Our Eating Disorder Services offer evidence based therapeutic interventions and follow the recommendations of the NICE Guidelines for Eating Disorders. The service consist of a multi-disciplinary team including:
- Consultant Psychiatrists
- Clinical Psychologists
- Psychological Therapists
- Specialist Dietitians
- Specialist Eating Disorder Practitioners
- Assistant Psychologists
The BSMHFT provision includes:
Inpatient
This provision is made up of 10 inpatient beds and offers intensive interventions for those at high medical or psychological risks and for those who are motivated to make changes but have been unable to do so as an outpatient or day treatment basis.
If admission is recommended the individual will be offered an opportunity to visit the unit and meet with inpatient staff for an introduction to the unit and to discuss the way in which the unit operates.
On admission a named member of staff will be assigned to the individual until discharge. This person is a specific point of contact. The length of stay will be guided by individual need and can vary from a few weeks to several months. The inpatient programme combines regular meals and nutritional support with more intensive medical and psychological support. Individuals will also take part in a weekly ward review as part of their inpatient stay.
Care is delivered through a combination of the following:
- Dietetic support
- Medical reviews
- Supported mealtimes
- Group work, these include:
- daily support group,
- craft group,
- body image group,
- nutrition group,
- anxiety management,
- Individual support sessions
- Psychological therapy
- Occupational therapy
Anyone offered inpatient treatment will be given a more detailed guide to the inpatient service on admission.
Day Treatment Service
This provision currently offers up to eight day treatment places and provides structured interventions Monday – Friday in a hospital setting, focusing on prevention of an in-patient admission and supporting individuals with transitions into our Community Outreach team.
The day treatment programme functions flexibly and offers either a step up from outpatient care or a step down from inpatient care, when a lower intensity of treatment is sufficient to maintain progress.
Treatment is provided five days a week from 8am until 4pm. Everyone referred to the day treatment service will be invited to a look around the unit and, if in agreement, they will be offered a comprehensive two-week assessment, which is used to determine the most appropriate treatment programme. Day treatment is tailored to individuals needs and may focus on weight restoration, by providing a consistent and stable structure around food and eating through to the giving of information and practical support. The programme can also tackle other disordered eating behaviours such as the use of laxatives, binge purging behaviour and over exercise.
More detailed information will be discussed in detail during the initial visit, as well as a detailed guide to the day treatment service on admission.
Day treatment care is delivered through a combination of the following:
- Dietetic support
- Supported meal times
- Therapeutic group programme
- Psychological intervention
- Medical reviews
Outpatient service
This provision provides support for individuals in a community setting with a primary diagnosis of an eating disorder including anorexia nervosa, bulimia nervosa, binge eating disorder, or a mixed eating disordered presentation referred to as Other Specified Feeding or Eating Disorder (OSFED).
As a service we recognise the complex issues faced by individuals living with disordered eating and we aim to offer a variety of therapeutic interventions to address these. All our interventions aim to promote autonomy and self‑determination as a key element of our work as an outpatient team, alongside helping the individual manage difficult feelings in ways other than through disordered eating.
We recognise that everyone coming into this service will be at different stages of understanding what the eating disorder means to them. We offer a range of interventions to suit an individual’s care needs and to promote and encourage positive change. We believe that in order to grow and develop it is essential that you take an active role in your treatment. As an outpatient this
usually means that we aim to help you address the complex issues often driving an eating disorder. We aim to support you in overcoming your eating disorder by offering support, information and guidance as needed. This can involve supporting you to maintain your weight within a healthy range and help you address other issues driving the eating disorder, which may interfere with your recovery.
If during the course of outpatient treatment we feel that an intensification of treatment through inpatients, day treatment or elsewhere is needed, we will discuss this with you.
The outpatient services care is delivered through a combination of the following:
- Routine Medical reviews
- Dietetic input
- Group and Individual psychological therapy
- Cognitive behavioural therapy (CBT)
- CBT bulimia nervosa information leaflet
- Dialectical behavioural therapy (DBT)
- Maudsley Model of Anorexia Treatment for Adults
- Specialist Clinical Supportive Management (SSCM)
- Community-based support with activities that may be a struggle due to the eating disorder.
- Carer’s support.
Please note that there is likely to be a waiting time prior to being offered the chosen therapeutic programme. If you are placed on the waiting list you will be given details of your point of contact within the eating disorder service and for your local community mental health team (CMHT), if you are registered with them.
While you are waiting you will continue to be offered routine monitoring reviews with the eating disorder service and you will be given details of who to contact if your situation changes and/or you feel the need for more immediate support
This service provides intensive time-limited support in the community and is intended to preventing admissions or provide increased support to those leaving intensive interventions such as inpatient or day treatment.
The outpatient services care is delivered through a combination of the following:
- Community meal support
- Physical health monitoring
First Episode Rapid Early Intervention for Eating Disorders (FREED) Pathway:
FREED is an evidence-based, specialist care package for 16 to 25-year-olds with a first episode eating disorder of less than three years’ duration. FREED aims to reduce the duration of untreated eating disorders through active engagement, using evidence-based treatments to promote full and robust recovery.
Our FREED pathway is embedded within two services. As FREED is designed for those between the ages of 16 to 25, it sits between the child and adolescence eating disorder service in SOLAR (TEDS) and the adult eating disorder service at the Barberry. TEDS treats those aged 16 to 17 ½ and the adult team treats those aged 17 ½ to 25.
What happens after a referral is accepted?
Engagement Call and Assessment
After the referral has been screened and deemed appropriate for intervention by FREED, an engagement call will take place. During this call, the onset of the eating disorder will be screened, key information about the service and the importance of early intervention will be provided, as well as arranging the first initial appointment for an assessment to take place.
FREED Pathway is delivered through a combination of the following:
- Easy access to treatment and proactive engagement
- Emphasis on early dietary change
- Developmentally adapted evidence-based treatment
- Family involvement in patient care
- Support though key transitions and changes, such as starting university.
FREED patients can benefit from access to several psychological groups that run between the services, including:
- Group Cognitive Behavioural Therapy (CBT)
- Emotional Eating Group
- University preparation
- Parents/carers education and support session
Information for Patients:
What happens after a referral is made?
All referrals are screened and if appropriate referrals may be triaged further. If an eating disorder is deemed to be likely, an eating disorders assessment will be offered with one of our team and appointment letter with further details included. The assessment lasts for approximately 1 hour and 30 minutes.
Extended assessment
If after the initial assessment it is felt that treatment from our service may be useful, we may offer an extended assessment, lasting between 2-4 sessions focusing on motivation and goal setting. After the extended assessment, the team will then be able to make an informed decision into the most appropriate course of treatment that suits your care needs.
