SAC Assignment 6
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RUNNING HEAD: ADDICTIVE BEHAVIORS EATING DISORDERS
Eating Disorders: Psychoeducation & Treatment Miranda Palmer California State University, Stanislaus
SAC Assignment 6 Eating Disorders: Psychoeducation & Treatment Eating disorders such as Anorexia Nervous, Bulimia and overeating are some of the hardest behaviors to treat because food is everywhere and is necessary to survival. Advising a person who has substance abuse issues to avoid social networks and places where drug use is
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involved would be advantageous. For those with eating problems, avoiding places where food is used would just be silly. Following is a short example of a psychoeducational session with a friend of someone who may be bulimic and a treatment plan. Well Mary, it sounds like you are very concerned for your friend. It sounds like it was pretty scary when you were hearing her throw up in the bathroom repeatedly and than she would deny it was happening. It sounds like this has also hurt you a lot that she has been avoiding you and saying she does not want to be friends with you over this. Well Mary I know that you came here hoping that I am going to be able to fix her and make her stop doing this. However, I have to let you know that it is not going to be easy. Because you told me here at school and because Jill is only 16 we will be involving her parents in what is happening. However, I want to be honest with you, it won’t be easy, we won’t be able to just talk to Jill or give her a pill and this will go away. The things are describing that you have seen for the last year: Jill hiding large amounts of food in her room, in the bathroom, and in her backpack are different. Many people who hide food, will save it to eat privately in a short amount of time, like that time you walked in on Jill demolishing off that pizza 5 minutes after it was delivered. This behavior is what they call bingeing. Bingeing is someone eating a huge amount of food in a short amount of time. Many times, after someone has binged, they may fill sick to their stomach, and they may start thinking that they are really fat, or the effects eating such a large amount will have on them,
SAC Assignment 6 than they may purge. Throwing up the food someone just ate is called purging. They do this to try to keep their body from using the calories. In some ways this works, they will lose a couple of pounds right away; they will not feel as full, but that is not all that happens. The person is not losing weight as we might think about, losing fat, they are losing water weight and becoming dehydrated. Not having enough water in the body makes it so the body does not work as well and may cause headaches, cramping, more vomiting and damage to someone’s organs. The person also is not getting enough calories, vitamins or nutrients to survive. This means that the body will go into starvation mode, like if you had been in the desert for days. Every calorie that Jill eats that in the past might have gone for energy, building muscle, keeping
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the body running smoothly is going to be stored for later in fat. The body does not know when it will next be able to eat so it wants lots of fat saved up for energy later. Jill’s body begins to burn the muscle in her body for energy, instead of using the calories she eats. It will not take long before Jill begins to become weaker and her body fat percentage may actually increase through this dieting technique! Furthermore, Jill is reeking havoc on her teeth. Vomiting is used by our bodies as a last ditch approach to rid harmful things from our bodies. Our bodies are not made to be vomiting on a regular basis. The acids in our stomachs that break down the food are purged with the food in the stomach. This acid is harmful to the calcium in Jill’s teeth and will begin rotting her teeth away. A dentist is often the first one to know someone is purging because it can be seen when looking at the teeth. I know all of this is probably really confusing to you Mary, why Jill would do these things. Well, you know that in some ways Jill is doing this because she wants to be thinner, but
SAC Assignment 6 as we look at her, we can see that she does not need to lose weight. However, this bingeing and purging is a viscous cycle. First, someone may try to limit their food intake and starve him or herself. Second, they may become so hungry that they binge and eat a large amount of food in a short period. Next, they may become worried again about the effect their intake has on their weight. Than they may experiment with purging. After that, the scale shows that they have lost weight making it seem like it worked, although it is really doing the opposite for them. People get hooked on this feeling of being able to control their weight immediately. So why is Jill so obsessed with her weight? Well there could be many reasons why. You
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talked about how you both became friends because of your love of Britney Spears music and that you wanted to be like her. Many girls look to the pictures in magazines and to music videos and begin measuring their body and their looks by society standards. You talked about how you were jealous of Jill because she was developing faster than you were, and that you felt like a beanpole. But your mom had also told you that when a woman goes through puberty that she gets an extra layer of fat cells to protect her organs and body: it was normal, expected and something you were looking forward to. For Jill, this may have been a scary experience; you talked about how her mom is always dieting and putting Jill on a diet. Jill may not have known what was happening. Today in our society, many girls are not educated like your are by your mom about what is normal during development. In addition, it is very easy when looking at the pictures in the magazine to begin judging yourself against those people. Many of the people in those magazines are very unhealthy and starve themselves, or purge the way that Jill does. However, there are places for you to get support. You can get onto chat rooms and talk to others with friends who do this; you can talk to your mom about your concerns and fears. In addition, I will be talking to the principal about having a presentation for the school and educating about these issues during
SAC Assignment 6 health classes. And of course, you can always come to me or any of your teachers about these and other types of problems. A situation such as that one outlined above contains a variety of treatment issues. First is that often this is a secretive disease, and it may not be found out for a long time. Second, is that family members are not always sensitive to the client’s needs and may exaggerate the person’s issues surrounding body image. Third, because the client is not coming in for help herself, she
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may not be accepting for change. Fourth, there are nutritional, dental and other health issues. It is important to examine all of these issues in concert when treating the client. Short-term goals include the several aspects of the behavior. Assessing the client’s motivation and moving her to the contemplation and action stage. Psychoeducation regarding the effects of bingeing and purging on the body. Referrals to appropriate community health resources. Lastly, the client gains understanding of the effects of bulimic behavior on her life. While long term treatment goals include increased understanding of cognitive and behavioral triggers, reduction in bulimic behaviors, and increase in alternate behaviors. 1. Semi-Structured Clinical Interview 2. EDI II 3. Assessment of motivation 4. Assessment for comorbid disorders 5. Referrals to psychiatrist, physician, dentist and nutritionist 6. Motivational interviewing focused on client reaching the action stage 7. Cognitive behavioral therapy focused on client being exposes to alternate explanations for experiences to assess maladaptive belief systems.
SAC Assignment 6 Self-Assessment
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This assignment felt rather natural. It may be that way because in another class a group of students gave a presentation about Bulimia. This assignment gave me a chance to review the presentation, use some of the information received and mold it into a style that fits my own. I think this assignment is going to make the information presented really stick with me. Discussion of eating disorders has always prompted thoughts that I would not want it to be my expertise. I think I still definitely know that, but unfortunately, in any clinical setting these issues do not go away. Being able to look at the issue from a multi-disciplinary approach where there are doctors, nutritionists and psychiatrists possibly involved I think takes a little bit of the pressure of me. In this particular area, it just seams that the odds are SO great against someone really getting past it. Unfortunately, that belief system of mine has not changed through this assignment.