Therapy Models for Anorexia Nervosa: History and Evolution - Essay Sample

Introduction

The earlier adopted models for anorexia nervosa therapy were based on psychodynamic form (NHS, 2016). During the early 1960s, the use of behavioural therapy was widely adopted approach for treating anorexia nervosa (Attia & Walsh, 2019). The primary adopted paradigm is based on isolating patients from social and material reinforcement which is depended on contingent delivery on weight gain and caloric intake. The approach was later ignored because the individuals under investigation seemed to gain weight over a reduced period. Depending on this earlier approach to treat anorexia nervosa, different models have been developed which try to establish to carry out therapy on patients with anorexia nervosa (Beumont, & Touyz, 2018). The paper focuses on determining the existence of severe anorexia nervosa condition across most adults by investigating the various models which have been found in countries such as the great United Kingdom.

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Literature Review on Anorexia Nervosa

Anorexia nervosa refers to a chronic and severe mental disorder which results in several psychological and social effects as well as leading in complications o their physical body. The condition has been established as the leading cause of death across various mental illnesses. According to the earlier researcher by the scholars, it is observed that almost less than 50% of the individuals found to have anorexia nervosa recover from the condition over a specified period. Among the survivors, it is estimated that at least 30% tend to continue with the condition. At least 20% of the patients are observed to continue experiencing the situation and, in some cases, persisted chronic conditions are recorded (Dixon et al. 2019).

Due to the inexistence of treatment and prevention method, the condition tends to grow complex across the various healthcare givers. From the diverse research conducted, it is observed that, due to different models being in use to approach anorexia nervosa disorder, there is no apparent treatment which has been established to deal with the condition. Taking the case of the United Kingdom recommended method to treat anorexia nervosa disorder, it is observed that at least 74 out of 75 present models have been given grade "C" by the United Kingdom's National Institute for Health and Care Excellence (NICE) (Fairburn et al. 2018).

Other researchers such as Zipfel carried out a randomized regulated trial relative to anorexia nervosa, which focused on identifying the comparison on the effectiveness of the models being tested. Carrying manualized treatment methods such as focal psychodynamic therapy and cognitive behavioural therapy to determine the respective treatment levels were presented the results obtained from the experiment indicated that, there was insufficient illness treatment since there was no notable difference between the participant groups (Russell, 2019). The results of the research also shown that the effectiveness of anorexia nervosa treatment increased after introducing the two manual methods for carrying out therapy. The existing evidence indicates that the approaches made towards treating the disease have almost similar significance.

Maudsley model of anorexia treatment for adults (MANTRA) and Specialist supportive clinical management (SSCM) are among the few approaches used in the United Kingdom to reinforce the existing treatment methods such as focal psychodynamic therapy and enhanced cognitive behaviour therapy.

Enhanced Cognitive Behavioural Therapy (CBT-E)

Researchers such as Fairburn tries to establish how the approach models such as Enhanced Cognitive Behavioural Therapy has been integrated within the United Kingdom. The sample size of the study comprised of ninety-nine participants all patients who had been diagnosed with the condition. The patients had either been obtained from various hospital clinics within the UK or from Italy. Treating the disorder incorporated the use of at least 40 sessions in which Enhanced Cognitive behavioural therapy was the only model used within the forty weeks. The study outcomes show that, a substantial increase in body weight (7.47kg, SD 4.94) and corresponding body mass index (BMI) of at least (2.77, 1.81) for the 64% of the patients who finished the set timeline for therapy (Russell, 2019). A significant improvement in eating disorder was noted within the 60-week schedule set for subsequent follow-up on the patients. Since there is a positive income by adopting the model to administer anorexia nervosa therapy, researchers such as Fairburn concludes, CBT-E can show significant results in outpatient treatment.

Other essential findings indicate that there is a positive outcome in both weight gain and eating disorder psychopathology for the individuals who completed the set period scheduled for the therapy. Studies show that there is minimal eating disorder despite the observed weight gain from the treatment method adopted. Other reviews by other scholars indicate that there is a significant reduction of the illness severity with the introduction of other complementary techniques such as Specialist Supportive Clinical Management (SSCM-SE) in treating anorexia nervosa disorder.

The quality of life was significantly improved alongside the patient condition from the study results hence an effective method offering better results when administered consistently to patients. Studies carried out by Tuoyz, and Hay shows that the output level of enhanced cognitive behavioural therapy has better results improved compared to other methods such as Specialist Supportive Clinical Management.

