The Eating Disorders Unit (EDU)
Introduction
An eating disorder is a complicated and debilitating psychiatric illness that results in pain, confusion and anxiety both for the sufferer and their family. By the time the decision is made to admit a patient a family has often been in turmoil for months and the decision to admit the patient is painful. However what seems to be a punitive response to a psychiatric disorder is often necessary to save a patient’s life. Crescent Clinic specialises in the caring and up to date treatment of psychiatric disorders. This includes a dedicated unit specialising in the treatment of eating disorders.
The Eating Disorders Unit has been and continues to provide comprehensive and specialized treatment programme's for:
Anorexia
Anorexia Nervosa is an illness which presents with weight loss and changes in eating habits.
Bulimia
Bulimia presents with a chaotic eating pattern of bingeing with vomiting or some other compensatory behaviour.
Binge Eating Disorder
Underlying the above is a severe psychological illness with many features of emotional disturbances. Through regular review, the programme continually incorporates current international trends as well as components that are found to be effective to many of the patients that have attended since our inception.
Treatment is designed to :
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Reverse weight loss |
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Normalize the eating pattern |
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Achieve stabilization at a normal weight |
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Encourage a healthy attitude towards food |
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Challenge eating or distorted beliefs and behaviours |
The success of treatment will depend ultimately on the patent’s ability to cope with these difficulties and emerge from the grip of emotions that may, in the early stages of treatment, feel overpowering.
The In - Patient programme involves a group structure that focuses on food and weight management as well as prompting psychological growth. The groups included are therapy based and practical skills based. The programme is reviewed at regular intervals. The aim throughout the group programme is to encourage the patient to make healthy choices about their bodies and lives.
Family involvement in the treatment process is very important as this promotes a greater understanding of the illness and will help the patient to recover. Families can be involved through information sessions and family therapy.
The continuation of care is important to support the psychological changes that have taken place during the period of inpatient and day patient treatment. This is usually arranged on an out-patient basis according to individual needs.
The staff on the Eating Disorder Unit work as members of a multi-disciplinary team. This team is led by consultant psychiatrists who all have special interest and extensive experience in the management of patients with eating disorders. There is also a dietician, occupational therapists and a psychotherapist who work exclusively for the unit. Family therapists and psychotherapists also work for the Unit on a sessional basis.
Meals are calorie controlled by the dietician in conjunction with the kitchen staff. Ingredients and cooking techniques are deliberately varied. Portion sizes are normal rather than enlarged, the extra calories needed to achieve weight gain, coming from the snacks that are given between meals.
The EDU at Crescent uses a multi-disciplinary and systemic approach to the treatment of eating disorders. As the unit is a separate entity in the hospital, we are able to offer dedicated staff and facilities with a very high ratio of staff to patients.
The Team
The EDU has a dedicated and committed team of professionals who have extensive experience in working with eating disorders. This multidisciplinary team liaises constantly and meets for a formal ward round every week. The team consists of the following professionals:
EDU Manager & Social Worker: Stephanie Watson
Psychiatrist: Dr Sheldon Zilesnick
General Practitioner: Dr Louise Chalmers
Clinical Dietician: Simone Pollak
Nursing Service Manager: Karin Coetzee
Consulting Psychologist: Linde Viviers
The Program
The program is varied and addresses the multi-factorial complexity of an eating disorder. It is important that the multi-disciplinary approach is followed allowing the patients to explore those factors that have led to the development of the disorder. The program includes the following:
Psychotherapy
Patients follow an individualised psychotherapy program with the consultant psychologist. An interactional systemic approach is followed in which patients are encouraged to explore their significant relationships, coping skills and interactional style.
Family Therapy
Family therapy forms an important part of the recovery process, as the patient will return to their family of origin. The focus and purpose of family therapy is not to apportion blame, but to restructure the family dynamics in such a way that the patient no longer needs to communicate through an eating disorder.
Occupational Therapy
These groups form the bulk of the therapeutic program and focus on life skills and coping skills. This takes place through a variety of activities ranging from conversational groups to activity-based groups. Each week covers a specific topic addressing a skill that is required for functioning in a modern society. Although the topics discussed are serious by nature, the activities are also fun and creative. The extensive use of art therapy encourages creative expression in a safe environment that allows the patient access to their emotional world. In these sessions patients will also be taught practical skills such as healthy meal preparation. By taking patients on outings to restaurants, normal eating is encouraged in a relaxed environment. All outings are fully supervised and permission is obtained from the parents prior to the outing.
Nutritional Therapy
In consultation with the dietician, the patient will learn a more informed approach to food and nutrition. Many of the problems experienced by our patients are the result of misinformation. The dietician will consult with the patient prior to discharge and be available for consultations thereafter.
General Practioner Groups
In these groups the General Practioner discusses the medical implications of eating disorders and answers many of the questions that have arisen from misinformation. As most of our patients are in adolescence it is helpful to be able to answer queries about the normal changes that take place in the body, as it is the transition into adulthood that is often key in the development of an eating disorder.
Email: stephanie@crescentclinic.co.za
Phone: +27 11 792 9400 - Stephanie Watson
Fax: +27 11 792 2277
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