By BodyMatters Clinical Psychologist Christie Lomas
Imagine this, your child is unwell, dying from a disease which stops her from eating and you watch her quickly fading away. You have tried local treatment approaches, however these are limited. Local clinicians are time poor and the treatment you really need for her is located hundreds of kilometres away. This is a reality for many families who live outside of the Sydney metro area.
Many families experience the tyranny of distance. In fact, I have heard of a family that travelled a seven hour round trip to attend appointments with a trained Maudsley Family Therapist each week! Doing this weekly with an unwell child who is fighting you tooth and nail to not have treatment would be a horrendous task. But as a parent you do it, because you know it will save your child’s life.
According to the Butterfly Foundation, there are 913,986 Australians with an eating disorder, the equivalent of around one in every 25 people [1]. Furthermore, anorexia nervosa has the highest death rate of any psychiatric illness with 15% of sufferers dying from this dreadful disease [2]. The Butterfly Foundation’s 2012 “Paying the Price” report estimates that 1,828 people died from eating disorders in Australia alone last year [1]. Hence, the severity of this disorder is clear.
Maudsley family based therapy (MFBT) is an evidence-based approach and the treatment of choice for children and adolescents presenting with anorexia nervosa. Studies have demonstrated the efficacy of this approach [3]. Within these studies, approximately two thirds of adolescent patients are recovered at the end of MFBT while 75 – 90% achieved full weight recovery at five-year follow-up. Similar improvements in mood and psychological factors were also noted [4]. More recent studies have shown that most young people with anorexia need on average about 20 sessions over 6-12 months and that 80% are weight restored and have started or resumed menstruation by the end of Maudsley FBT [5].
If you are living outside of the Sydney metro area, your local GP is usually the first point of call for families seeking help with a child suffering from an eating disorder. Following this, the option of accessing treatment online is now available.
I previously worked as a Clinical Psychologist in the Department of Psychological Medicine at the Children’s Hospital, Westmead. Here, for very difficult cases of varying presentation more remotely located families were able to be assessed and treated through Telemedicine. This involved remotely located clinicians sitting with patients and connecting to Hospital clinicians through a computer using a video-conferencing setup.
E-therapy is now emerging as an incredibly useful and accessible treatment option available through most computers. At BodyMatters one third of our clients travel a great distance to see us or receive therapeutic input via Skype. In fact, we have had clients located in Europe, South America, Asia & the Pacific Islands accessing our service via E-therapy.
As family therapist at BodyMatters I am offering a new service to those families for whom access to treatment is otherwise limited. Specifically, I can provide Maudsley Family Based sessions via Zoom for families in regional or remote locations, or for those with mobility issues. (Please note, previously we used Skype for e-therapy however have subsequently moved to using Zoom for this service). This will involve partnering with the local treatment team for medical input. Generally speaking for E-therapy treatment we undertake intensive work from our Sydney office to set up treatment and ensure medical safety, in conjunction with a local General Practitioner. Once deemed safe & appropriate (which may take many months, depending on your child’s progress) we continue treatment via E-therapy from your home.
If you are interested in obtaining more information regarding setting up E-therapy session you can find out more here. Please contact us on 02 9908 3833 or via info@bodymatters.com.au.
References:
[1] Butterfly Foundation Report: Paying The Price. The Economic and Social Impact of Eating Disorders in Australia. The Deloitte Access Economic report 2012
[2] Le Grange, D., Agras, S., & Dare, C. (2002). Treatment Manual for Anorexia Nervosa: A Family Based Approach. Guilford Publication.
[3] Eisler, I., Dare, C., Hodes, M., Russell, G., Dodge, E., and D. Le Grange. 2000. Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. Journal of Child Psychology and Psychiatry, 41, 727-736.
Le Grange, D., Eisler, I., Dare, C., and G. Russell. 1992. Evaluation of family treatments in adolescent anorexia nervosa: a pilot study. International Journal of Eating Disorders, 12, 347-357.
Russell, G. F. M., Szmukler, G. I., Dare, C., and I. Eisler. 1987. Family therapy versus individual therapy for adolescent females with anorexia nervosa and bulimia nervosa. Archives of General Psychiatry, 44, 1047-1056.
[4] Eisler, I., Dare, C., Russell, G. F. M., Szmukler, G. I., Le Grange, D., and E. Dodge. 1997. Family and individual therapy in anorexia nervosa: A five-year follow-up. Archives of General Psychiatry, 54, 1025-1030.
[5] Le Grange, D., Binford, R., and K.L. Loeb. 2005. Manualized family-based treatment for anorexia nervosa: A case series. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 41-46.
Lock, J., Agras, W.S., Bryson, S., and H. Kraemer. 2005. A comparison of short- and long-term family therapy for adolescent anorexia nervosa. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 632-639.
Lock, J., Le Grange D., Agras, W.S., Moye, A., Bryson, SW., and B. Jo. 2010. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Archives of General Psychiatry, 67, 1025-32.
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