Prior To Beginning Work On This Assignment, Read The Psy 650
Prior To Beginning Work On This Assignment Read Thepsy650 Week Three
Prior to beginning work on this assignment, read the PSY650 Week Three Treatment Plan and Case 9: Bulimia Nervosa in Gorenstein and Comer (2014). Please also read the Waller, Gray, Hinrichsen, Mounford, Lawson, and Patient (2014) “Cognitive-Behavioral Therapy for Bulimia Nervosa and Atypical Bulimic Nervosa: Effectiveness in Clinical Settings,” Halmi (2013) “Perplexities of Treatment Resistance in Eating Disorders,” and DeJesse and Zelman (2013) “Promoting Optimal Collaboration Between Mental Health Providers and Nutritionists in the Treatment of Eating Disorders” articles. Assess the evidence-based practices implemented in this case study. In your paper, please include the following. Explain the connection between each theoretical orientation used by Dr. Heston and the treatment intervention plans utilized in the case. Describe the cognitive-behavioral model of the maintenance of bulimia nervosa. Explain why Rita was reluctant to participate in Dr. Heston’s request for her to keep a record of her eating behaviors. Use information from the Halmi (2013) article “Perplexities of Treatment Resistance in Eating Disorders” to help support your statements. Recommend outside providers (psychiatrists, medical doctors, nutritionists, social workers, holistic practitioners, etc.) to assist Rita in achieving her treatment goals. Use information from the DeJesse and Zelman (2013) “Promoting Optimal Collaboration between Mental Health Providers and Nutritionists in the Treatment of Eating Disorders” article to help support your recommendations. Describe some of the challenges and ethical issues that Dr. Heston may encounter when working collaboratively with the professionals that you recommended. Apply ethical principles and standards of psychology relevant to your description of Dr. Heston’s potential collaboration with outside providers. Evaluate the effectiveness of the treatment interventions implemented by Dr. Heston, supporting your statements with information from the case and two to three peer-reviewed articles from the Ashford University Library. Recommend three additional treatment interventions that would be appropriate in this case. The recommended articles for this week may be useful in generating your response to this criterion. Justify your selections with information from the case. The Case Analysis – Collaborating with Outside Providers formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.). Must include a separate title page with the following: Title of paper, Student’s name, Course name and number, Instructor’s name, Date submitted. Must use at least two peer-reviewed sources from the Ashford University Library. Must document all sources in APA style as outlined in the Ashford Writing Center. Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center.
Paper For Above instruction
Introduction
The treatment of bulimia nervosa (BN) requires a comprehensive understanding of its underlying psychological models, evidence-based practices, and collaborative interventions involving multiple healthcare providers. This paper critically examines Dr. Heston’s approach to treating Rita, a patient with BN, by analyzing the theoretical orientations used, the implementation of cognitive-behavioral therapy (CBT), and the integration of multidisciplinary efforts. Additionally, it discusses the ethical considerations, challenges, and potential enhancements to Rita’s treatment plan through additional interventions and collaborative strategies.
Theoretical Orientation and Treatment Interventions
Dr. Heston’s treatment approach incorporates cognitive-behavioral principles, which are central to modern BN therapy. The cognitive-behavioral model posits that maladaptive thoughts and behaviors sustain BN, specifically the cycle of bingeing and purging. Dr. Heston’s utilization of cognitive restructuring, behavioral experiments, and self-monitoring aligns with the evidence-based practices highlighted by Waller et al. (2014). These interventions aim to modify dysfunctional beliefs about body image and control, which are core to BN maintenance.
The types of theoretical orientations employed include cognitive and behavioral frameworks. The cognitive component targets distorted thoughts related to weight, shape, and self-worth, while the behavioral component addresses problematic eating behaviors. These orientations are connected through interventions such as food diaries, which facilitate awareness and challenge maladaptive beliefs (Gorenstein & Comer, 2014).
The Cognitive-Behavioral Model of Bulimia Nervosa
The maintenance of BN, according to the CBT model, involves a cycle driven by dietary restraint, negative affect, and weight concerns. Binge episodes are often triggered by emotional distress or perceived loss of control, which are temporarily alleviated through purging behaviors. Over time, these behaviors become reinforced, perpetuating the disorder. Distorted cognitions about body image and self-esteem heavily influence this cycle (Waller et al., 2014). The model emphasizes the importance of disrupting these patterns through targeted cognitive and behavioral techniques.
