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Bulimia Nervosa – Rita
March 28, 2022
Explain the connection between each theoretical orientation used by Dr. Heston and the treatment intervention plans utilized in the case
Dr. Heston has used various theoretical approaches, which have been integrated. He used about four different therapies to wholly address the condition (Bulimia Nervosa) experienced by Rita. Bulimia Nervosa is an eating disorder characterized by eating excessively then purging to eliminate the extra calories. The first therapy intervention involved teaching Rita what causes eating disorders or etiology. Secondly, Rita was awarded manuals and psychological education notes to read further, regarded as homework. Rita was also aided to regulate her eating disorder. This was well-taken care of by being awarded a nutrition journal. Finally, the doctor educated Rita on dysfunctional cognitions and functions. All the interventions were essential for Rita to develop a healthy coping ability and cognitions.
Describe the cognitive-behavioral model of the maintenance of bulimia nervosa
Dr. Heston utilized the cognitive-behavioral model to be fully aware of the feelings and activities of the disorder. It is an essential model in determining the sequence of binges or purges as well as the problems with a normal lifestyle. According to the cognitive-behavioral model, a person suffering from Bulimia nervosa has obsessive thoughts about food, purging, binge eating etc. Waller et al. (2014) argue that the victims of Bulimia nervosa have low self-esteem due to a feeling of negativity toward their physical appearance. The case of Rita is no different. She showcases similar behaviors whereby she excessively eats the tries to purge to leverage her binge eating. Her doctor intervened by targeting her cognition levels by advising Rita to negatively view other women in terms of their traits to understand that no woman is perfect. The doctor further insisted that Rita should always take lunch and avoid skipping her meals.
Explain why Rita was reluctant to participate in Dr. Heston’s request for her to keep a record of her eating behaviors. Use information from the Halmi (2013) article “Perplexities of Treatment Resistance in Eating Disorders” to help support your statements.
Dr. Heston insisted that Rita should have a nutritional plan to record her eating behaviors. A nutrition plan was necessary to enable Dr. Heston to understand the exact problem Rita faced. Rita was, however, resistant because she had earlier done it and was even more obsessive than any other period before. According to Halmi (2013), it is common for patients suffering from eating disorders to be reluctant to treatment. Some factors, including weight and body image, are the main occupants that facilitate the treatment of eating disorders. Patients with Bulimia nervosa are more hesitant to treatment over fears of treatment failure, which they think would alleviate the further concern of depression or being socially disabled for their failures to control their eating behavior despite treatment.
Further, Rita seems to be affected by severe perfectionism, affecting her treatment acceptance. Rita’s reluctance to treatment may also be linked to genetic factors. Her mother has an unhealthy obsession with appearance and the behavior has been a challenge.
Recommend outside providers (psychiatrists, medical doctors, nutritionists, social workers, holistic practitioners, etc.) to assist Rita in achieving her treatment goals. Use information from the DeJesse and Zelman (2013) “Promoting Optimal Collaboration between Mental Health Providers and Nutritionists in the Treatment of Eating Disorders” article to help support your recommendations
According to DeJesse et al. (2013), the collaboration between mental health professionals and nutritionists is essential in addressing eating disorders. The partnership is vital in accelerating the intervention and the treatment process. Patients involved in the inter-personal training and education of the two health professionals enjoy a great primary aspect of treatment. In this case, Dr. Heston should collaborate with dieticians or nutrition and social workers. Nutritionists and dieticians play a vital role in developing a healthy diet plan that mental health professionals may not formulate. The social workers target the perception of society to create new positive perceptions. They can be vital in eliminating negativity towards body appearance and subsequently terminating perfectionism traits.
Describe some of the challenges and ethical issues that Dr. Heston may encounter when working collaboratively with the professionals that you recommended. Apply ethical principles and standards of psychology relevant to your description of Dr. Heston’s potential collaboration with outside providers
The collaboration between Dr. Heston, nutritionists and social workers can lead to a moral challenge to differences in evidence-based therapies and their interpretations. Clinicians apply evidence-based therapies. They utilize the association hypothesis, which establishes the effectiveness of each therapy on different patients. There are varied approaches to evidence-based therapies, and every professional mentioned in this case has their means of style. For instance, some social workers may show strict adherence to documented therapies while the other professionals may develop their approach, which they feel best suits the challenge. Different health professions offer different approaches to handling patients. In the case of Rita, Dr. Heston actively involves her in determining the best approach to solve her condition. Other professionals may choose not to engage the patient in their treatment plan and rather employ their technique. Such differences in treatment plans may raise moral and ethical conflicts, which can interfere with the treatment process.
Evaluate the effectiveness of the treatment interventions implemented by Dr. Heston, supporting your statements with information from the case and two to three peer-reviewed articles from the Ashford University Library.
Dr. Heston employed numerous interventions in Rita’s case. As stated in the reviewed articles, these intervention approaches can be regarded as effective since they align well with the cognitive behavior approach. For instance, Dr. Heston intervened by attempting to modify Rita’s thinking pattern and requesting her to keep a nutritional plan. After that, Dr. Heston educated Rita on eating disorders. Dysfunctional cognitions were the main focus.
Recommend three additional treatment interventions that would be appropriate in this case. The recommended articles for this week may be useful in generating your response to this criterion. Justify your selections with information from the case.
One of the most recommended approaches is family-based therapy. This type of therapy does not address eating disorders directly but rather takes an agonistic view. It means that mental health professionals do not analyze the cause of the development of eating disorders, nor do they blame the family. It rather presumes the powerful bond between families and empowers the parents to use their love to help the family. In short, the therapeutic approach focuses on identifying and solving the issue which can cure the eating disorder. In Rita’s case, the intervention can change the opinion of an individual regarding physical appearance and disorders.
The second approach is group cognitive behavior therapy. According to Muhliheim (2022), CBT is considered the most effective methods used to treat bulimia nervosa. It should be the primary intervention offered at the outpatient level. The therapeutic approach focuses on the core problem of eating disorders over concerns with shape and weight. It characterizes the manifestation of these over concerns in five ways: binge eating, compensatory behaviors like self-induced vomiting, low weight, and strict dieting. Most of these concerns are evidenced in Rita’s case; therefore, this intervention can be very effective.
The finally recommended treatment intervention is medicinal nutrition therapy. This is a holistic approach to the treatment of various mental conditions and other symptoms. The approach uses tailored meal plans depending on the condition of a patient. A qualified dietician formulates these meal plans. The main components of the Medical Nutritional Diet (MND) include dietary modification and patient education. It is employed on patients suffering from eating disorders to enable them to re-establish their normal eating behaviors and improve their relationship with food and the body.
References
DeJesse, L. D., & Zelman, D. C. (2013). Promoting optimal collaboration between mental health providers and nutritionists in the treatment of eating disorders. Eating Disorders, 21(3), 185-205.
Halmi, K. A. (2013). Perplexities of treatment resistance in eating disorders. BMC psychiatry, 13(1), 1-6.
Muhlheim, L. (2022). Cognitive Behavioral Therapy for Eating Disorders. Verywell Mind. Retrieved 28 March 2022, from https://www.verywellmind.com/cognitive-behavioral-therapy-for-eating-disorders-4151114.
Waller, G., Gray, E., Hinrichsen, H., Mountford, V., Lawson, R., & Patient, E. (2014). Cognitive‐behavioral therapy for bulimia nervosa and atypical bulimic Nervosa: effectiveness in clinical settings. International Journal of Eating Disorders, 47(1), 13-17.