Adult Eating Disorder Clinic

Age Group of Clients

The Adult Eating Disorders Team provides assessment, consultation, and multidisciplinary treatment services to outpatients (female and male) 18 years of age and older.

Geographical Catchment Area

The Adult Eating Disorders Team is part of the MOHLTC’s East Region Eating Disorder Programs. The geographical catchment area is comprised of both the South Eastern Ontario LHIN and the Champlain LHIN including Kingston, Trenton, Belleville, Brockville, Perth, Smiths Falls, and surrounding communities.

Program Details

The Team

• Consulting Psychiatrist
• Dietitian
• Nurse Practitioner
• Occupational Therapist
• Psychologist
• Registered Nurse
• Social Worker
• Medical Secretary

Services Offered
The Adult Eating Disorders Team provides client-centered treatment to individuals who are diagnosed with Anorexia Nervosa, Bulimia Nervosa, and Eating Disorders-Not Otherwise Specified.in the form of:

• cognitive behavioural group therapy,
• psychoeducation,
• goal setting,
• nutrition counseling,
• occasional individual therapy

Outpatient Treatment Program

Referral Process
Referrals are accepted from a variety of health professionals. The referral must also include recent blood work and an ECG. Any other pertinent information should also be forwarded to the clinic by the referring health-care practitioner. The involvement of a family physician is required to provide medical testing and ongoing medical monitoring.

Admission Criteria
Clients meet diagnostic criteria for Anorexia Nervosa, Bulimia Nervosa, or Eating Disorder – NOS. Historically, the Adult Eating Disorders Team provides services to over 100 clients annually.

Initial Assessment

Telephone Interview:
The registered nurse contacts the client by telephone to conduct a standardized phone interview.

Assessment:
The initial biopsychosocial assessment consists of two appointments that require approximately 2 to 2 ½ hours of the client’s time. This formal assessment includes completing a series of self-report measures and attending a standardized interview conducted by team members and for the purpose of formulating diagnoses and treatment recommendations.

During the testing assessment appointment with the psychologist, assessment and treatment services are explained, privacy, confidentiality, and limits there of are reviewed, and consent is obtained. In addition, the client is provided with immediate feedback about the severity of symptoms and clinically significant symptoms are discussed.

Standardized measures completed at the initial assessment are repeated assessments at 6-months, 12-months to provide ongoing monitoring of symptom progress and treatment outcomes: Eating Disorder Inventory – 3rd edition, Beck Depression Inventory – 2nd edition, Beck Anxiety Inventory, Clark-Beck Obsessive Compulsive Scale, Rosenberg Self Esteem Scale, and the Nutrition Patterns Questionnaire.

Typically, the client attends the multidisciplinary psychiatric interview within 2- to 3- weeks of the assessment appointment with the psychologist. At the completion of the interview, members of the team interview meet to discuss treatment recommendations, which are then discussed with the patient. At this time, the patient typically receives information about group treatment opportunities and an appointment is scheduled.

Wait-times:
Initial phone interview with the registered nurse usually occurs within a week of the referral being received by the Adult Eating Disorders Team. The initial assessment appointments are usually scheduled 4- to 6- weeks after the initial telephone interview. Group therapy treatment is usually available 2- to 8- weeks after the multidisciplinary assessment.

Treatment:
Ideally, the Adult Eating Disorders Team strives to provide client-centred treatment that follows the intraprofessional collaborative model. Our goal is to provide comprehensive and holistic patient care.

The primary treatment offered by the Eating Disorder Clinic is group therapy, with few patients seen for individual, short-term counselling.

The clinic operates 3 days a week from 8:30am to 4:30pm.

Group Sessions Offered:

Nutrition and Meal Planning Group:
This is for 1-2 sessions where patients have an opportunity to ask questions about food and eating. Education is provided on Canada's Food Guide and portion sizes using food models. A meal plan may be provided as a first tool to reflect normal eating.

Psychoeducational Group:
This group consists of an 8 week structured program, based on the Turning Points Program, which aims to provide education and to initiate normalization of eating patterns. The group is co-led by two members of the treatment team and meets once per week for two hours.

Cognitive Behaviour Therapy for Recovery Group:
This is a 10 week cognitive behaviour therapy group for patients who have previously completed the Psychoeducation group. We work with clients to normalize their eating, bring activity level within healthy guidelines, and to teach ways to cope with situational, interpersonal, and emotional triggers of eating disordered behaviours. This group is also co-led by 2 members of the team.

Body Image and Self-Esteem Group:
These 6 or more sessions encourage patients to explore a variety of areas related to self-concept and body image. Topics include examining and challenging perfectionistic standards and size/shape expectations, developing assertive communication strategies, and managing negative cognitions (e.g., self-defeating beliefs). In addition, weekly goals for daily food intakes and eating disordered behaviours are established and monitored.

Goal-Setting Group:
This is an on-going, drop-in group that meets weekly for one hour. This group provides ongoing support for patients to maintain healthy eating patterns, particularly during times of increased stress. The group meetings focus on establishing and supporting individual goals for maintenance of recovery (e.g., SMART goals--specific, measurable, attainable, realistic and time-bound).

Family and Friends Meeting:
This evening meeting is designed to provide education and information to family and friends of individuals with eating disorders served by the clinic. It is an opportunity to increase support, ask questions, discuss concerns and learn helpful ways of coping while they assist a loved one in her/his efforts to recover.

Additional Information (2009-2010 dataset)

Age of clients:
18-24 years old 57%
25-34 years old 21%
35-44 years old 9%
45-54 years old 9%
55 + years old 4%

Gender of clients: 97% females, 3% males

41% of our clients live in rural communities.

49% of our clients are currently enrolled in a post-secondary education program

Diagnosis at the time of initial assessment: