Treatment typically involves a series of outpatient psychotherapy appointments. Your therapist will discuss with you how long your therapy will last. Links to the types of therapy offered are below.
Your therapist will work together with you to try to overcome your problems and will be the person who is responsible for planning and organising your care.
We expect you to attend your appointments but if you are unable to attend a particular session, please let your therapist know. It is not uncommon for patients to find sessions uncomfortable or distressing, particularly at the beginning of therapy. Your therapist will try to help you manage these emotions.
The majority of our patients are managed as outpatients but occasionally more intensive treatment, such as day patient or inpatient care may be considered. From time to time during your treatment you will also be asked to fill in some questionnaires. These help us to evaluate your treatment and to ensure that high standards are maintained.
How can psychotherapy help?
Evidence shows that some form of psychotherapy is an important part of recovery from an eating disorder. Psychotherapy involves sharing your problems over a period of time with a professionally trained therapist. This means being prepared to talk about your concerns not just about weight and eating, but also wider issues which may be important, such as relationships with people, low self-esteem or handling difficult emotions. In addition you may be expected to carry out tasks such as keeping a diary or trying out something new in your everyday life. The emphasis is on achieving a better understanding of your difficulties and new ways of coping, rather than relying on eating or weight control. Experience suggests that about two-thirds of patients benefit significantly from psychotherapy.
Motivation and Psycho-educational Package for People with Eating Disorders (MOPED)
MOPED has been developed by clinicians at the Leicestershire Eating Disorders Service in collaboration with Loughborough University Centre for Research into Eating Disorders (LUCRED). It incorporates some techniques proved to help people with disordered eating. You may be issued with a booklet or access to the online version of MOPED. It is designed to be used by you at home.
MOPED will take you through the difficult journey of change. It educates you about eating disorders and suggests a series of exercises to help you break the vicious cycle between eating and other issues.
Psychodynamically Informed Therapy for Anorexia (PITA)
Psychodynamically Informed Therapy for Anorexia (PITA) is an intervention in line with NICE guideline recommendations for patients with anorexia nervosa. The therapy aims to help people with anorexia type disorders to restore and maintain their weight within a normal healthy range, without use of unhealthy weight management behaviours. Regular weighing, dietary advice and homework tasks are all part of the therapy. The therapist provides support with weight restoration.
Cognitive Behavioural Therapy (CBT)
Cognitive Behaviour Therapy (CBT) is suitable for a range of eating disorders. In its 20 session format it has very strong evidence for the treatment of eating disorders where binge eating and/or purging behaviours (being sick or using laxatives) are present. CBT is the recommended treatment for bulimia nervosa under the NICE Guidelines (2004).
Sessions are 45 to 60 minutes duration. In the first few weeks you may be asked to attend twice a week. This can help support early change which can improve outcome. It is important that you attend all your sessions so please let your therapist know if are unable to attend. CBT explores how thoughts and beliefs about eating, weight, body shape and the control of these serve to maintain the eating disorder. Your therapist will explain this in more detail when you start therapy.
You will start to monitor your eating and will be helped to establish a regular eating pattern. Your therapist will need to find out a lot of detail about your current problem areas and the questionnaires that you have completed are important in helping to inform this process. You will be given homework activities outside of the sessions which will be reviewed at your next appointment. Towards the end of your therapy focus will be on developing a personalised relapse prevention plan.
During therapy you will be asked to obtain and read, under guidance, the following CBT manual:
- Overcoming Binge Eating by Dr Christopher Fairburn. ISBN 0-89862-179-8 (Guildford Press) 2nd Edition.
Interpersonal Psychotherapy (IPT)
Interpersonal Psychotherapy (IPT) is an effective treatment for bulimia nervosa and is recommended under the NICE Guidelines (2004).
Treatment consists of 12 - 16 sessions of 45 minutes duration. Initial sessions will help you and your therapist understand more about your eating disorder. The questionnaires that you have completed are important in helping to inform this process.
Your therapist will help you to establish a focus for therapy, you will be encouraged to take an active role and to work collaboratively with your therapist to make changes to help to improve your eating and any mood difficulties.
In the last sessions you and your therapist will review therapy and plan for how you can continue to improve by using what you have worked on in therapy.
Some people have found the following books helpful:
- Overcoming Binge Eating by Dr Christopher Fairburn. ISBN 0-89862-179-8 (Guildford Press) 2nd Edition
- Bulimia Nervosa and Binge Eating— A Self-Help Guide Using Cognitive Behavioural Techniques by Peter Cooper. ISBN 9781849010757 (Constable and Robinson Press)
- Defeating Depression by Roslyn Law. ISBN 978-184901-712-1 (Robinson 2013).
Dialectical Behaviour Therapy (DBT)
Dialectical behaviour therapy (DBT) is a type of talking therapy. It is based on Cognitive Behavioural Therapy (CBT) but has been adapted to meet the needs of people who experience emotions very intensely. Like CBT, DBT also helps you change unhelpful behaviours, but also focuses on accepting who you are at the same time.
Supportive psychotherapy (also referred to as Specialist Supportive Clinical Management)
Supportive psychotherapy is a type of talking treatment where a patient will meet with a clinical specialist, as required. It may also be used to prevent someone deteriorating whilst awaiting a more formal, structured treatment or to help that person manage to live with, or get better from, their eating disorder.
This 9 session course, led by an experienced eating disorder therapist, aims to help individuals understand and improve their self-esteem. The group allows individuals to work at their own pace and provides opportunity for mutual support.
Body Awareness Therapy
A 10 session group for patients who are above a BMI of 17. The group aims to address body dissatisfaction. It uses individual mirror exposure and develops skills in both recognition and management of thoughts, feelings and behaviours that arise from, and help to maintain, unhelpful body appraisals.
Information on Eating disorders
Why do people develop eating disorders?
There are lots of theories about what causes eating disorders, but most professionals would take the view that there are a range of factors which may lead to a person being vulnerable to developing such problems. These include low self-esteem, problems in personal relationships and an overemphasis on the importance of weight and shape. In this service, we take the view that each patient is unique and we need to understand their individual backgrounds, personal circumstances and personality in order to help find a solution to their particular problems.
More information about eating disorders can be found on the Beat website.
We do not provide an emergency or out of hours service. For urgent care or advice please contact your GP, Urgent Care Centre or Emergency Department.