Relapse. Systematic Nutrition Therapy during Re-occurring Lapses in Eating Disorder Behavior

Kelle, Pamela C.

Thursday, March 22, 2012: 8:30 AM-10:30 AM

Crystal A (The Charleston Marriott)

The final phase of treatment is relapse prevention. Due to the intense nature of eating disorder behavior and the complexity in receiving proper long term treatment, the role of the experienced Nutrition Therapist is essential to multi disciplinary teams and to work through lapses to optimize treatment outcomes.

Content Outline: Pamela Kelle RD CEDRD

I. INTRODUCTION OF TOPIC

A. Definitions of Recovery

1. Recovery Process or Recovered

2. Definitions of Relapse

3. Relapse or Lapse

B. Current Statistics for Relapse

C. Current Statistics of Recovery

II. RELEVANCE OF TOPIC

A. Current Treatment Plans Limited by Insurance Coverage

1. Length of stay shorter in hospitals

2. More complex medical issues

B. Toleration of Weight Gain

1. Maintenance and Stabilization of weight goals

C. Body Image Issues More Complex

III. ADVANCED NUTRITION PRACTICE

A. Countertransference and the risk of the ego: Is it our failure or theirs?

B. Goal setting and negotiation: Meeting the client where they are

1. Body Image Issues

2. Weight Acceptance; living with a different body

C. Using Lapses as teaching tools: Non judgment

D. Negotiating for Small Concrete Changes

1. What if they are eating only 1,000 calories

2. Setting Goals and contracts

3. Food diaries and weigh ins? Help or Hindrance

E. The Marriage of Mindful Eating with the Meal Plan

1. Gradual introduction of intuitive eating styles blended with caloric requirements

2. Accountability for the client

F. Ethics of continued Relapse: what are we to do?

IV.WORKING WITH THE TREATMENT TEAM

A. Know the Inpatient Facility: Their Treatment Model and Discharge plans

1. Make site visits

2. Encourage team visits to your location

3. Become a member of discharge planning teams

B. Open communication with families and support systems

C. ON line support groups and mentoring

D. Communication with the Therapist and Doctor

V. ULTIMATE GOAL IS TO RELEASE A CLIENT

a. Case Study

VI. CONCLUSION AND RECAP

An essential component of the interdisciplinary treatment team working with disordered eating is the experienced Registered Dietitian (RD). Across the continuum of care RDs are seeing younger, older and sicker clients. We are seeing more relapse caused in part by the current environment of shorter hospital stays, coupled with those who are denied treatment. Some clients who have struggled for years may have never experienced nutrition therapy treatment at all until now. It makes the inclusion of the seasoned Nutrition Therapist (RD)more important than ever before. In the work with clients who cycle through various stages of eating disorder behavior, the experienced eating disorder specialized RD apply strategies targeting both internal and external factors in an effort to disrupt undesirable eating patterns. These require that the RD not only be experienced and capable but also be able to comprehend and utilize treatment skills to stay with the client who often relapse multiple times during treatment.

Primary Presenter:

Pamela C. Kelle, RD, CEDRD, LDN

Maintain a private practice for over 15 years as a nutritionist/registered dietitian. Certified as an Eating Disorder Registered Dietitian through International Association of Eating Disorder Professioanls. Previous Co owner of Solace Intensive Outpatient Eating Disorder Clinic. Certified diabetes educator and Certificate in Adult Weight Management through the American Dietetic Association. Regular contributor to Health Scope Magazine, frequent guest on local television and radio.

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