Through this week’s Learning Resources, you become aware not only of the prevalence of factors involved in the treatment of eating disorders, but also the societal, medical, and cultural influences that help individuals develop and sustain the unhealthy behaviors related to an eating disorder. These behaviors have drastic impacts on health. In clinical practice, social workers need to know about the resources available to clients living with an eating disorder and be comfortable developing interdisciplinary, individualized treatment plans for recovery that incorporate medical and other specialists.
For this Discussion, you focus on guiding clients through treatment and recovery.
To prepare:
Post a 300- to 500-word response in which you address the following:
Note: You do not need to include an APA reference to the DSM-5 in your response. However, your response should clearly be informed by the DSM-5, demonstrating an understanding of the risks and benefits of treatment to the client. You do need to include an APA reference for the treatment approach and any other resources you use to support your response.
American Psychiatric Association. (2013h). Feeding and eating disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm10
Khalsa, S. S., Portnoff, L. C., McCurdy-McKinnon, D., & Feusner, J. D. (2017). What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders, 5(20), 1–12. doi:10.1186/s40337-017-0145-3
Lewis, B., & Nicholls, D. (2016). Behavioural eating disorders. Paediatrics and Child Health, 26(12), 519–526. doi:10.1016/j.paed.2016.08.005
American Psychiatric Association. (2013q). Somatic symptom and related disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm09
Brown, P., Lyson, M., & Jenkins, T. (2011). From diagnosis to social diagnosis. Social Science & Medicine, 73(6), 939–943. doi:10.1016/j.socscimed.2011.05.031
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The Case of Tiana
Intake Date: August 2019
DEMOGRAPHIC DATA: This was a voluntary intake for this 16-year-old single
African American female. Tiana lives with her family in New York City, where
she was born. She is currently in the 10th grade. Her dad works in the garment
district and her mom works for a major hotel as the front desk manager. Tiana has
an older brother and sister and one younger brother.
CHIEF COMPLAINT: “My mom wanted me to go to therapy. She thinks I
should be more social like my older sister was at this age. I do not agree. I can
handle my life. I am doing fine. My grades are good.”
HISTORY OF PRESENT ILLNESS: Tiana admitted to throwing up when she
overeats several times per week. She finds herself eating a lot of sweets when she
is under stress and is concerned about gaining weight. She found websites on the
Internet describing ways to keep her weight down. Tiana reports that she was
much heavier when younger and wants to confirm she doesn’t get like that again.
Her fear of gaining weight contributes to her not engaging in social interaction
with others. If her peers see what she eats, they may judge her so she chooses not
to socialize a lot.
Tiana reported that she is stressed in school trying to get good grades. She doesn’t
want to socialize, it makes her anxious and she needs to focus on her school. She
has attempted to attend school activities, but they just brought up a lot of anxiety
with all the students looking at each other. She thinks her behavior and anxiety
would be prominent. She did not mind attending parties as a young child but once
she got in her teen years, it became uncomfortable. Tiana noted that at times over
the past year she has very strange experiences of being overwhelmed with fear. A
couple of times when she tried to attend a social situation she began sweating and
had chest pains and chills. Reluctantly, Tiana admitted to bingeing to calm her
down from these episodes.
PAST PSYCHIATRIC HISTORY: Tiana denies any history of psychiatric
problems in the past. Tiana denies any alcohol or drug use.
MEDICAL HISTORY: Tiana is allergic to penicillin and has a lactose
intolerance. She wears glasses for reading.
PSYCHOSOCIAL AND DEVELOPMENTAL HISTORY: Tiana’s parents
were married when her mother was 19-years-old. Tiana’s sister was born the
following year. Two years later, her brother was born. Tiana was born one year
after that, then 4 years later her younger brother was born. Tiana reports her
mother started worrying about her when she began high school. Tiana’s mother
said that Tiana began isolating. Tiana states she “adores her father” because he
was never the disciplinarian.
Tiana reports that when she was in junior high school, her maternal aunt, who was
dying of cancer, came to live with the family and this was very stressful for the
family. Tiana reports she was always an above-average student. She said she was
always very focused on school and wants to get into a good college. She is
concerned that she may move away to college and would have to connect with
people she does not know. This thought builds anxiety in her.
Currently, Tiana is friendly with a student that sits next to her in chemistry class.
She does not talk much about herself since she does not want her classmate to
know of her behaviors. Tiana works during summer vacation in the library. She
does not have to interact with many people in her work so this makes her
comfortable. Tiana also babysits.
MENTAL STATUS EXAMINATION: Tiana presented as a slightly overweight,
somewhat disheveled, African-American female. She was anxious during the
interview. Her facial expression was mobile. Her affect during the initial interview
was constricted and her mood dysphoric. Tiana’s speech was normal. Her thinking
was logical. Tiana denied hallucinations. She denied suicidal and homicidal
ideation.
Tiana was oriented to person, place, and time. Her fund of knowledge was
excellent for her age. Tiana was able to calculate serial sevens easily and
accurately. Tiana repeated 7 digits forward and 3 in reverse. Her recent and remote
memory was intact, and she recalled 3 items after five minutes. Tiana was able to
give appropriate interpretations for 3 of 3 proverbs. Her social and personal
judgment was appropriate. When asked how she sees herself in 5 years, Tiana
replied, “Hopefully graduating from college .” If Tiana could change something
about herself, she would “try to be more comfortable around people.”
