Prior to beginning work on this assignment, read the Treatment Plan Preview the document and Case 9: Bulimia Nervosa in Gorenstein and Comer (2014). Please also read the Waller, Gray, Hinrichsen, Mounford, Lawson, and Patient (2014) “Cognitive-Behavioral Therapy for Bulimia Nervosa and Atypical Bulimic Nervosa: Effectiveness in Clinical Settings,†Halmi (2013) “Perplexities of Treatment Resistance in Eating Disorders,†and DeJesse and Zelman (2013) “Promoting Optimal Collaboration Between Mental Health Providers and Nutritionists in the Treatment of Eating Disorders†articles.
Assess the evidence-based practices implemented in this case study. In your paper, please include the following.
Explain the connection between each theoretical orientation used by Dr. Heston and the treatment intervention plans utilized in the case.
Describe the cognitive-behavioral model of the maintenance of bulimia nervosa.
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.
Recommend outside providers (psychiatrists, medical doctors, nutritionists, social workers, holistic practitioners, etc.) to the 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.
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.
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.
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.
The Case Analysis – Collaborating with Outside Providers
Must be 3 to 5 double-spaced pages in length Bulimia Nervosa in Gorenstein and Comer (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.).
Must include a separate title page with the following:
Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted
Must use at least two peer-reviewed sources from in the Ashford University Library.
Must document all sources in APA style as outlined in the Ashford Writing Center.
Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center.
TO BE RE-WRITTEN FROM THE SCRATCH
Bulimia nervosa case analysis
This paper analyses a case study of bulimia nervosa as exhibited by Rita and treated by Dr. Heston. It explores the theoretical orientation in the treatment intervention, the cognitive behavioral therapy for bulimia nervosa, resistance to recordkeeping about eating, potential outside treatment providers, challenges and ethical issues in treatment collaboration, and possible additional treatment interventions.
Theoretical orientation of treatment interventions
The first intervention implemented byDr. Heston regards educating Rita about the etiology of eating disorders. This has various theoreticalorientations that include a psychopathology theory founded on attachment, interpersonal relationships, body perception and emotional processing. Rita took her mother’s words regarding appearing good as a personal challenge, especially considering the closeness of the extended primary attachment between mother and daughter and their consequent interpersonal relationship. Appearing good became the basis of Rita’s body perception, leading to her suffering bulimia nervosa. However, to actually determine the role of attachment in the pathogenesis of eating disorders, multifactorial and process-oriented models need to be established.
The second intervention regarding Rita reading psychoeducation materials and treatment manuals also has a psychotherapy basis in that it relates to cognitive behavior therapy theory that recognizes various processes in the treatment of bulimia nervosa. This include CBT-BN that has both self-help and therapist-assisted approaches. Worth reading too would be interpersonal psychotherapy material that has theoretical and empirical evidence of long-term effectiveness in treatment of bulimia nervosa and other related eating disorders.
The third intervention about Rita monitoring her foodconsumption using a nutritional journal regards Exposure and Response theoretical orientation. Through Rita and the therapist been exposed to the actual food consumption and its effect, they are able to respond appropriately.
The final intervention is about Dr. Heston teaching Rita to identify dysfunctional thinking and to develop healthier cognitions and coping skills. This has the effect of long-term treatment of bulimia nervosa through interpersonal relationship theoretical orientation. It involves viewing flaws in other people with seemingly perfect body weight and shape.
Cognitive behavioral therapy for bulimia nervosa
Cognitive behavioral therapy for bulimia nervosa (CBT-BN) is a twenty-week program that targets binge eating, unsuitable compensatory behaviors and undueuneaseabout body weight and shape. A three-phase program, the first phase of CBT-BN regards psychoeducation about weight and shape, physiological repercussions of extreme dieting, binge eating and purging. Consequently, this phase assists the patient eat regularly and establish an appropriate schedule to monitor their weight.
The second phase focuses on minimizing concerns about weight, shape and dieting behavior. It also aims at identifying antecedents for binge eating and purging with a view to elimination of these behaviors.
The final phase of CBT-BN focuses on planning how to maintain the newly acquired behavior and preventing chances for a relapse.
Treatment resistance
Rita’s severe preoccupation with her body weight was one of the reasons she was reluctant to keep a record of her eating behavior. She feared that she would capture her discordant eating habits and this would make her feel fat. That her self-esteem was pegged to her body weight would also make her feel ashamed of her efforts (or lack thereof) to control her weight.
Rita has issues forming positive relationships that could signal a personality disorder. Indeed, Dr. Heston refers her to a psychiatrist to help her deal with the issues of interpersonal relationships. In relationship to treatment resistance for people …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….. Bulimia Nervosa in Gorenstein and Comer ……………….
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