Other studies carried out by other researchers such as Touyz and Hay gives recommendations that anorexia nervosa treatment calls for a collaborative application of skills such as the patient strength and competence instead of focusing on the various issues associated with the developed models. Most healthcare givers are faced by several challenges when attending patients suffering from anorexia norvesa, especially those with despair. Most patients have pre-existing conditions such as an empty sense of prevailing and experiencing loneliness which makes it difficult for clinicians to give the correct administration of the condition. The various studies, in this case, provide a recommendation on multiple issues which needs to be incorporated in the treatment. Clinicians should endure the individual's willingness, for example, sameness and exploring self-experience, any pre-existing sickness and solitude. Enhancing patients hopefulness regarding their recovery should be increased for complete condition recovery.

Focal Psychodynamic Therapy

In some cases, anorexia nervosa, the condition is considered to be severe. Therefore, Focal Psychodynamic therapy approach for treating the disease is aimed at taking at-least 40-hour patient psychodynamic-related treatment which is applied to ease the situation. Therapist carrying out the treatment starts by identifying the essential psychodynamic foci in the earlier stage of treatment. There are three main psychodynamic therapy phases approaches adopted in this case. The first step involves developing self-esteem, pro-anorectic behavior, ego-syntonic belief and therapeutic alliance.

The second stage of treating anorexia nervosa using Focal Psychodynamic therapy includes classifying the interrelations and relationships between interpersonal relationship and eating (anorectic) behavior.

The third phase adopted involves evaluation of the daily intervention anticipation, parting and termination. Scholars such as Schmidt argue that, before initiating any treatment process, it is essential to carry an assessment on patient's weight and document it. On the other hand, Zipfel adds that both psychotherapy and structured care from a given therapist are combined when administering a patient using Focal Psychodynamic model (Russell, 2019). The approach adopted forms the foundation for patients treated in outpatient anorexia nervosa arrangement. In this study model, positive outcomes are experienced after at least 12 months with daily follow-up. Also integrating the earlier method such as Enhanced Cognitive behavior therapy had significant results compared to adopting focal psychodynamic therapy model alone when factors such as weight gain and eating disorders are to be considered. Use of focal psychodynamic therapy to treat anorexia nervosa seems to be adequately provided with the evidence-based approach used in this case.

As observed in the earlier cases and various models adopted, it can be noted that enhanced cognitive behavior therapy is paramount for the effectiveness of every approach to bring the expected results. Adopting a focal Psychodamic approach is only applicable when focusing on resolving the earlier experiences. This means that to increase the effectiveness of the model patient's reflection on the previous events resulting in the current behavioural changes is highly encouraged. The approach is built on a psychodynamic approach, which aims to help patients recover from challenging issues such as thoughts, emotions, and other challenging situations hence improving their life quality.

Specialist Supportive Clinical Management (SSCM)

Amongst all the essential inventions and interventions for anorexia nervosa, SSCM is the best, leave alone it being vital in ensuring the patients get the outpatient care. Outpatient care is usually essential to patients with less weight. The treatment procedure involves analyzing individual psychotherapy together with mental and behavioural therapy (Fairburn et al., 2018). To be precise, SSCM combines the application of standard clinical protocols and those of psychotherapy. The clinical management is essential in SSCM as it bears all the processes needed to deal with anorexia nervosa. The SSCM seeks to determine the signs and symptoms of anorexia nervosa, starting with the low weight of an individual. After learning anorexia nervosa, the first step is ensuring that an individual resumes correct eating behaviours (Fairburn et al., 2018). The supportive psychotherapy is needed in SSCM to determine what a patient needs.

Clinical management is essential for the treatment of every type of patient. However, In the case of anorexia nervosa, it portrays to start failing. On the other side, supportive psychotherapy tends to improve. To make a simple research conclusion, clinical management is incorporated into SSCM methodology to be efficient in the treatment of the condition (Fairburn et al., 2018). The SSCM approach, after it has interacted to clinical medicine, is to be used in events when extreme conditions appear. These main conditions revolve around bad eating habits; that lead to low weight and harmful compensatory properties.

The SSCM approach lays its purpose of assisting a patient in resuming proper eating habits, gaining weight to return to normal, educating the individuals involved in anorexia nervosa. The therapy is aimed to spread information about the condition (Halmi, 2018). Patients, among other people, are advised about the situation, and relevant information is shared to them. The therapy also assists other people experiencing different life conditions and especially who need supportive chemotherapy therapy.

The prescription about SSCM therapy is made by a specialist who is well conversant with eating disorder management. Before administering SSCM, the specialist should know what standards an average person should conform to mostly after the outpatient care is done. In events when a patient has BMI levels ranging below 15kg/m2, the person should be prescribed to receive sessions totalling 30 per every week, and a follow-up check should be made within four month...