Day treatment

The Edinburgh controlled trial of a day-patient programme has already been discussed. ^.J9) At the Toronto Hospital a day-hospital programme for eating disorders utilizing group treatment has been established since 1985. ^J31) The programme originally operated on 5 days each week, but since 1994 it has been reduced to 4 days per week. The goals are as follows:

1. a normalization of disturbed eating behaviour and weight gain;

2. the identification of psychological and familial processes that serve to perpetuate the eating disorder.

Two meals (lunch and dinner) and a snack are provided during the treatment hours. The staff take turns in supervising the patients during meal times. The psychological treatment consists of intensive group therapy divided between disturbed behaviours around eating and weight, and more general conflicts.

The clinical advantages of day treatment are a reduction in the dependence of patients who still have to maintain themselves in a functioning state outside the hospital. The group treatments carry the advantage of providing an atmosphere of mutual support while permitting interventions through group pressures. There are few contraindications to this treatment, but patients with medical or suicidal risks are admitted instead to inpatient care. For some patients day treatment does not provide as strong a sense of containment as might be found on an inpatient unit. When patients succeed in reducing their disturbed eating behaviours they may 'act out' by self-harm. The clinical staff may find their skills severely taxed by the continuous staff-patient interaction.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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