Discussion: The Complexity Of Eating Disorder Recovery In The Digital Age

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:

  • Review the Learning Resources on experiences of living with an eating disorder, as well as social and cultural influences on the disorder.
  • Read the case provided by your instructor for this week’s Discussion.

Post a 300- to 500-word response in which you address the following:

  1. Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
  2. Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
  3. Explain why it is important to use an interprofessional approach in treatment. Identity specific professionals you would recommend for the team, and describe how you might best utilize or focus their services.
  4. Explain how you would use the client’s family to support recovery. Include specific behavioral examples.
  5. Select and explain an evidence-based, focused treatment approach that you might use in your part of the overall treatment plan.
  6. Explain how culture and diversity influence these disorders. Consider how gender, age, socioeconomic status, sexual orientation, and/or ethnicity/race affect the experience of living with an eating disorder.    

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.


Required Readings

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.





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



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.”

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