motivation should be done throughout the patient’s treatments instead offocusing on it at the beginning like in treatments for other diagnoses. Focusing on settinglife goals for the future can be beneficial as well like raising a family and getting married.What needs to be taken into consideration while talking about this would be that thesepatients can attribute this to a feeling of loss so we need to approach this in a safe andsupportive way to help manage the emotions associated with these feelings. Using
Page 1 and 2: Special ProjectsFinal CATJessica A.
Page 3: What was also determined is that pa
Page 7 and 8: etter idea of who they are or who t
Page 9 and 10: Level V study by Bamford & Mountfor

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?