Program interventions, eating disorder inpatient handbook CHW

Your child will receive a number of interventions as part of their admission. These are in addition to the general program.

Psychological support

Your child may have individual check-ins with a member of the therapy team if needed. The nursing staff are experienced in caring for adolescents and can provide support if your child is upset or stressed.

  • Your child’s eating disorder thoughts are not the focus of admission.
  • This is because your child’s physical state impacts the brain’s capacity to take on new skills. The eating disorder is too strong for your child to change their thinking at this stage.
  • Nutritional recovery, removing decision-making and regular eating may help with disordered thoughts. 

An outpatient treatment plan will be developed as part of your child’s admission. Family therapy is usually recommended as we know that family support is vital for recovery. 

Medical stabilisation

Most people admitted to the program are due to medical instability. This means their body was not sustaining itself safely with the amount of energy they were
consuming. 

  • To become medically stable, your child needs to receive the right amount of energy regularly.
  • Initially, your child will receive nutrition through a nasogastric tube containing nutrition supplement. The tube remains in place until your
    child is medically stable and able to eat sufficient nutrition.
  • This process is carefully monitored and the medical team will discuss progress with you and your child regularly.  

Medical and psychiatry assessment

Your child will receive daily medical and psychiatric management while in hospital. They will also have a separate psychiatry assessment to clarify diagnosis and any other mental health issues. 

It is common for people with eating disorders to also be experiencing mood issues.

Diet assessment and education

Your child will meet with our dietitian to discuss nutrition requirements. They will give guidelines on the amount and types of food your child needs.

Once your child is medically stable and eating meals, we will ask you to have meals with them. Initially it will be on the ward with tray foods and then home foods and off the ward.

Physiotherapy

Physiotherapy group occurs twice a week for 30 minutes per session. The goals are to maintain physical condition while balancing energy conservation. These sessions start with stretching (when on level 2) and moves to strengthening (when on level 3).

Avoidant restrictive food intake disorder (ARFID)

If your child has ARFID, their care is likely to be different from what has been described in this handbook. ARFID has different drivers from Anorexia Nervosa and Bulimia Nervosa and care is adjusted for this. Nutritional recovery and re-establishing eating will still be integral to treatment. 

Other aspects of care will be based on your child’s individual needs. Care for a child with ARFID may include:

  • Focusing on preferred foods for nutritional recovery and using a graded approach to increase variety.
  • Using a reward system.
  • Providing anxiety interventions.
  • Addressing any underlying stressors.