help me please
by Jenny Bryan
Accepting that you have a problem and seeking help is a bold and courageous step if you have anorexia or bulimia. But unless your weight is life threatening, it can take weeks to get a referral to see a specialist. Steven Bloomfield from the Eating Disorders Association (now beat) explains that specialist facilities are highly variable and that, realistically, not every NHS unit can boast the kind of service seen in the top half dozen in the country.
© Getty
'There are roughly two dozen well equipped NHS eating disorder units in the UK and a similar number of private clinics which specialise in eating disorders. Then there are about another 24 NHS units which include an eating disorders service alongside their general psychiatric service,' he explains.
'If you don't live near one of the NHS units and you can't afford private care, you'll probably be seen in a psychiatric hospital which will do the best it can for you,' he adds.
Even the fully equipped centres and private clinics cannot guarantee successful treatment.
'With eating disorders, so much depends on the personal chemistry between the person with the disorder and the treatment team. In the same week, we'll get a letter from someone condemning a unit and another from someone saying it was wonderful,' says Steven.
treatment options
Most people with eating disorders are treated as outpatients or day patients, but inpatient treatment may be needed if they are severely depressed or have psychological or medical problems that need additional support.
Ideally, those who attend day programmes should have access to a dietitian to help them put together a healthy diet and follow their progress, a physiotherapist to help devise a healthy exercise programme, a psychological specialist who will provide the most appropriate cognitive therapy, and an occupational therapist who can help people re-learn the routine activities of daily life, such as eating, shopping and cooking.
Some centres – particularly private clinics – are likely to offer other therapies, including relaxation, art, drama and dance therapy, and aromatherapy, any or all of which may be helpful.
Receiving treatment close to home has obvious advantages; it is less disruptive to family life than travelling miles for therapy and it makes it easier for parents and siblings to take part in therapy when that is considered helpful.
How long someone needs treatment is very variable. While health authorities continue to pay for the full 12 weeks treatment that many eating disorder specialists consider essential, few if any private health insurers will now pay for more than five or six weeks treatment. This means, says Steven Bloomfield, that people can rarely get treatment through private insurance, as units will not take them for less than 12 weeks. Even three months is unlikely to be long enough to get to the root of a complex disorder which may have lasted for many years, and many people with eating disorders will need continuing emotional support.
guided self-change
Recent research has shown that people with bulimia respond well to a treatment programme which combines clinic visits for cognitive behavioural therapy with self help. They see a therapist less often than in conventional treatment, but they work through exercises and monitor their own progress between visits using a self-help manual. Comparative studies have shown bingeing and purging is as well controlled in those who use the guided self change approach as those undertaking a more intensive programme of therapy.
self help
Some people with eating disorders who refuse to seek formal help from a specialist will consider a self-help approach. A number of books have been written which help people establish healthier eating patterns, understand the thoughts and feelings at the root of their problem and support them in their journey towards getting better.
The EDA runs the Self Help Network (SHN), which can offer on-going support and information. The SHN is a UK-wide network of dedicated volunteers who offer postal, e-mail and telephone support to people affected by eating disorders. See the EDA entry in help and info to find your nearest self help group.
support groups
Some people find it helpful to talk to others with eating disorders at a local support group. Others find this approach counter-productive as they compete to become thinner than other members.
It isn't always easy to finding the type of treatment which is best suited to your own particular needs. You may need to try several different approaches before you work out what helps you most. Don't give up, keep trying. There is a way for everyone to get better.
help and info
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organisations
British Association for Counselling and Psychotherapy
BACP House
15 St John's Business Park
Lutterworth
Leicestershire LE17 4HB
Tel: 0870 443 5252 (Mon-Fri 8.45am-5pm)
E-mail: bacp@bacp.co.uk
Website: www.bacp.co.uk
BACP can provide a list of private counsellors in your area, plus information on counselling and choosing a counsellor. Please telephone or send an SAE to the above address. Alternatively, you can search for a counsellor at the website which, along with an online directory of counsellors, contains details about membership, training and an extensive publications list.
Careline
Cardinal Heenan Centre
326 High Road
Ilford IG1 1QP
Tel: 0845 122 8622 (Mon-Fri 10am-1pm and 7-10pm)
E-mail: info@carelineuk.org
Website: www.carelineuk.org
Provides confidential telephone counselling for children, young people and adults on any issue including eating disorders, depression, loneliness, anxieties and phobias. The website has a forum and an online counselling portal.
beat (formerly Eating Disorders Association)
103 Prince of Wales Road
Norwich NR1 1DW
Adult Helpline: 0845 634 1414 (Mon-Fri 10.30am-8.30pm and Sat 1-4.30pm)
E-mail: help@b-eat.co.uk
Youthline: 0845 634 7650 (Mon-Fri 4.30-8.30pm and Sat 1-4.30pm)
E-mail: fyp@b-eat.co.uk
Website: www.b-eat.co.uk
Campaigning organisation that provides information, advice and publications on all aspects of eating disorders. Operates a UK-wide telephone helpline and a youthline for information, help and support if you're aged 18 years and under. There is also a webzine, message board and chat room on the website.
