Caitlin B. Shepherd, Rebecca G. Boswell, Jessica Genet, Wendy Oliver-Pyatt, Christine Stockert, Rebecca Brumm, Shaun Riebl, Katie Piel
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This case report highlights the viability of treating clients with AN remotely using an evidence-based practice approach, resulting in weight restoration and symptom remission. The client presented with a longstanding history of severe binge-eating/purging AN with numerous medical complications but was motivated and treatment-compliant. Her eating disorder (ED) was conceptualized using a biopsychosocial perspective and treated using a multidisciplinary, evidence-based practice approach encompassing individual, group, and supportive interventions. She was successfully discharged from treatment after 150 days, having restored weight to a healthy range and showing substantial improvements in ED, depressive, and anxiety symptoms based on validated measures. This case contributes to the evidence that remote care can be an accessible and effective treatment option, even in cases of severe AN. 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引用次数: 0
摘要
对于神经性厌食症(AN)的严重病例,包括存在低体重指数(BMI)和病程较长等不良预后因素时,通常需要进行中级治疗。现行指南要求治疗方案采用循证实践方法,以实现个性化治疗并优化疗效。研究支持中级护理的有效性,包括增加治疗机会的远程计划。然而,关于在远程治疗期间安全恢复患者体重的能力,存在相互矛盾的证据,因此有必要进行进一步研究。本病例报告强调了采用循证实践方法远程治疗自闭症患者的可行性,从而使患者恢复体重并缓解症状。患者有长期严重暴饮暴食/进食障碍的病史,并伴有多种医疗并发症,但她积极配合治疗。她的进食障碍(ED)是用生物心理社会学的观点进行概念化的,并采用多学科循证实践方法进行治疗,包括个人、小组和支持性干预。经过 150 天的治疗,她成功出院,体重恢复到健康范围,而且根据有效的测量方法,她的 ED、抑郁和焦虑症状都有了很大改善。本病例为远程护理提供了证据,证明远程护理是一种方便有效的治疗选择,即使是在严重的 AN 病例中也是如此。该病例强调了循证实践方法如何通过强调使用远程设备和自我监测的个性化治疗计划来安全地恢复体重。
Weight Restoration and Symptom Remission for Longstanding, Untreated Anorexia Nervosa in a Remote Eating Disorder Treatment Program: A Case Study
For severe cases of anorexia nervosa (AN), including when poor prognostic factors like low body mass index (BMI) and longer illness duration are present, intermediate levels of care are often indicated. Current guidelines call for treatment programs to use an evidence-based practice approach to individualize treatment and optimize outcomes. Research supports the effectiveness of intermediate levels of care, including remote programs which increase access to treatment. However, conflicting evidence exists regarding the ability to safely weight restore clients during remote care, necessitating further research. This case report highlights the viability of treating clients with AN remotely using an evidence-based practice approach, resulting in weight restoration and symptom remission. The client presented with a longstanding history of severe binge-eating/purging AN with numerous medical complications but was motivated and treatment-compliant. Her eating disorder (ED) was conceptualized using a biopsychosocial perspective and treated using a multidisciplinary, evidence-based practice approach encompassing individual, group, and supportive interventions. She was successfully discharged from treatment after 150 days, having restored weight to a healthy range and showing substantial improvements in ED, depressive, and anxiety symptoms based on validated measures. This case contributes to the evidence that remote care can be an accessible and effective treatment option, even in cases of severe AN. The case highlights how an evidence-based practice approach can enable safe weight restoration via a personalized treatment plan that emphasizes the use of remote devices and self-monitoring.
期刊介绍:
Clinical Case Studies seeks manuscripts that articulate various theoretical frameworks. All manuscripts will require an abstract and must adhere to the following format: (1) Theoretical and Research Basis, (2) Case Introduction, (3) Presenting Complaints, (4) History, (5) Assessment, (6) Case Conceptualization (this is where the clinician"s thinking and treatment selection come to the forefront), (7) Course of Treatment and Assessment of Progress, (8) Complicating Factors (including medical management), (9) Managed Care Considerations (if any), (10) Follow-up (how and how long), (11) Treatment Implications of the Case, (12) Recommendations to Clinicians and Students, and References.