Outpatient Treatment

We offer a number of treatments that are recommended by the National Institute for Health and Care Excellence (NICE). At assessment we will discuss treatment options with you to tailor a treatment plan to meet your individual needs.

Starting treatment with NCEDS

NCEDS aims to offer treatment as quickly as possible after assessment. We will contact you as soon as a treatment slot becomes available and try to give you as much notice as possible, although sometimes this may only be 1-2 weeks in advance. If you have a preferred or more convenient method of contacting you (e.g. email, SMS text), please let us know at your follow-up assessment appointment or by calling 0300 300 0142.

Treatment appointments are usually held at the same time on the same day each week (i.e. weekly). This is to enable you to plan in advance and make any necessary arrangements in order to be able to attend. It is likely that you will need to re-schedule some commitments, organise alternative help (e.g. with childcare) and / or talk to others (e.g. people at work).  Please let us know if you would like any support in taking time off work as NCEDS can send a letter to your employers to confirm you require time off in order to be able to attend a health appointment.  You can also discuss any arising issues with your clinician when you start treatment. 

We know that people prefer and benefit from starting treatment as soon as possible. Due to high demand, it will not always be possible to offer the slot which would be your first preference and you will need to decide whether or not you are able to attend the slot offered to you. If you decide that you are unable to attend, you can decline and it will be offered to the next person on the waiting list. You will retain your place on the list and be contacted again when the next slot becomes available although we may be unable to estimate for how long this may be. Please note that in order to manage our waiting list effectively, your place may be reviewed should you decline two or more appointments.

If you have any questions about your position on the waiting list or you need to update us if your contact details change, please call 0300 300 0142.

Treatment

Treatment for your eating disorder will primarily consist of psychological therapy. During your treatment, you might also meet with our Psychiatrist for a psychiatric or medical review and / or have a consultation with our dietician. You may also need to have your physical health monitored by your GP.

The aim of psychological treatment is to equip you with the skills to recover from your eating disorder. The focus of treatment is about creating and facilitating change within a supportive and caring environment in order for you to be able to do so. Treatment appointments are usually held weekly (1hour) and provide the opportunity to discuss the changes you are trying outside the therapy room. All psychological treatments are time limited and may be delivered on an individual basis or in a group. The exact length of your treatment and the frequency of sessions will be discussed with you when you first meet your therapist and reviewed regularly during your treatment.

NCEDS encourages patients to involve significant others to support them with their treatment where possible or desired. If this is something you are happy to consider, your clinician will talk to you about inviting them to treatment reviews (see below).

Treatment Interventions

Keeping Myself Safe Podcast

Following your assessment, you will be given details on how to access the Keeping Myself Safe podcasts and accompanying workbook. This is the first step in your treatment plan with NCEDS.

To access the relevant information to keep yourself safe, please click here [insert link to page ‘How to Keep Myself’]. 

After you have finished the podcasts and workbook, you will be invited to review these with an NCEDS clinician and develop your own plan to keep yourself safe to reduce the harmful effects of an eating disorder whilst on the waiting list for treatment. You will then be offered one of the following options below. 

Cognitive Behaviour Therapy (CBT and CBT-T)

Cognitive Behaviour Therapy (CBT) has been recommended as a treatment for individuals with an eating disorder by the National Institute for Health and Care Excellence (NICE). It has been demonstrated to help a significant number of people to recover from Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and Atypical eating disorders.

CBT focuses on understanding what maintains your eating disorder by drawing links between troublesome thoughts, feelings, your physical state and how you become caught in patterns to manage those thoughts and feelings. This will involve understanding your eating behaviour as well as your body, weight and shape fears and concerns. Factors that led to the development of the problem are explored and treatment may also include tackling related difficulties such as low self-esteem, perfectionism and / or difficulties managing emotions. Your therapist works with you to help you challenge problematic thinking and behavioural patterns and work towards recovery. The aim of CBT is that the individual learns to become their own therapist through learning a range of skills and techniques to manage their difficulties. For further information about CBT refer to the British Association of Cognitive Psychotherapies website.

 

MANTRA

MANTRA is a new outpatient psychotherapy developed by the Maudsley eating disorder service. It targets the key factors that are maintaining the anorexia nervosa. These include a thinking style characterised by rigidity, detail focus and fear of making mistakes and an avoidant emotional style. It addresses positive beliefs about the utility and value of anorexia to the person and the response of close others that might be characterised by high emotional expression and enabling and accommodation of the illness.