Centre for Eating Disorders (Scotland)
10 Carment Drive
Glasgow G41 3PP
Tel: 0141 632 6663
Independent private practice set up by Mary Hart, Edinburgh and Grace Coia, Glasgow, which offers a counselling service to those who suffer from eating disorders.
Mental Health Foundation
9th Floor, Sea Containers House
20 Upper Ground
London SE1 9QB
Tel: 020 7803 1101 (Mon-Fri 8.30am-5.30pm)
E-mail: mhf@mhf.org.uk
Website: www.mentalhealth.org.uk
WWorking to improve the support available for people with mental health problems offering information and literature on all aspects of mental health. Unable to offer advice on an individual basis.
Mind (National Association for Mental Health)
15-19 Broadway
London E15 4BQ
Tel: 020 8519 2122
Mind Info Line: 0845 766 0163 (Mon-Fri 9.15am-5.15pm)
E-mail: contact@mind.org.uk
Website: www.mind.org.uk
Campaigns for better mental health services in England and Wales and publishes a range of helpful books and leaflets. Contact them for details of your nearest local group or for more information.
Royal College of Psychiatrists
17 Belgrave Square
London SW1X 8PG
Tel: 020 7235 2351 (Mon-Fri 8am-7pm)
E-mail: rcpsych@rcpsych.ac.uk
Website: www.rcpsych.ac.uk
Offers public information leaflets and factsheets on mental health issues including depression, sleeping well, eating disorders, bereavement, social phobias and schizophrenia.
UK Council for Psychotherapy (UKCP)
2nd Floor, Edward House
2 Wakley Street
London EC1V 7LT
Tel: 020 7014 9955 (Mon-Fri 9am-5pm)
E-mail: info@psychotherapy.org.uk
Website: www.psychotherapy.org.uk
Umbrella group for over 5000 practitioners all registered through member organisations. Will provide lists of registered psychotherapists free of charge; the database can be searched by local area or other criteria such as wheelchair access or language spoken.
United Kingdom Register of Counsellors (UKRC)
BACP House
15 St John's Business Park
Lutterworth LE17 4HB
Tel: 0870 443 5252 (Mon-Fri 8.45am-5pm)
E-mail: ukrc@bacp.co.uk
Website: www.bacp.co.uk/ukrc
A register of counsellors in England, Scotland, Wales and Northern Ireland.
YoungMinds
48-50 St John Street
London EC1M 4DG
Tel: 020 7336 8445 (Office only, Mon-Fri, 9.30am-5.30pm)
Parents Information Service: 0800 018 2138 (Mon & Fri 10am-1pm; Tue-Thur 1-4pm and Wednesday evenings from 6pm-8pm)
E-mail: enquiries@youngminds.org.uk
Website: www.youngminds.org.uk
Campaigning to improve mental health services for children and young people and providing information to anyone with concerns about the mental health or emotional wellbeing of a child or young person. Can give details of local and national advice agencies and leaflets for young people.
Youth Access
1-2 Taylors Yard
67 Alderbrook Road
London SW12 8AD
Helpline: 020 8772 9900 (Mon-Fri 9am-1pm, 2-5pm)
E-mail: admin@youthaccess.org.uk
Website: www.youthaccess.org.uk
A national membership organisation for youth information, advice and counselling agencies. Provide details of and referrals to local youth agencies and counselling services for young people aged between 14 and 25, but do not offer direct advice.
websites
Body Image Betrayal & Related Issues
www.bibri.com
This US-based website contains resources on eating disorders, plus details of chat rooms, range of links and suggested reading. Also has a section that suggests client/patient guidelines for evaluating therapy/counselling experience.
Eating Disorders Resources
http://edr.org.uk/
Informative website with resources on eating disorders including anorexia nervosa, bulimia nervosa, compulsive eating and binge eating, with details of organisations, publications and links to other websites.
National Centre for Eating Disorders
www.eating-disorders.org.uk
Aims to provide solutions for all eating problems, compulsive or binge eating, 'yo-yo' dieting, bulimia and anorexia. Offers information, counselling, and professional training.
Something Fishy
www.something-fishy.org
American website raising awareness and offering support on eating disorders. Includes information about different types of eating disorders, signs to look out for, advice for helping loved ones and details of online support such as chat rooms. Also contains a treatment finder for the UK.
Support, Concern and Resources for Eating Disorders (SCaRED)
http://p218.ezboard.com/bscaredeatingdisorders
A page devoted to providing discussion boards for different eating disorders and self-injury.
Women's Therapy Centre
www.womenstherapycentre.co.uk
Provides individual and group psychotherapy for women of all ages. Themes explored include compulsive eating and bulimia. Website contains information about the services and therapy available.
reading
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Getting Better Bit(e) by Bit(e) by Ulrike Schmidt, Janet Treasure (Psychology Press, 1993) |
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Helping People with Eating Disorders by Bob Palmer (John Wiley and Sons, 2000) |
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Treatment Manual for Anorexia Nervosa by J. Lock, D. Le Grange, W. S. Agras and C. Dare (Guilford Press, 2002) |
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(resources updated October 2005)
