Hunger for Understanding

Research suggests that anorexia nervosa and other eating disorders, whilst not prevalent in the population, have the highest mortality rate of all psychological problems. The development of effective treatment programs is therefore an important priority for health care professionals. This flexible book has been designed for use by therapists as part of a programme when working with young people with eating disorders. The aim is to help young people understand more about their own experience, and alongside guidance ofr therapists it includes a complete workbook for use by the young persons themselves. This presents tasks ranging from reflective thinking to drawing to promote engagement with difficulties as a first step to overcoming them.

About the authors vii Foreword ix Acknowledgements xi 1 The purpose of the workbook 1 Who is Hunger for Understanding for? 2 Who can use Hunger for Understanding? 3 When and how should Hunger for Understanding be used? 3 Accessing the workbook electronically 4 Issues of confidentiality 5 2 Psychological interventions for anorexia nervosa and the role of psycho-education 7 Psychological interventions 8 Motivational-enhancement therapy (MET) 9 Cognitive-behavioural therapy (CBT) 10 Psycho-education in anorexia nervosa 11 The psychological symptoms of starvation 12 The cultural context of eating disorders 12 Set-point theory 12 The physical effects of starvation 13 3 Therapeutic challenges, skills and techniques 15 Challenges of work with people with anorexia nervosa 15 Physical issues 15 Psychological issues 16 Therapeutic skills and techniques 17 Externalisation 17 Instilling hope 17 Empathy 17 Developing emotional awareness 18 Rolling with resistance 18 Dealing with distress 18 Managing relapses 18 4 The contents of the workbook and guidelines for use 21 Section 1 What is anorexia nervosa? 21 Section 2 What causes anorexia? 22 Section 3 How does dieting affect us? 25 Section 4 How does anorexia affect you? 25 Section 5 What keeps anorexia going? 26 Section 6 The tricks anorexia plays 27 Section 7 Thinking about change 27 Section 8 Getting better 29 Section 9 Teamwork 30 Section 10 Becoming assertive 30 Section 11 Myths and questions about anorexia nervosa 31 Some good advice and messages of support 31 Ending the workbook 31 The Workbook 33 Useful contacts 161 References 163 Index 167