SOLUTION FOCUSED PRACTICE IN THE CONTEXT OF EATING

DISORDERS TREATMENT AND RECOVERY

Simone Howieson

RIVERDALE GRANGE

• Context of setting – Riverdale Grange • 9 Beds – Small service allows for more patient therapeutic interaction • ED is not a choice - chronic mental illness • There is an Impact of diet culture on patient group – • Diet culture tries to sell us the idea our bodies are not enough, than thinness is more

important than any other quality – including mental and physical health.

“ A culture fixated on female thinness is not an obsession about female beauty, but an obsession about female obedience” Naomi Wolf – Beauty Myth

DIET CULTURE

• System that marginalises anyone who is not thin, able bodied, young, toned…

• It’s a 66 Billion dollar industry that exploits the insecure

• Client group who are not present for their own life, often and for many and varied reasons chasing an endless path to weight loss by whatever means necessary, including cutting out whole food groups necessary for brain function.

• Team want to effect real change

RATIONALE

• What was the point?

• Provides hope in a field saturated by negative statics – just over half will recover.

• Patients have opportunity to share their story, know they are not alone.

• Moves patients past disordered thoughts by removing shame and secrecy

• Practical model for clinical team to give focus and meaning to sessions

• Practitioners like Barbara & David McFarland Book and Frederick Jacob have paved the way for a better approach to the problem of ED

• “ I trained to be a psychodynamic therapist with a specific interest in the recovery from eating disorders and I was first introduced to SFT in 1997. I immediately started incorporating the ideas into my work and was struck by the difference it made, not only to my clients but to myself too! From feeling drained and tired after a days work, I started coming home energized, and I put this down to the optimistic stance of the model”

 

PROCESS

• Business case to Hospital director • Likely impact of Single Clinical Model – Improvements in consistency & outcome & a clear and articulate recovery

focus • Developed training plan – embedded over 6 week period – staff given model to take away, use with patients and

reflect back weekly. • Skills practice

METHOD

• 6 week programme felt realistic and achievable whilst running and staffing service

• Training was staggered and staged with 2 mixed groups based on experience.

• Support workers viewing change

• In vivo supervision – why important/what achieving

• Sf meetings

RESULTS

• Staff were well engaged in the process • One year in - Now embedded in practice.

• All RMN’s trained as part of induction process

• All RMN’s receive live supervision • For patients it lets life in as an option, allowing for the possibility of different future in an illness that

bullies/limits options

• Moves patients through service – patient is accountable between sessions for progress against goals

FINDINGS

• Change is slow – at odds with sf practice, but staff are engaged and practicing • Feedback – staff and pts • Challenging to use when risks to physical health and Low weight has impaired cognitive

function • Young practitioners – building confidence and competence takes practice

SUSTAINING PRACTICE • How do we sustain? –

• Planning, inductions, booked for year – live supervision & meetings – continued positivity about the approach

• Away day with Guy – teambuilding so team have a shared understanding

• SFBT meetings – keeping up to date with Sf practice, case discussion role plays etc

BEST HOPES• A service of skilled clinicians

• Used in all aspects of hospital communication – supervision etc

• Non registered staff on board

• Patient group that are able to move towards freedom, self acceptance and love.

Thank – you – any questions?