Patterns of Relapse and Recovery Following Intensive Treatment for Eating Disorders: A Qualitative Description

Woodside, D. Blake; Kohn, Magdie L; Kerr, Ann

doi:10.1080/10640269808249258

Cited by 3 publications

(3 citation statements)

References 10 publications

(6 reference statements)

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“…The extent to which these findings apply to clients who have recently completed treatment is not known. However, the answer to this question has great clinical value, because the period immediately following discharge has been identified as challenging (Fichter & Quadflieg, 1996; Herzog et al, 1999; Olmstead et al, 1994; Woodside et al, 1998) and a time when individuals are most prone to slips and relapse (Strober et al, 1997). The purpose of this study was to identify factors that help or hinder the maintenance of change and the ongoing promotion of recovery during the critical 6 months immediately following eating disorder treatment.…”

Section: What Hinders Recovery?mentioning

confidence: 99%

“…There is a growing body of research investigating ways to enhance readiness to change eating disorder behaviors (Cockell, Geller, & Linden, 2002, 2003; Geller, Williams, & Srikameswaran, 2001; Treasure & Schmidt, 2001; Vitousek, Watson, & Wilson, 1998), but relatively little attention has been given to an equally important topic—how to promote the maintenance of change once it has been achieved. Learning more about this critical phase of change is important, as relapse rates in the eating disorders are reported to range from 33% to 63% (Field et al, 1997; Herzog et al, 1999; Keel & Mitchell, 1997; Olmstead, Kaplan, & Rockert, 1994), and repeated admissions to treatment programs are common (Woodside, Kohn, & Kerr, 1998).…”

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confidence: 99%

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Maintaining change following eating disorder treatment.

Cockell¹,

Zaitsoff²,

Geller³

2004

Professional Psychology: Research and Practice

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Residential eating disorder treatment involves emotional, financial, and time commitments from clients, staff, and the health care system. At discharge, most clients have made substantial nutritional, social, and psychological changes. However, maintaining these changes when intensive support is no longer available represents a significant challenge, and it is common for individuals to slip back into previous eating disorder patterns. Interviews with 32 individuals were conducted 6 months after discharge. Qualitative analyses revealed a pattern of factors that facilitated and hindered recovery. These factors were integrated with past research findings to develop a conceptual model about how changes are maintained. Recommendations regarding ways that health care professionals can assist with the transition from intensive treatment to community living are discussed.One of your eating disorder clients is nearing her date of discharge, and she tells you that she is worried about being able to maintain the changes that she worked so hard to make during her admission. She tells you that her family and friends also worry that she may relapse. You suggest that she keep a log of her thoughts and feelings in a journal, use the coping skills she has developed in the program, follow her meal plan, maintain appointments with her therapist, and join a support group in the community. However, deep down you share the uncertainty about her ability to choose non-eating disorder coping strategies when her distress level runs high. You consider keeping her in the program longer, but even if this were feasible, you are aware that this may simply delay the inevitable. Is there anything that you can do to help her with this inherently destabilizing transition? Is there anything that you can say to help her maintain the changes she has made? Is there anything that you can recommend to outpatient practitioners who will provide her with follow-up care?There is a growing body of research investigating ways to enhance readiness to change eating disorder behaviors (Cockell,

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Section: What Hinders Recovery?mentioning

confidence: 99%

mentioning

confidence: 99%

Maintaining change following eating disorder treatment.

Cockell¹,

Zaitsoff²,

Geller³

2004

Professional Psychology: Research and Practice

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“…The failure to maintain the clinical gains achieved during acute treatment is, unfortunately, a common phenomenon in the course of EDs and especially for individuals with AN. Relapse rates of EDs are reported to range from 33% to 63% (Field et al, 1997) with the greatest risk of relapse occurring during the first year after discharge from initial treatment (Herzog et al, 1999), then commonly followed by a "revolving door" of repeated inpatient admissions (Kaplan et al, 2009;Woodside, Kohn, & Kerr, 1998). Research has shown that although ED symptoms are typically reduced by the end of hospitalization, the ability of individuals to reach full recovery or partial recovery by 2 years later is 0 and 10%, respectively, and 1-21% at the end of 3 years (Cockell, Zaitsoff, & Geller, 2004;Strober, Freeman, & Morrell, 1997).…”

mentioning

confidence: 99%

Stopping the “revolving door”: “Zeida Laderech,” a unique rehabilitation house for young adults with severe and enduring eating disorders

Latzer

2019

J Clin Psychol

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A failure to maintain improvement achieved during acute treatment, followed by a “revolving door syndrome,” is a common phenomenon in eating disorders (EDs). As a result, many patients develop a chronic course that is difficult to treat. To target these difficulties, we established a novel rehabilitation treatment model in Israel for patients with severe and enduring EDs, based on the “recovery theory” in mental health treatment. This paper describes the process of conceiving this model and specifies the components of this rehabilitation house, “Zeida Laderech” (Provisions for the Journey), that aims to provide a home‐like environment, while assisting in developing a healthy and balanced lifestyle. Finally, the model is discussed in light of other residential programs established in the world. With the hope to improve the overall prognosis of individuals with EDs, it is suggested that the similar programs and ongoing innovation will continue to emerge internationally.

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Readiness to Change Dietary Restriction Predicts Outcomes in the Eating Disorders

et al. 2004

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This study examined the relationship between readiness and motivation to change eating disorder symptoms and clinical outcomes during and following intensive residential eating disorder treatment. Sixty-four women completed the Readiness and Motivation Interview (RMI) at baseline, and a subset of participants were reassessed at post-treatment (n=45) and at 6 month follow-up (n=38). The RMI provides readiness scores for each of four symptom domains: restriction, cognitive, bingeing, and compensatory strategies. RMI scores were used to predict decision to enroll in treatment, dropout, symptom change following treatment, and maintenance of symptom change at six-month follow-up. The extent to which participants did not want to make changes to their dietary restriction at baseline (restriction precontemplation) was the most consistent predictor of short-term clinical outcome. The extent to which participants reported changing their restriction for themselves versus others (restriction internality) predicted outcome at 6-month follow-up. These preliminary findings suggest that assessing client readiness and motivation to change dietary restriction is most useful in predicting short and long-term clinical outcomes.

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Patterns of Relapse and Recovery Following Intensive Treatment for Eating Disorders: A Qualitative Description

Cited by 3 publications

References 10 publications

Maintaining change following eating disorder treatment.

Maintaining change following eating disorder treatment.

Stopping the “revolving door”: “Zeida Laderech,” a unique rehabilitation house for young adults with severe and enduring eating disorders

Readiness to Change Dietary Restriction Predicts Outcomes in the Eating Disorders

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