Family Work

Living with an eating disorder within a family can make life more stressful which can lead to problems appearing around communication. Family work may play a role in an individual's recovery depending on the needs of the family. Some level of therapy can help families to improve their understanding of eating disorders, learn skills to help support an individual with an eating disorder and improve communication within the family.

NCEDS is keen to encourage patients to involve their partners and/or family members in their treatment where appropriate. Improved understanding and communication can promote and support recovery. If this is something you are happy to consider, your clinician will discuss with you how best this may be included in your treatment.  

Multi-Family Therapy (MFT)

This is a 3 day, intensive treatment usually offered to those people who’s eating disorder is long-standing, resistant to change and / or where interpersonal issues are seen to largely maintain their illness. It involves inviting 2-3 patients and their families to work together, share resources and support the patient in their recovery. The MFT intervention is facilitated by 3-4 NCEDS’ clinicians.

Interesting to meet other families with similar experiences

Very useful to hear experiences with other families and have open conversations within our own

I found it helpful to be able to talk as a family in a safe place and to learn what is helpful for recovery

Thank you for laying on these 3 days. They have been very helpful. There should be more!

Reviews

Whilst engaged with our service, your progress and treatment plan will be regularly reviewed together with you and your clinician. NCEDS offers several different types of review including: 

Treatment reviews

These are an opportunity for you and your therapist to discuss how you feel things are going and whether you are progressing with your therapy goals. During a review, you and your therapist will discuss your progress, identify any difficulties and agree your next therapy goals and number of sessions.

It may be that you decide you do not wish to continue in therapy and / or feel that it is not the right time for you to make the changes.  This is not uncommon - people often find that they may not be as ready to make the changes required to work towards recovery as they thought when they started treatment and / or their personal circumstances change, making it difficult for them to use therapy effectively. If this is the case, your therapist will want to work with you to devise a plan on how best to look after yourself as well as discuss how and when you might seek a re-referral to restart treatment at some point in the future. It may also involve a discussion about being referred to other services and / or identifying other sources of help. 

Your therapist will discuss the review process with you at the start of treatment and you can request a review at any time yourself.

Medical / psychiatric reviews

During the course of your treatment, your therapist might arrange a review for you with one of our psychiatrists. The goal of these reviews might be to review your health and make recommendations on how to keep you safe or review your mental health, particularly if there are concerns that you might also be experiencing additional mental health problems. The psychiatrist might make recommendations on the use of medication, medical monitoring at your GP, the input of other services or the use of inpatient treatment. You can bring your significant others/carers to psychiatric reviews.

CPA reviews

If your circumstances are complex and / or you are involved with other services, you may be placed under the Care Programme Approach (CPA). If so, you and your therapist will organise a CPA review. CPA reviews are similar to a treatment review but also include inviting all those who support you (family and services) in order to discuss your wellbeing and treatment plan. These usually take place every six months but can be organised if your circumstances change.

You will usually be informed at you assessment if you need to be under the CPA and / or in the event that your circumstances change whilst you are receiving treatment with NCEDS. For more information about the Care Programme Approach, please click here [insert link to main CPFT page http://www.cpft.nhs.uk/help/cpa.htm].

Treatment Appointments and Cancellations

Engaging in a psychological intervention for your eating disorder can be likened to taking a course of antibiotics for an infection – i.e.  you need to take the full course in order to benefit from the positive effects. In the same way, it is important to prioritise and attend your treatment appointments in order to make progress. As mentioned above, treatment appointments are usually held at the same time on the same day each week (i.e. weekly) in order to enable you to plan in advance and make any necessary arrangements in order to be able to attend. It is likely that you will need to re-schedule some commitments, organise alternative help (e.g. with childcare) and / or talk to others (e.g. people at work).  NCEDS can send a letter to your employers to confirm you require time off in order to be able to attend a health appointment. 

In the event that you do not attend or need to cancel several appointments, your clinician will discuss with you to explore whether it is advisable to postpone treatment until you are more able to fully engage.

The page was last updated on 19 June 2017 by eleanor.buckle.

Cambridgeshire and Peterborough NHS Foundation Trust
Elizabeth House, Fulbourn Hospital
Cambridge, CB21 5EF

T 01223 219400 (open 8:30am to 5pm)
F 01480 398501

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