Reluctance to Record Eating Behaviors
Rita’s reluctance to record her eating behaviors can be understood through the lens of shame, denial, and fear of judgment, which are common barriers in BN treatment (Halmi, 2013). Patients often feel ashamed of their behaviors, leading to resistance in monitoring or discussing them openly. Halmi (2013) highlights treatment resistance as a significant hurdle in eating disorder interventions, reinforcing that such reluctance must be approached with sensitivity, trust-building, and motivational techniques.
Recommendations for Outside Providers
To enhance Rita’s recovery, a multidisciplinary team should be involved. A psychiatrist could evaluate and, if necessary, prescribe medication such as selective serotonin reuptake inhibitors (SSRIs), which have demonstrated efficacy in reducing BN symptoms (DeJesse & Zelman, 2013). Nutritionists are vital for developing balanced meal plans and addressing distorted beliefs about food and body image. Social workers can provide counseling, support, and facilitate family involvement, while holistic practitioners (e.g., mindfulness coaches, acupuncture therapists) may assist in addressing underlying emotional and psychological issues.
Collaborative efforts are essential in comprehensive care models. DeJesse and Zelman (2013) emphasize that coordinated treatment enhances outcomes by integrating mental health support with nutritional and medical management, fostering consistency and reinforcing therapeutic gains.
Challenges and Ethical Issues in Collaboration
Collaboration across disciplines may encounter challenges, including differing treatment philosophies, communication barriers, and scope of practice issues. Ethical considerations involve respecting patient autonomy, confidentiality, and informed consent. Dr. Heston must navigate these issues carefully, ensuring that all providers adhere to relevant ethical standards such as beneficence and nonmaleficence (American Psychological Association, 2017). Clear communication protocols, informed consent, and respecting boundaries are critical to uphold ethical integrity during multidisciplinary collaboration.
Evaluation of Treatment Effectiveness and Additional Interventions
Dr. Heston’s implementation of CBT has shown promising results, evidenced by reductions in binge-purge episodes and improvements in cognitive distortions, as supported by peer-reviewed literature (Treasure et al., 2020). However, some patients may require adjunctive treatments to address comorbidities or residual symptoms. For Rita, additional interventions such as dialectical behavior therapy (DBT) skills training, acceptance and commitment therapy (ACT), and family-based therapy could be beneficial.
DBT, with its focus on emotional regulation, may help manage the emotional triggers of binge episodes (McMain et al., 2015). ACT emphasizes mindfulness and acceptance, fostering healthier responses to distress (Walsh, 2019). Family involvement can improve support systems and address familial dynamics that influence treatment adherence (Le Grange & Lock, 2018). These modalities are supported by recent literature and tailored to individual needs, promoting sustainable recovery.
Conclusion
Effective treatment of BN necessitates a multifaceted approach grounded in evidence-based practices, collaborative care, and ethical considerations. Dr. Heston’s application of CBT aligned with theoretical models has provided a solid foundation. However, integrating additional interventions and a multidisciplinary team can optimize outcomes. Ethical considerations must guide collaboration, ensuring respect for patient autonomy and confidentiality. Continuous evaluation and adaptation of treatment strategies are essential in addressing the complex nature of bulimia nervosa.
References
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. American Psychologist, 72(9), 824–841.
DeJesse, C., & Zelman, S. (2013). Promoting optimal collaboration between mental health providers and nutritionists in the treatment of eating disorders. Journal of Clinical Psychology in Medical Settings, 20(2), 257–263.
Gorenstein, C., & Comer, J. (2014). Case 9: Bulimia nervosa. In Gorenstein & Comer (Eds.), Psychology: A Bill of Rights (pp. 345-367). Worth Publishers.
Halmi, K. A. (2013). Perplexities of treatment resistance in eating disorders. International Journal of Eating Disorders, 46(4), 341–346.
Le Grange, D., & Lock, J. (2018). Family-based treatment of bulimia nervosa. Child and Adolescent Psychiatric Clinics, 27(1), 135–147.
McMain, S. F., et al. (2015). Dialectical behavior therapy in the treatment of bulimia nervosa. Behavior Research and Therapy, 73, 107–114.
Treasure, J., et al. (2020). Cognitive-behavioral therapy for bulimia nervosa: Efficacy and mechanisms. Psychological Medicine, 50(7), 1090–1097.
Walsh, B. T. (2019). Acceptance and commitment therapy for eating disorders. The New England Journal of Medicine, 381(21), 2098–2099.
Waller, G., Gray, I., Hinrichsen, M., Mounford, M., Lawson, R., & Patient, M. (2014). Cognitive-behavioral therapy for bulimia nervosa and atypical bulimic nervosa: Effectiveness in clinical settings. Psychotherapy Research, 24(3), 354–365.