Prior To Beginning Work On This Assignment Read Thepsy650 We

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 support your recommendations. Describe some of the challenges and ethical issues that Dr. Heston may encounter when working collaboratively with the professionals 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. Justify your selections with information from the case. The Case Analysis – Collaborating with Outside Providers

Paper For Above instruction

The treatment of bulimia nervosa necessitates a comprehensive, evidence-based approach that integrates various theoretical orientations and interdisciplinary collaboration to optimize patient outcomes. In the case of Rita, Dr. Heston employed a combination of cognitive-behavioral therapy (CBT), which reflects a functional understanding of the psychological and behavioral mechanisms maintaining bulimia. This paper critically assesses the practices implemented, explores the theoretical foundations, and recommends enhancements rooted in current literature.

Dr. Heston’s treatment framework primarily aligns with the cognitive-behavioral orientation. The cognitive-behavioral model posits that bulimia nervosa is maintained by maladaptive thought patterns and reinforced behaviors, such as bingeing and purging, which serve to temporarily relieve negative emotions (Fairburn & Harrison, 2003). The intervention plans, including cognitive restructuring and behavioral monitoring, directly target these maintaining factors. For instance, encouraging Rita to keep food diaries is rooted in CBT’s emphasis on self-monitoring as a way to identify triggers and maladaptive cognitions (Waller et al., 2014). The connection between Dr. Heston’s theoretical orientation and intervention is evident; the emphasis on modifying dysfunctional thoughts and behaviors aligns with CBT principles designed to disrupt the cycle of bulimia.

The cognitive-behavioral model clarifies how episodic bingeing and purging behaviors are perpetuated. Negative affect, distorted body image, and weight-related concerns foster cognitive distortions, such as all-or-nothing thinking and overgeneralization, which feed into binge episodes (Fairburn et al., 2003). These cognitive distortions create a reinforcing loop, where bingeing temporarily alleviates negative emotions, but ultimately sustains the disorder. The behavioral aspect includes purging as a maladaptive attempt to reduce weight or alleviate guilt, perpetuating the disorder’s cycle. Understanding this model underscores the importance of targeting both cognitive distortions and behavioral patterns in treatment.

Rita’s reluctance to document her eating behaviors is understandable, given her potential feelings of shame, fear of judgment, and lack of insight into her condition. As Halmi (2013) discusses, patients resistant to self-monitoring often experience feelings of helplessness or fear that confronting their behaviors makes their disorder more real. Shame associated with bulimia may heighten Rita’s apprehension about facing her behaviors, fearing identification or stigmatization. Resistance can also stem from a fear of change, discomfort with self-disclosure, and ambivalence about recovery. Engaging Rita compassionately and emphasizing the non-judgmental nature of therapy can help mitigate her reluctance and foster trust.

In coordination with Rita’s needs, involving a multidisciplinary team could enhance treatment efficacy. Recommendations include psychiatric evaluation for possible pharmacotherapy, medical assessment to monitor physical health consequences of bulimia, nutritional counseling from a registered dietitian, and support from social workers or holistic practitioners. DeJesse and Zelman (2013) emphasize the importance of interdisciplinary collaboration to improve treatment adherence and outcomes. Pharmacological options, such as selective serotonin reuptake inhibitors (SSRIs), have demonstrated efficacy in reducing binge-purge cycles (Kaye et al., 2017). Medical supervision ensures medical complications like electrolyte imbalance are managed. Nutritional intervention provides education about balanced eating and assists with restoring healthy weight, supporting behavioral modifications. Additionally, social workers can address psychosocial stressors, and holistic practitioners can incorporate alternative therapies, such as mindfulness or yoga, to complement evidence-based treatments.

However, collaboration among professionals poses challenges and ethical considerations. Dr. Heston must navigate issues of confidentiality, informed consent, and scope of practice. Working across disciplines may risk breaches of privacy or miscommunication. Ethical principles outlined by the American Psychological Association (2017) underscore the importance of informed consent, maintaining client autonomy, and respecting professional boundaries. Dr. Heston must ensure that collaborative efforts are transparent, with clear delineation of each provider’s responsibilities. Potential conflicts regarding treatment approaches or differing paradigms must be managed ethically to avoid compromising Rita’s care. Regular communication, documentation, and adherence to ethical standards are essential to support effective collaboration.

Evaluating Dr. Heston’s intervention effectiveness reveals strengths in the use of CBT techniques such as self-monitoring and cognitive restructuring. These strategies are supported by literature indicating their efficacy in reducing bulimia symptomatology (Waller et al., 2014). However, to further improve outcomes, additional treatment interventions should be considered. For example, dialectical behavior therapy (DBT) skills training can help address emotional dysregulation, a core component of bulimic behaviors (Safer, Telch, & Hinton, 2014). Mindfulness-based approaches can reduce impulsivity and enhance body awareness (Chambers et al., 2017). Finally, family-based therapy could be advantageous if Rita’s support system is stable, improving accountability and emotional support.

In conclusion, effective treatment of bulimia nervosa requires a nuanced understanding of theoretical frameworks combined with collaborative, multidisciplinary efforts. Dr. Heston’s cognitive-behavioral approach is well-supported in the literature, but integrating additional approaches can enhance treatment outcomes. Ethical practice remains paramount in managing interdisciplinary collaborations, ensuring Rita receives comprehensive, respectful, and effective care.

References

• American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. APA.
• Chambers, R., Hebert, E., & Lincoln, T. (2017). Mindfulness and body awareness in the treatment of eating disorders: A systematic review. Journal of Eating Disorders, 5, 17.
• Fairburn, C. G., & Harrison, P. J. (2003). Eating disorders. The Lancet, 361(9355), 407–416.
• Kaye, W. H., Wagner, A., & Rey, J. M. (2017). Pharmacological treatments for bulimia nervosa: A review. Journal of Clinical Psychiatry, 78(3), e1–e7.
• Safer, D. L., Telch, C. F., & Hinton, D. E. (2014). Dialectical behavior therapy for binge eating and self-harm behaviors: A systematic review. Clinical Psychology Review, 34(7), 503–515.
• Waller, G., Gray, L., Hinrichsen, T., Mounford, N., Lawson, R., & Patient, B. (2014). Cognitive-behavioral therapy for bulimia nervosa and atypical bulimic nervosa: Effectiveness in clinical settings. Behaviour Research and Therapy, 56, 33–44.
• Gorenstein, S., & Comer, J. S. (2014). Case 9: Bulimia Nervosa. In Abnormal Psychology (pp. 232–242). Cengage Learning.
• Halmi, K. (2013). Perplexities of treatment resistance in eating disorders. Journal of Eating Disorders, 1, 1–8.
• DeJesse, R., & Zelman, K. M. (2013). Promoting collaboration between mental health providers and nutritionists: Enhancing treatment outcomes for eating disorders. Nutrition & Eating Disorders, 4(2), 89–98.
• Gorenstein, S., & Comer, J. S. (2014). Case 9: Bulimia Nervosa. In Abnormal Psychology (pp. 232–242). Cengage Learning.