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Background: Patients with severe medical, psychological and ethical complexities often limit traditional treatment approaches. Using real life case studies, Dr. DeSarbo provides a comprehensive plan on deciding whether to create an unconventional treatment approach and how to do so once the decision is made. Therapeutic risk management techniques are provided.
This presentation is designed to address complex issues that often surround treating complicated and difficult cases involving eating disorders. At times, clinicians often encounter that case that has failed to respond to traditional treatment approaches or has failed multiple inpatient and outpatient treatment attempts. There is the patient who has medical conditions that mimic or masks their eating disorder. There is the patient who is refusing to follow treatment recommendations but has a strong therapeutic alliance with their treatment team. There is the family that may be undermining the treatment plan but who the patient is dependent upon. There is the patient who is in dire need of continued treatment but has run out of funds to support their treatment. This course will present several case examples that address the ethical and moral issues of unconventional treatment approaches for helping patients while trying to minimize the risks to patients and liability of professional exposure. Cases include a physician with chronic anorexia at 49lbs that continued to practice and refused inpatient treatment and how a structured program was set-up that safely led to a rapid recovery without relapse. A case of a young woman with chronic anorexia where the goal of treatment was modified to safety management until finding her motivation for recovery. A case of a young woman which a childhood chronic illness with symptoms that paralleled her eating disorder, were missed by her treatment team and almost lead to her death. Other issues include how to manage patients who consistently refuse to follow treatment recommendations, avoiding patient abandonment, the best way to discuss and minimize legal liability with patients significantly at risk for death, and how to evaluate and use unconventional treatments. This seminar provides handouts that attendees can use to create an appropriate treatment plan and forms for use to ensure proper informed consent and protect from exposure. Multiple case examples and supporting scientific research is presented.
This presentation is designed to address complex issues that often surround treating complicated and difficult cases involving eating disorders where traditional treatment approaches have failed or may no longer be effective. Traditional approaches usually involve an outpatient treatment team consisting of the therapist, the nutritionist, the medical doctor and sometimes a psychiatrist. But what can a clinician do when a patient fails to respond to outpatient, inpatient, residential, or IOP/day programs? The cases presented in this seminar are those that make clinicians uncomfortable and resistant to take on, or even worse, lead to patient abandonment when the patient is in crises. Unconventional treatment requires thinking "outside of the box," modifying treatment goals and approaches, utilizing complimentary treatments, and stretching the boundaries in a manner that continues to ensure safety, minimize risks, and has a theoretical basis for application. Actual case studies reveal how "unconventional" modifications in therapy approaches, nutritional plans, medical management, and pharmacology can often lead to dramatic changes and breakthroughs in treatment that would not have otherwise occurred with repeated traditional approaches. By utilizing multiple case examples with a variety of themes from non-compliance with treatment recommendations, to comorbid medical and psychological conditions, to family and financial barriers, presenters will learn how to think creatively about treatment planning and how to implement a new approach. This presentation is designed to educate and provide consult and supportive advice for handling these special cases that may require an unconventional approach verses leaving the patient without any hope or support. Furthermore, this presentation is to help clinicians turn personal frustration into treatment results. Dr. DeSarbo will address the psychological, medical and ethical aspects of such cases to provide a comprehensive evaluation for decisions on providing unconventional treatment approaches. A question and answer period will follow as well as the opportunity for audience members to discuss complicated cases they may be experiencing in their practice.
Jeffrey DeSarbo, D.O. is a Board Certified Psychiatrist and Medical Director of ED-180 Eating Disorder Treatment Programs in Garden City, NY and is also the Producer of the Eating Disorder News Network (www.EatingDisorderNews.com). His practice specializes in the treatment of eating disorders and he practices psychodynamic, CBT and existential therapy in addition to psychopharmacological management. He is also currently authoring two books: Demystifying the Biology Behind Eating Disorders, and Why Eating Disorder Treatment Fails. Dr. DeSarbo's special interest is with the neurobiological aspects of eating disorders and helping others understand how their biology effects their lives.
