Brandon/Miya please respond to each person by name and give 2 references per response.
Discussion: The Complexity of Eating Disorder Recovery in the Digital Age
Through this week’s Learning Resources, you become aware not only of the prevalence of factors involved in the treatment of eating disorders, but also the societal, medical, and cultural influences that help individuals develop and sustain the unhealthy behaviors related to an eating disorder. These behaviors have drastic impacts on health. In clinical practice, social workers need to know about the resources available to clients living with an eating disorder and be comfortable developing interdisciplinary, individualized treatment plans for recovery that incorporate medical and other specialists.
For this Discussion, you focus on guiding clients through treatment and recovery.
To prepare:
Review the Learning Resources on experiences of living with an eating disorder, as well as social and cultural influences on the disorder.
Read the case provided by your instructor for this week’s Discussion.
By Day 3
Post a 300- to 500-word response in which you address the following:
Provide the full DSM-5-TR diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Explain why it is important to use an interprofessional approach in treatment. Identity specific professionals you would recommend for the team, and describe how you might best utilize or focus their services.
Explain how you would use the client’s family to support recovery. Include specific behavioral examples.
Select and explain an evidence-based, focused treatment approach that you might use in your part of the overall treatment plan.
Explain how culture and diversity influence these disorders. Consider how gender, age, socioeconomic status, sexual orientation, and/or ethnicity/race affect the experience of living with an eating disorder.
Note: You do not need to include an APA reference to the DSM-5-TR in your response. However, your response should clearly be informed by the DSM-5-TR, demonstrating an understanding of the risks and benefits of treatment to the client. You do need to include an APA reference for the treatment approach and any other resources you use to support your response.
By Day 6
Respond to at least two colleagues who identified a treatment strategy that differs from yours in the following ways:
Explain whether you agree or disagree with your colleague’s treatment strategy.
Explain additional cultural influences that your colleague should consider when addressing the specific eating disorder they identified.
Brandon Thornton
Week 8
COLLAPSE
Diagnosis:
(F 50.89) Atypical Anorexia Nervosa
(F 50.89) Purge Disorder
(Z 60.9) Other Problems related to Social Problems.
Elizabeth is a teenage girl that has been obsessing over her eating. She was recently in a break up that caused her to lose her best friend as well. Since the break up, Elizabeth has been obsessed with being thin, and receiving compliments from her peers about her appearance. She spends time planning her caloric intake, and has purged when she feels she ate too much. She went to the Dr. and they said that she still is in a normal weight range for her age. While she has not lost enough weight to become ill, or affect her menstrual cycle, she is beginning to worry her family.
I believe that Elizabeth has (F 50.89) Atypical Anorexia Nervosa and (F 50.89) Purge Disorder and (Z 60.9) Other Problems related to Social Problems (APA, 2022). She has intense fear of gaining weight, or becoming fat. She has persistent behavior that interferes with weight gain. She will deliberately eat less throughout the day, schedule what she will eat, and purge when she feels she has eaten too much. She also meets the criteria for “disturbance in the way in which one’s body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.”. She has been admitted to the ER, and still seems to lack the recognition of the seriousness of her situation. The only criteria of the diagnosis that does not match Elizabeth is having a weight that is below average. Her current weight is not deemed medically urgent, but she has been hospitalized due to her lack of eating. This would reflect the diagnosis criteria for Atypical Anorexia Nervosa, “All of the criteria for anorexia nervosa are met except that despite significant weight loss, the individual’s weight is within or above the normal range. Individuals with atypical anorexia nervosa may experience many of the physiological complications associated with anorexia nervosa”. I also chose the diagnosis of purge disorder because Elizabeth has purged her food intake to keep her figure (APA, 2022). Lastly, the Z code I diagnosed her with is due to her unique social issues with her boyfriend and best friend. This is difficult to classify but still relevant in her case.
There are several reasons to use interpersonal psychotherapy (IPT) to treat Elizabeth. One reason is that (IPT) is common in patients with eating disorders and they appear to contribute to their maintenance. For late adolescence, periods for the development of relationships, teh eating disorder often resulted in profound interpersonal disturbance by the time that an individual seeks treatment. Many patients also often become more isolated from the normalizing influence of their peers and, as a result, their psychology tends to persist unchallenged. It is also noted that certain eating disorder features may be directly maintained by interpersonal difficulties (Wilfley et al., 2012). I believe that this reflect Eliziabeth’s situation. She is currently dealing with interpersonal difficulties, during her formative relationship developmental years.
When working with Elizabeth, I believe that there should be a team that works with her. Firstly, I believe that there should be a medical representative that works with Elizabeth. They would be able to ensure that she is not losing weight at a dangerous rate. Elizabeth would also need a social worker or counselor to speak with in school hours, or on designated days to help her cope with her issue. Lastly, Elizabeth’s family should be a part of her treatment. It has been noted in studies that, “Adolescents suffering from anorexia nervosa generally do well when the main treatment is family therapy.” (Eisler, 2005). It is best for her family to be more understanding of what her treatment will look like, and how they can help Elizabeth in her recovery.
