Eating Disorders are recognised as a group of illnesses that can be treatment resistant. This presents a significant challenge to clinicians and carers of the individual with the eating disorder. How do you help someone recover when they do not want to?
Motivational Enhancement Therapy
Helping somone with an eating disorder work towards recovery can be difficult. The person affected may not recognise they have a problem and be very reluctant to make the lifestyle changes required to give up the eating disorder. Motivational Enhancement Therapy is often used to help sufferers recognise the extent of the problem and work through the lifestyle changes required. The therapy addresses the person's readiness to change and helps them move through the five stages of change required to achieve full recovery. The Stages of Change are:
Precontemplation
The person does not see the extent of the problem and is reluctant to initiate any lifestyle or behavioural change. An example of this may be someone with Anorexia Nervosa who is actively restricting their diet in order to continue to lose weight.
Contemplation
The person begind to recognise that the eating disorder is having a negative impact on their life. For example, they may feel physically unwell or cold all the time. However they are not quite ready to make any changes in order to address this.
Preparation
The person is able to recognise the extent of the problem and is able to identify that change has to be made. They may, at this stage, be able to work with the therapist to set goals to help work towards recovery.
Action
The person begin to actively make change. This may include increasing dietary intake or reducing illness driven behaviour such as vomiting after meals or excessive exercising. This stage can be frightening for the sufferer and they may slip back to precontemplation or contemplation stages.
Maintenance
This stage is when the person has introduced changes to challenge the eating disorder and has been able to work towards a full recovery.
The therapist's stance in Motivational Enhancement Therapy is open and collaborative. The aim is to work with the patient against the eating disorder and help them work through each stage of change. The therapist will often help the patient explore the postives and negatives of the eating disorder. He/she will encourage the patient to reflect on how the eating disorder is impacting on their quality of life. The positive message is that recovery from an eating disorder is possible.
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