Treatment of eating disorders can be challenging. Effective treatment must address the underlying emotional and mental health issues, which often date back to childhood and a person’s self perception and self image. Building strong therapeutic alliances with clients is imperative.
When working with a client who presents with an eating disorder it is fundamental that, as a counsellor, you do this in conjunction with a medical doctor and a nutritionist.
The first step when someone presents with an eating disorder is to insist on them receiving a medical from their GP. There are various reasons as to why this is important. Firstly, if the client has a Body Mass Index (BMI) of 17 or less, you cannot work with them. This is due to the effects that a very low weight can have on one’s brain. Furthermore, the need for a medical is important as someone who has engaged in the behaviour may have encountered serious health consequences and may need to be admitted to hospital, or in extreme circumstances, to a psychiatric ward.
It is important to work with both a doctor and a nutritionist so as you can focus on why the client may have an eating disorder and what maintains it. The other professionals then, focus on issues of weight and increasing this weight, if necessary. All treatment should be tailored to the individual and will vary according to both the severity of the disorder and the patients’ individual problems, needs and strengths.
Due to the psychological causes and effects of some eating disorders, talking therapy can play an important role in treatment. Cognitive Behavioural Therapy (CBT) is considered the treatment of choice for people presenting with eating disorders. CBT is a focused approach that enables a person with an eating disorder to understand how their thinking and negative self-talk and self-image can directly impact their eating and negative behaviours. CBT focuses on identifying and altering dysfunctional thought patterns, attitudes and beliefs which may trigger and perpetuate the clients’ eating disorder.
Nutritional counselling and advice can help your client to identify their fears about food and the physical consequences of not eating well. The initial aim of treatment is to re establish a healthy attitude toward food and a consistent pattern of eating. It is a necessary stage of treatment and should incorporate education about nutritional needs and planning for, and monitoring, rational choices of the individual patient.
There are a number of treatment approaches used for those with eating disorders, in which a combination may be offered. As a counsellor you must work in conjunction with a medical doctor and nutritionist, so as the most effective treatment approach can be put in place for your client.