I believe that CBT would be an effective method of assisting Elizabeth in her Anorexia. A study states that “adolescents regain weight more successfully, and at a faster rate, than adults, and may therefore benefit from a shorter treatment program” (Lauren Muhlheim, 2020). The process of using CBT in treating anorexia will help an individual to understand the interaction between their thoughts, feelings, and behaviors to improve their mood and function. CBT has been proven to be successful and evidence based.
Reference:
American Psychological Association. (2022). What is cognitive behavioral therapy? American Psychological Association. Retrieved July 6, 2022, from https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
Eisler, I. (2005). The empirical and theoretical base of family therapy and multiple family day therapy for adolescent anorexia nervosa. Journal of Family Therapy, 27(2), 104–131. https://doi.org/10.1111/j.1467-6427.2005.00303.x
Lauren Muhlheim, P. D. (2020, July 20). Cognitive behavioral therapy for eating disorders. Verywell Mind. Retrieved July 20, 2022, from https://www.verywellmind.com/cognitive-behavioral-therapy-for-eating-disorders-4151114
Wilfley, D. E., Iacovino, J. M., & Van Buren, D. J. (2012). Interpersonal psychotherapy for eating disorders. Casebook of Interpersonal Psychotherapy, 125–148. https://doi.org/10.1093/med:psych/9780199746903.003.0008
Miya Jackson
Week 8 Discussion 1
COLLAPSE
Provide the full DSM-5-TR diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention).
The diagnosis that best describes Elizabeth’s symptoms is Other Specified Feeding or Eating Disorder 307.59 (F50.8): purging disorder. Specifiers include mild because Elizabeth is still at a heathy weight for her age, it is important to note when supporting her case. Z codes to condition in this are Z61.0 loss of love relationship in childhood and Z91.5 personal history of self-harm.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Elizabeth symptoms all the criteria for anorexia nervosa expect the significant weight loss. Elizabeth continues to maintain a healthy weight for her age. The criteria for anorexia nervosa include:
B. intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
Elizabeth finally finds she has some praise for something and begins to more consciously restrict her food intake to ensure that she continues to lose weight and feel good about herself. Elizabeth finds herself eating more than she wants and goes into the bathroom and induces vomiting to rid herself of the extra calories. She has done this about 6 times over the past several months.
Explain why it is important to use an interprofessional approach in treatment. Identity specific professionals you would recommend for the team, and describe how you might best utilize or focus their services.
Interpersonal approach focuses on four areas of conflict; relationship conflicts that cause stress, life changes that alter a person’s role or relationship, difficulty beginning or maintaining relationships, and lastly grief or loss (Rieger et al 2010). Elizabeth’s interpersonal should include the school social worker, a psychiatrist, and family physician. Each of these members would be about to evaluate Elizabeth in different areas and capacities and monitor changes she may experiences.
Explain how you would use the client’s family to support recovery. Include specific behavioral examples.
In the case study, Elizabeth noted her family made the comment, “there are plenty more fish in the sea”. The comment causes her to feel ashamed and embarrassed. Elizabeth does not feel comfortable trying to her family about her concerns because the issue does not seem several for them. Having a family session would help to family understand Elizabeth’s point of view and the changes in her adolescent life and how they directly have affected her.
Select and explain an evidence-based, focused treatment approach that you might use in your part of the overall treatment plan.
Adolescent Focused Therapy or Ego-Oriented Individual Therapy (EOIT) emphasized building ego strength, adolescent autonomy, and insight (Robin et al 1995). Measuring body mass index, self-reported general and eating-related conflict, and observed general and eating-related communication creates a better understanding on the concerns of the individual. Treatment can produce significant reductions in negative communication and parent-adolescent conflict, with some differences between condition and between eating and non-eating related measures; the improvements in eating-related conflict were maintained at a 1-year follow-up (Robin et al 1995).
Explain how culture and diversity influence these disorders. Consider how gender, age, socioeconomic status, sexual orientation, and/or ethnicity/race affect the experience of living with an eating disorder.
Young people between the ages of 15 and 24 with anorexia have 10 times the risk of dying compared to their same-aged peers (Smink et al 2012). During this age range, individuals are looking for acceptance but also are heavily influenced by peers and outside factors like social media making this population a vulnerable group.
References
Rieger, E., Buren, D. J. V., Bishop, M., Tanofsky-Kraff, M., Welch, R., & Wilfley, D. E. (2010, February 14). An eating disorder-specific model of interpersonal psychotherapy (IPT-ed): Causal pathways and treatment implications. Clinical Psychology Review. Retrieved July 21, 2022, from https://www.sciencedirect.com/science/article/pii/S027273581000022X
Robin, A. L., Siegel, P. T., & Moye, A. (1995). Family versus individual therapy for anorexia: impact on family conflict. The International journal of eating disorders, 17(4), 313–322. <a href=”https://doi.org/10.1002/1098-108x(199505)17:43.0.co;2-8″ target=”_blank” title=”https://doi.org/10.1002/1098-108x(199505)17:43.0.co;2-8″>https://doi.org/10.1002/1098-108x(199505)17:4<313::aid-eat2260170402>3.0.co;2-8
Smink, F. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414.
