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Description
In our performance focused society we often encounter problems generally referred to as eating disorders. There has been an increasing number of families where such disorders exist (anorexia, bulimia, obesity). Specialists from different fields help with addressing these issues however the dimension of family relations is not adequately represented.
Our project aims at building a therapeutic centre for children to deal with eating disorders with more emphasis placed on using family therapy. By changing the approach to the treatment of this disorder we would like to help in reducing the probability of further worsening of these issues among children and teenagers in the Ústecký Region.
We would like to change the existing situation by implementing the following key activities:
1) In terms of the therapy during the initial or fully developed disorder we want to provide family therapy in their own environment where they struggle with this disorder either in its early or later stages.
2) The second activity is focused on improving the communication skills of parents in families with these disorders in the form of frequent semi-open groups.
3) Provide feedback to the professional community in the form of two workshops on numerous possibilities where family therapy can be used to deal efficiently with eating disorders.
4) The fourth activity would be centred around additional professional assistance depending on the particular needs of clients (nutritional specialist, fitness coach and others if necessary).
A Norwegian partner will be involved in the project and will share his long-term experience in this area with us and we will apply it in our activities.
Summary of project results
We see the need of our project in the high incidence of eating disorders in society. Based on an analysis carried out in 2023 by the Ústí Government, every third child is at risk of malnutrition. In addition, there is no service dealing with eating disorders in the Ústí Region. Also, the multidisciplinary approach involving the whole family within one multidisciplinary centre is unique and highly effective. Information was discussed between experts; the client was provided with a comprehensive service without the need to look for other experts. During the duration of the project, we encountered insufficient capacity of experts with appropriate qualifications. This created a long waiting list and clients were admitted to the centre more than 1 month apart. Despite advertisements and contacts with professional chambers and other organizations, it was not possible to find other experts with appropriate qualifications. We are still looking for these experts. Another problem were "parent groups". Not all parents want to share their problem, and time availability also played a big role. Therefore, in the future, we would like to change the format of these groups to open ones, but led by a psychologist, so that myths and half-truths are not presented here. On the other hand, providing information on conferences was successful, there is a lot of interest in the topic. We plan to continue these activities in the future. One of the big challenges will be getting the additional funding for the centre.
The following activities were implemented as part of the project: Family therapy including psychotherapeutic work with the family using the family therapy method. Each client has an initial consultation with a psychotherapist mapping the situation in the family. The frequency of the following psychotherapies depends on the individual needs of the family. Another activity was professional consultations, which were connected with the psychotherapeutic consultations. Expert consultations were physical and nutritional. These consultations were in some cases separated, but very often they were combined. Movement and nutrition are, especially for this target group, very strongly connected. For consultations with the client, documents were created by the nutritional therapist, after the nutritional status, food selection, and possibly diseases were analysed. Based on the data, the individual program was created, taking into account the movement, which is important for the correct setting of the diet. Clients, who were indicated for a disease other than celiac disease and lactose intolerance, were sent to a specialised medical centre. Also clients, whose BMI was lower than 16, were sent to other medical centre. In our case, it was the Masaryk Hospital in Ústí nad Labem. There are documents archived from each consultation. Another project activity was Parent Groups. The aim of this activity was to increase the communication skills of the parents. The capacity of the group was set to a maximum of 12 clients. Originally it was focused on the communication skills of parents. Due to the low participation of parents, we changed the format of the groups to a predetermined topic, e.g. how to manage celebrations, holidays, etc. while suffering with eating disorders. Participation increased slightly, but even so, the participation of parents was still low. Therefore, the implementation of parent groups was suspended after the end of project. The last activity were seminars for professionals. We held 2 seminars where we focused on the theoretical basis of the eating disorders and case studies. As part of the second seminar, our Norwegian partner was present and shared its experience and methods of working with clients suffering from eating disorders. Both seminars were well attended, and therefore we plan to hold similar events in the future after the end of project.
The purpose of the project was to provide a help to eating disorder clients with an emphasis on the family therapy. Family therapy targets directly on the causes of the problem, not just its consequences. Eating disorders were dealt within the framework of a multidisciplinary centre, it also includes other related experts (nutritional therapist, movement specialist) and therefore the solution is comprehensive and meets the individual needs of the client. Due to the constantly worsening situation of eating disorders amongst children (2024 ÚZIS data), the project brought another possibility to solve the problem. For the end users, children and parents, the project brought the possibility of solving the problem in a different way than hospitalization in a medical centre. A multidisciplinary approach was also an advantage, which meant a direct connection between individual experts. Every client received comprehensive individual service and there was no need to look for other specialists, they were included within the centre. 51 families underwent individual therapy within the project. Despite the great interest, it was not possible to serve more families, we were limited by the capacity of psychotherapists. As part of the project, we also focused on the parents themselves, so that the entire environment of the child was treated. Therapy groups were created to improve communication skills, which are closely related to illness in the family. This activity was not used enough even though it offered important information that should have contributed to changing the family system and thus solving the problem. Only 17 parents participated. The project had a great benefit for experts, when we held 2 professional seminars for them. Experts were given information about the causes of eating disorders. The case reports were also discussed. 60 experts participated in the seminars.
Summary of bilateral results
The involvement of the partner organization Spiseværdigesforeningen has been active and very effective since the beginning of the project. We have collaborated with the organization on exchange of experiences in the field of providing services for clients with eating disorders. Together we completed online interviews and successfullyplanned a visit to the partner in the Czech Republic. The cooperation with the partner generated valuable results that will be beneficial for the future activities of our organization. Both sides presented their approaches to working with clients. The Norwegian partner''s approach is more social, sometimes called accompaniment in our country. The Norwegian organization doesn´t implement direct work with the client (therapeutic part). We discussed this way of working a lot because it seemed very beneficial to us and in the future we are considering expanding our activities to include this part. The cooperation was beneficial for both parties and both parties definitely want to continue the cooperation.