The+Maudsley+Approach

=Treatment: The Maudsley Approach=

The National Eating Disorder Information Centre (NEDIC) promotes that eating disorders are serious health conditions that are physically and psychologically demanding and damaging. Bulimia Nervosa and Anorexia Nervosa can develop in to chronic health issues and become highly toxic with the use of stimulants, which are life threatening.

Long lasting recovery involves a multidiscipline approach that treats more than just eating patterns. Treatment should involve the coupling of psychotherapy, counseling with attention to medical and nutritional needs that are tailored to the client. More than just eating habits have to be examined. Psychological, biological, interpersonal and cultural factors must be investigated because these are influences that contribute and maintain the eating disorder. Medical and nutritional needs should incorporate education about nourishment planning to monitor rational choices.

Majority of clients respond well to outpatient measures in a variety of counseling practices and consultations. These include: individual, family, group therapy sessions and medical management, which is conducted through a doctor. Although inpatient has its advantages, it is costly and disrupts a clients family, occupational and social life, which results in higher relapse rates due to the controlled environment.

The Maudsley Approach is a form of treatment for eating disorders that was developed by child psychologists. The approach is designed to prevent hospitalization associated with the eating disorder by assisting families in their efforts to help with the patients recovery; and to return the patient to normal development that is unaccompanied by the eating disorder and the substance use. The average number of sessions was 20 over the period of 12 months. Approximately, two thirds of patients have recovered by the end of the family based treatment and anywhere from 70 percent to 95 percent of patients were fully weight recovered during a five year follow up (LeGrange & Lock, 2005).

The Maudsley Approach operates in an intensive outpatient environment to help restore weight to healthy levels according to the patient’s age, and height. The Maudsley Approach also aims that the client take control back from the eating disorder and encourages normal development through the inclusion of family and other support systems for the client. This approach recognizes that families and other supports have influence in the recovery process for the client and acts as a source of empowerment to maintain a healthy and balanced lifestyle. This is also a way in which, the Maudsley Approach differs from traditional eating disorder treatment. Traditional treatment, mainly inpatient treatments, suggests that the eating disorder is individually based with little accommodation for outside support. Family problems are considered to be as part of the etiology of the eating disorder, but the system of support is considered to be an essential resource to success. This approach is divided into three continual phases: weight restoration; ownership of control over eating; and establishing a healthy identity.

Phase I: Weight Restoration This first stage focuses on the severity of malnutrition and assessment of the family interaction, as well as their eating habits. Weight restoration also assists the client to be aligned with the family; this is commonly done through a family meal. The goal is to observe interactions, eating patterns and use of substances. The weight restoration provides opportunities to families to encourage the clients to eat a little more than prepared to, in the clients who are anorexic, or to portion out their binges as much as possible with the addition of reducing the amount of purging, in cases for bulimics. Weight restoration also accommodates for resistance. This is common in the early stages of weight restoration. Resistance can be challenged through family’s persistence. This will illustrate to the client that starvation and bingeing and purging is no longer an option. Families are coached to express support and empathy to the client so that family persistence is no seen as confrontational or judgmental. The realignment of peers is essential in the first phase because it assists the client in developing strong and positive relationships. The therapist’s role during this stage is to model the family in a non judgmental stance towards the client. The ultimate goal of the first stage is for the client to accept the family’s demand for increased and balanced nutritional intake and a cease in the

Phase II: Ownership of Control over Eating Once the client accepts the family’s challenge and steady weight gain is evident, the second stage is initiated. The focus of this phase is on the client’s encouragement to take control and to be empowered by the progress made during the previous stage. The main task of taking control is to return to a physical healthy state. It is suggested that any family concerns that had been postponed during the previous stage can now be brought forth. The therapist’s role during this stage is about encouraging the family to support and monitor physical health according to the client’s age and height.

Phase III: Establishment of Healthy Identity Once the client has been able to reach and maintain 95 percent of healthy weight gain the final stage is commences. The focus of this phase is to illustrate the impact of the eating disorder and stimulant use in order to establish a healthy identity. This phase mainly deals with coping strategies that help the client disprove their distorted body image that is associated to the eating disorder. The main goal is to support the client’s autonomy, development of health family boundaries and reorganize family structure due to the eating habits departure.

The Maudsley Approach is a new concept in dealing with and treating individuals with eating disorders and substance use. The approach’s greatest success is among clients who are young teenagers with anorexia nervosa. The short fall of this approach is that with its greatest success with young teenagers, this excludes individuals with long term chronic eating disorder. Common length of its clients have had anorexia nervosa or bulimia nervosa for less than three years. The strength of the Maudsley Approach is that it recognizes how family can be involved in a positive manner in the client’s recovery and illustrates them as a successful support system.