tailieunhanh - Handbook of Eating Disorders - part 10

Điều này bao gồm đồng ý một định dạng, xác định được chia sẻ và (không chia sẻ) có mục tiêu và kỳ vọng, và xác định tiến bộ trong điều trị có thể được xem xét như thế nào. Các kế hoạch quản lý nhu cầu xây dựng trong việc theo dõi vật lý, và trách nhiệm làm rõ, | 428 DASHA NICHOLLS AND RACHEL BRYANT-WAUGH understandable to everyone whatever its nature. This includes agreeing a format identifying shared and non-shared aims and expectations and identifying how progress in treatment can be reviewed. The management plan needs to build in physical monitoring and responsibility for this clarified together with how the information will be fed back to parents young person and all others involved in treatment Agreeing boundaries and responsibilities includes agreeing responsibility for care with parents including responsibility for food provision reporting concerns ensuring attendance etc. Informed decision making requires information. Since we ask children and parents to be involved in the decision-making process we provide information at every stage information about onset course prognosis and outcome information about physical aspects behavioural aspects and emotional aspects contact addresses and a reading list and encourage questions. This process of information sharing has a number of functions it demystifies the diagnosis and can provide a framework for understanding the development and the maintenance of the eating disorder. But perhaps more importantly it allows parents and young people to make informed decisions regarding treatment in a way that attempts to minimise the escalation of issues around power and control. Once a formulation a framework for management goals and expectations boundaries and responsibilities have been clarified and agreed therapeutic work can continue in a number of formats. In the younger age group it is our expectation that intervention will involve those with parental responsibility. Family Work The nature of family work has changed considerably over the years as have assumptions about the role of the family in aetiology of eating difficulties. Family work is the first line treatment for anorexia nervosa with or without binge-purges in younger patients. Controlled studies have demonstrated .