A new service model for the treatment of severe anorexia nervosa in the community: the Anorexia Nervosa Intensive Treatment Team

Abstract

Aims and method A community intensive treatment service for severe anorexia nervosa is described. The service is multidisciplinary but driven by a focus on psychological formulation. Psychological and dietetic interventions are grounded in a process of active risk management. Evaluations of safety, cost and acceptability of the service are described.Results Patients are highly satisfied with their care. A relatively low mortality rate for such a high-risk population was observed. In-patient bed use and costs were substantially reduced.Clinical implications There is a case for greater use of intensive community care for patients with severe anorexia nervosa, as it can be acceptable to patients, relatively safe and cost less than admission.

Becoming needless: A psychoanalytically informed qualitative study exploring the interpersonal and intrapsychic experiences of longstanding anorexia nervosa

“…They, therefore, do not attempt to remove coping strategies until the client can establish other means of meeting their needs. Contrary to accepted wisdom, they report even at low BMI's the majority can engage in meaningful therapy once a trusting relationship is established (Munro et al, 2014). This approach warrants further investigation as a hopeful framework for this group.…”

“I Need Someone to Help Me Build Up My Strength”: A Meta-Synthesis of Lived Experience Perspectives on the Role and Value of a Dietitian in Eating Disorder Treatment

“…A total of 630 participants were included in this review (range 3-310). Participant age was reported in all but three studies [24][25][26] and ranged from 9 to 74. Four studies [26][27][28][29] included adolescent populations (i.e., under 18 years of age), three studies [26,27,29] explored parent or carer perspectives, and 11 studies [24,25,[30][31][32][33][34][35][36][37][38] considered only adult-client lived experience perspectives.…”

An Integrative Bio‐Psycho‐Social Theory of Anorexia Nervosa

“…The Schema Therapy model has been shown to be highly effective in large clinical trials amongst both Borderline and Cluster C Personality Disorders (Bamelis, Evers, Spindhoven & Arntz, ; Giesen‐Bloo et al , ), both highly prevalent co‐morbid conditions amongst patients with AN. We have adapted the Schema Therapy model for work with patients with severe AN (sAN) over the last 8 years, integrating further ideas from neuroscience, physiology and theories of emotion (Munro et al , ). Simpson and colleagues have developed and are testing further a group Schema Therapy model (Simpson, Morrow, van Vreeswijk & Reid, ).…”