VINCENT SQUARE EATING DISORDER SERVICE Involving Family and Friends

For the service user:

While recovery from an eating disorder is achievable, it can be a long and difficult journey. It can often be helpful to have someone to help you along the way. As a service, we believe that families and friends are helpful resources in treatment. They can help by attending some of your therapy sessions and working alongside you, by helping you with the tasks of treatment, by giving you their opinion or advice or just by being someone to listen and “sound things out” with you.

There is almost always someone who could assist you in your journey. Even if you have not yet told them about your eating difficulties, they may be surprisingly understanding and non- judgmental. It is worth considering if there is anyone who could support you with your recovery. This may be a parent, a sibling, a partner, a part of your extended family, a friend, a family friend etc.

Even if you do not want any of your family members or friends involved, they could benefit from knowing a bit about eating disorders and the services out there to support them, as people who care about you and want the best for you. This could help them to better understand the struggles that you experience and to be more patient with you during difficult times.

We would encourage you to pass this information sheet over to them so that they may start to understand a bit about our service and to point them towards some helpful resources.

For family members and friends:

If you have been given this, it is obvious that your family member or friend who is suffering from an eating disorder feels that you may be a helpful person to support them and may benefit from information about their difficulties and how to help. As a service, we see family members and friends as important resources in treatment. We would like to share information about our service with you and point you in the right direction to learn more about eating disorders (who they effect, the causes, treatment, etc) and the resources that can provide you with information and support. Supporting someone with an eating disorder can be challenging and anxiety-provoking and we hope that this information could be helpful resource.

A bit about Eating Disorders

Eating Disorders such as Anorexia Nervosa , Bulimia Nervosa and Binge Eating Disorder, are mental health problems. They involve an unhealthy relationship with food (e.g. restricting one’s food intake, bingeing on large amounts of food, sticking to strict dietary rules). They also typically involve a poor or distorted body image and/or a fear of gaining weight. People with Anorexia Nervosa fall below a body mass index (BMI) of 17.5 kg/m2. A normal (BMI) is 20 to 25 kg/m2. There is no one cause for eating disorders and no one type of person get them. It is rather a combination of things (some of which may be: a genetic predisposition, a personality style, traumatic events, bullying etc.) that contribute to the development of an eating disorder.

Last updated 04.04.13 Eating disorders primarily effect women, however, 10% of sufferers are men. The typical time of onset is in the middle to late adolescence however, the onset may be earlier or later than this. For Anorexia Nervosa there is no one treatment of choice. However, a structured type of treatment/therapy is better than no treatment at all. The most effective (‘evidence-based’) treatment for people with Anorexia Nervosa who are adolescent and in the first few years of their illness is Family Therapy. For Bulimia Nervosa the ‘evidence-based’ treatment is Cognitive Behavioural Therapy. However, other therapies can also be effective, particularly if there are additional difficulties. Medication or a combination of medication and therapy can also be effective.

About the Service

Vincent Square Clinic is located on the Chelsea and Westminster Hospital site in central London and offers a comprehensive range of specialist services for women and men aged 16 years and over suffering from anorexia nervosa, bulimia nervosa and other eating disorders. There is also a satellite clinic at Northwick Park Mental Health Unit in Harrow for patients local to Brent and Harrow.

People are referred to our service by other health professionals (eg. GP, psychiatrists, psychologists). Once referred, there is a short wait until they are assessed by a member of our team. We are a multidisciplinary team, which include doctors, nurses, psychologists, family therapist, art therapists, physiotherapist, and occupational therapists. Once the assessment has taken place, patients may start treatment quite soon afterwards (particularly if they need to have inpatient or daypatient care) or they may be placed on a waiting list. Unfortunately, due to the demand and wide catchment area we cover, the waiting time may be several months. While on the waiting lists, we advise GPs to keep a close eye on your family member/friend and to let us know if there are any significant deteriorations. If you are worried that there is deterioration, please encourage your family member or friend to see his or her GP for a review, or contact the professional who initially assessed them at the clinic.

