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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. Page | 37