NEDA TOOLKIT for Parents
Common Elements of the Psychological Treatment of
Anorexia Nervosa
C — Therapies to be considered for the psychological
treatment of anorexia nervosa include cognitive
analytic therapy (CAT), cognitive behavior therapy
(CBT), interpersonal psychotherapy (IPT), focal
psychodynamic therapy, and family interventions
focused explicitly on eating disorders.
Psychological Aspects of Inpatient Care
C — For inpatients with anorexia nervosa, a structured
symptom-focused treatment regimen with the
expectation of weight gain should be provided in
order to achieve weight restoration. It is important to
carefully monitor the patient’s physical status during
refeeding. C — Patient and, where appropriate, carer preference
should be taken into account in deciding which
psychological treatment is to be offered.
C — Psychological treatment should be provided
which has a focus both on eating behavior and
attitudes to weight and shape and on wider
psychosocial issues with the expectation of weight
gain. C — The aims of psychological treatment should be to
reduce risk, to encourage weight gain and healthy
eating, to reduce other symptoms related to an eating
disorder, and to facilitate psychological and physical
recovery. C — Rigid inpatient behavior modification programs
should not be used in the management of anorexia
nervosa. Outpatient Psychological Treatments in First Episode
and Later Episodes
C — Most people with anorexia nervosa should be
managed on an outpatient basis, with psychological
treatment (with physical monitoring) provided by a
health care professional competent to give it and to
assess the physical risk of people with eating
disorders. C — Outpatient psychological treatment and physical
monitoring for anorexia nervosa should normally be of
at least 6 months’ duration.
C — For patients with anorexia nervosa, if during
outpatient psychological treatment there is significant
deterioration, or the completion of an adequate
course of outpatient psychological treatment does not
lead to any significant improvement, more intensive
forms of treatment (for example, a move from
individual therapy to combined individual and family
work or day care or inpatient care) should be
considered. C — Dietary counseling should not be provided as the
sole treatment for anorexia nervosa.
Post-Hospitalization Psychological Treatment
C — Following inpatient weight restoration, people
with anorexia nervosa should be offered outpatient
psychological treatment that focuses both on eating
behavior and attitudes to weight and shape and on
wider psychosocial issues, with regular monitoring of
both physical and psychological risk.
C — The length of outpatient psychological treatment
and physical monitoring following inpatient weight
restoration should typically be at least 12 months.
Additional Considerations for Children and
Adolescents with Anorexia Nervosa
B — Family interventions that directly address the
eating disorder should be offered to children and
adolescents with anorexia nervosa.
C — Children and adolescents with anorexia nervosa
should be offered individual appointments with a
health care professional separate from those with
their family members or carers.
C — The therapeutic involvement of siblings and other
family members should be considered in all cases
because of the effects of anorexia nervosa on other
family members.
C — In children and adolescents with anorexia
nervosa, the need for inpatient treatment and the
need for urgent weight restoration should be balanced
alongside the educational and social needs of the
young person.
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