Frames of reference utilized in the rehabilitation of individuals with eating disorders

The St George's eating disorders service meal preparation group for inpatients and day patients pursuing full recovery: a pilot study

This naturalistic cohort study evaluates a meal cookery group-based occupational therapy intervention for adult inpatients and day patients with severe eating disorders. It also evaluates the Eating and Meal Preparation Skills Assessment (EMPSA) as an outcome measure, allowing clients pursuing recovery to rate ability and motivation to perform tasks related to preparing and eating 'normal' meals. Twenty-seven participants completed EMPSAs at their first, 10th and final sessions, plus 1 year later. The Ability subscale of EMPSA indicated significant improvements (p < 0.001) by the 10th session, which was maintained 1 year later. The Motivation subscale of EMPSA indicated no significant changes at the 10th session but highly significant improvements (p < 0.001) between the 10th and final session, which was maintained 1 year later. Internal consistency for EMPSA was demonstrated by Cronbach's alpha of 0.71 for Ability subscale and 0.95 for Motivation subscale. We conclude that the meal preparation group is effective and durable.

Is There a Role for Occupational Therapy within a Specialist Child and Adolescent Mental Health Eating Disorder Service?

In Northern Ireland, only two occupational therapists work within the specialist field of child and adolescent mental health (CAMH). This is despite recommendations made by the Bamford Review of Mental Health and Learning Disability (Northern Ireland) that occupational therapy should be a core element of CAMH provision. The College of Occupational Therapists has urged practitioners to challenge inequalities in health and social care provision and to use occupational language to reinforce the relationship between occupation, recovery and wellbeing. This opinion piece highlights occupational therapy core skills and occupational therapy frames of reference or modalities, underlining the application of both to eating disorders. The treatment models discussed are the Model of Human Occupation, the Canadian Model of Occupational Performance and sensory integration. Evidence reinforces that the models discussed are applicable, appropriate and valuable when treating children and adolescents with an eating disorder.

It is argued that the valuable and unique role of occupational therapy must be recognised by health and social care commissioners and CAMH providers and be vocalised by occupational therapists. CAMH teams are advised to embrace the unique skills that occupational therapists have to offer children and adolescents with eating disorders in order to ensure that clients receive truly multidisciplinary and client-centred evidence-based services.