Involvement of parentscarers in the treatment of young people

Before describing the specialist treatment options it is worth considering the issue of how involved parents/carers should be in the treatment of young people with eating disorders. All too often parents are actually excluded, or feel that they are being unnecessarily excluded, from their child's treatment regime and the EDA help-line receives many calls from frustrated parents on this subject.

Different therapy teams have different views on how involved parents should be. In particular, therapy teams who are not used to dealing with young people with eating disorders may not appreciate how important it is for the family to be involved in the treatment and recovery process. Some therapy teams hide behind the issue of confidentiality and seek to exclude the parents in order to protect their patient's confidentiality. The NICE guideline supports involving families and carers, but it does point out that every individual has rights of confidentiality. Young people with eating disorders might be having difficulties in their family life and in some cases there may have been familial abuse, which has contributed to the eating disorder. A young person has to trust his therapy team not to go running back to his parents with every comment that he makes. The therapy process that an eating disorder patient goes through can be very painful and very private to the individual and there is no reason why his parents should be privy to every detail. The NICE guideline states that confidentiality should only be broken if the patient or others are deemed to be at significant risk and where informing the parent is likely to reduce that risk. However, whilst confidentiality is clearly an important issue, it should not be used as a reason to exclude parents altogether.

The NICE guideline considers this a very important issue and states that the families of young people being treated for an eating disorder should be involved in their treatment and care. This is not because they are part of the problem, but because they are vital to the solution and can play a vital role in helping and supporting the young person on the long road to recovery.

The NICE guideline suggests that parents who are feeling left out, or are unsure what their role should be in the treatment process, should consider asking the patient's therapy team the following questions:

• What role can we have in helping the person with the eating disorder with their problem?

• Can you please let us know how the treatment of the person with the eating disorder is progressing?

• Can you advise us on the kind of support that you think we might benefit from as a family?

The NICE guideline goes on to say that parents/carers should be given enough information to help them provide care effectively. Respecting the patient's confidentiality should not be accepted as an excuse for excluding the parents or carers from being involved in the treatment process.

When our son was first admitted to an in-patient unit we felt excluded and were frustrated at the lack of communication. We felt that the more we asked questions, the more was being kept from us. In actual fact Joe's therapy team had very little to report in the first month. Joe was too ill to start therapy and he needed very close supervision from the nursing team to ensure his re-feeding programme didn't put too much pressure on his fragile body. Joe was angry and frustrated at the seemingly slow rate of progress and vented his anger at the family when we came to visit. This was all quite normal for a very sick anorexic child but we didn't know that. In time we got to know the therapy team and we started to understand that there is no magic cure for anorexia. The road to recovery is a long and slow one and everyone involved has to be extremely patient. Once we understood this it was much easier for us to have a useful dialogue with Joe's therapy team and we all worked together to ensure his recovery phase went as smoothly as possible.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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