- Therapeutic alliance is a
predictor in severe and enduring anorexia nervosa.
- Providing hope improves
therapeutic alliance and anorexia nervosa
Therapeutic alliance could be a key factor in the progress of anorexia nervosa
, an eating disorder that is characterized by
I) Distorted Self-image
- People with anorexia tend to believe that their body is out of
shape and that certain parts of the body are too flabby, even though it might
not always be true.
with Weight Loss
- Though the patients may be lean, they have
an excessive obsession with weight loss and keep a check on every calorie they
of an Unhealthy Low
- They refuse to
put on additional weight even when they are advised to do so by family and
friends. Intake of smaller amounts of food to avoid
gaining weight is a common practice.
Need to Exercise
- Fearing weight gain, people with anorexia exercise hard, even
though they might not need to.
Facts about Anorexia Nervosa
- This eating disorder is growing at an alarming rate among early teens and adolescents.
- The affected individual could weigh 85% below ideal body weight (IBW).
- Highest mortality rates among mental disorders.
- One of the most common psychiatric disorders seen among women, though men too suffer from this disorder.
Symptoms of Anorexia Nervosa
A person with
anorexia may exhibit these symptoms:
- Moody or sad behavior
- Inability to eat comfortably, constantly nagged by the fear of gaining weight
- Poor decision-making ability
- Memory lapses
- Thinning of hair or brittle hair that easily break
- Muscle weakness with a sense of lethargy that prevents the individual from being active
- Dull or flaky skin, with eruptions
- Increased risk of miscarriage or delivering a baby with low birth weight.
alliance is the bond created between a clinician and the patient, as both of
them work together to reach a common goal. This
relationship is essential as it drives therapy and treatment of the client.
psychological counseling session, the bond that is forged between the patient
and the doctor forms the crux of the healing process. Enthusiasm and active
participation of the patient are seen as signs of acceptance by the doctor who in turn infuses self-confidence and helps the patient stay motivated.
The main aspects
of this intricate relationship are:
- Emotional connect shared between
the patient and the doctor
- A consensus on the final goal
- Patient history
Various researches into psychotherapy
have shown that different methods of psychotherapy may yield the same result
for a particular condition. This could be due to the therapeutic alliance being a non-specific variable. Bordin (1979) described how therapeutic alliance can be used to "fight against patient's suffering and self- destructive behavior."
A new study by
Colleen Shields and colleagues titled "Predictors of therapeutic alliance in two treatments for adults with severe and enduring
anorexia nervosa" and published in the Journal of Eating Disorders
, reveals the
factors important in forging a therapeutic alliance.
Sixty three adult women with severe enduring Anorexia nervosa were included in the
study and information regarding the expectations of the patient, the symptoms
associated with the condition and the demographics of the patient were
collected using a series of questionnaires and interviews.
Some of the
parameters that were tested as probable predictors of therapeutic alliance
included the duration of illness, severity of the disease condition and lowered
motivation levels. The results of the study, however, showed that none of these
factors affected therapeutic alliance except the patient expectation about the
outcome of treatment.
undergoing psychotherapeutic treatment undergoes two phases during the
treatment period. In the first phase, the doctor is seen as being supportive
while in the second phase, it is more of collaboration,
where the doctor and the patient work together to reach common goals.
delicate balance of therapeutic alliance is disturbed, it leads to patients
dropping out of treatment or loss of motivation. For a patient suffering from
anorexia nervosa, therapeutic alliance aids in:
- Encouraging a healthy weight gain
during the stay at the hospital.
- Undertaking a healthy lifestyle
that promotes health and well-being.
is a condition in which the patient believes that eating less and exercising more will provide a thinner body,
which is the only perceived goal, regardless of the poor health associated
beliefs and the even stronger urge to impress peers can make it difficult for
treatment and care at home, requiring professional help. Since the severity of the illness and the duration of the illness are not predictors
of therapeutic alliance, a good understanding of the expectations of the
patient will aid in forging better doctor-patient relationships.
- Anorexia Nervosa
- What is anorexia nervosa?
- Anorexia Nervosa - Overview
- Perceived coercion in inpatients with Anorexia nervosa: Associations with illness severity and hospital course
- The Therapeutic Alliance