Most of our patients will be seen as outpatients for weekly therapy sessions. We offer four types of outpatient treatment: Cognitive Behavioural Therapy, Cognitive Analytic Therapy, Family Therapy and Supportive Clinical Management. Whatever sort of treatment, we always aim to involve family and friends to some extent. We routinely talk to our patients about having a session with their family members or friends/significant other. The inpatient and daypatient services involve a combination of nutritional and medical management and psychological therapies, individual, in groups and with families. There are specific sheets to explain more about these parts of the service.

Why involve family and friends?

While getting better can be a long and difficult journey. As a service, we believe that families and friends are helpful resources in this journey.We also understand that supporting someone with an eating disorder is also not an easy task. It is for these simple reasons why we, and most other professionals, think that involving families is so important. We believe that by learning more about the individual, their family, and the context in which they live their lives the better it is we can help them. We do not believe that families cause eating disorders, nor do we want to exclude families and friends. But, just like ourselves, we know that sometimes, even with their best intensions, families and friends may get things a bit wrong. We think that providing you with information and support, we can help you to help your family member or friend.

Last updated 04.04.13 Resources for carers

Vincent Square family and friends (‘carers’) support group

We run a family and friends (‘carers’) support group for people who would like to get some support for themselves. These groups are held every fortnight on Monday evenings from 6:30- 8:00pm at Vincent Square Clinic. These are on-going and you can just turn up. Usually about 4-8 carers attend.

We also run a family and friends' skills-based workshops which involves teaching and practicing skills to help manage challenging situations and improve communication between you and your relative. These run in modules of six every other Monday from 6-8:00pm at Vincent Square Clinic and require registation. Usually 12-16 carers attend.

Both groups are facilitated by a family therapist and a cognitive behavioural therapist. For more information and a list of the next dates for the meeting, you can ring us on 0203 315 2104.

Other london-based family and friends (‘carers’) support group

There are other ‘carer’ support groups that are run in London that are independent from our service including The London Carers’ Group: A Self Help Group run by and for Carers. Please see: http://www.londoncarersgroup.org.uk/ for more information.

Other organisations with information about the illness

BEAT is a national, non-profit, charitable organization that provides information, support groups and hotlines for sufferers, families and friends. http://www.b-eat.co.uk/Home; email [email protected]; Helpline 0845 634 1414

The Institute of Psychiatry Research group provide information and a ‘tool kit’ for family and friends through their website - www.eatingresearch.com. They also collaborate with BEAT to provide annual ‘carer conferences’ for families and friends.

The Royal College of Psychiatrists provide information about a variety of mental health difficulties on their website - http://www.rcpsych.ac.uk/mentalhealthinfoforall.aspx

Recommended Literature

In addition to information from the organisations above, there have been some very good books written to provide information and advice to family members and friends. One of the authors in the book immediately below is a family member of someone with Anorexia Nervosa. Family members and patients were consulted in the development of both books.

Skills-based Learning for Caring for a Loved One with an Eating Disorder: The New Maudsley Method by Janet Treasure, Grainne Smith and Anna Crane

Anorexia Nervosa: A Survival Guide for Families, Friends and Sufferers by Janet Treasure

Last updated 04.04.13 Family and Friends Service Development Forum

You can get involved and help us to improve our service by getting involved in our Friends and Family Service Development Forum. You can contact us by telephone and speak directly with our receptionist/administrator, Pam, at Reception to obtain an information leaflet to learn more about this forum. We also have a carer email forum that you may wish to join.

You may be interested in our other leaflets:

- CBT, CAT, Family Therapy , Supportive Clinical Management - Information on Confidentiality and Information Sharing - Inpatient Service, Daypatient Service

If you would like additional information about the service or about services and support for families and friends, please talk to your loved one’s therapist or keyworker or one of our service administrators.

Last updated 04.04.13