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首页> 外文期刊>Journal of Eating Disorders >The journey from opposition to recovery from eating disorders: multidisciplinary model integrating narrative counseling and motivational interviewing in traditional approaches
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The journey from opposition to recovery from eating disorders: multidisciplinary model integrating narrative counseling and motivational interviewing in traditional approaches

机译：从对立到饮食失调的旅程：采用传统方法结合叙事咨询和动机访谈的多学科模型

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BackgroundIn the world of today’s of ever-briefer therapies and interventions, people often seem more interested in outcome than process. This paper focuses on the processes used by a multidisciplinary team in the journey from opposition to change to recovery from eating disorders. The approach outlined is most relevant to those with severe and enduring illness. MethodsThis paper describes a five-phase journey from eating-disorder disability and back to health as it occurs for patients in a community-based facility. This integrative model uses narrative and motivational interviewing counseling weaved into traditional approaches. It approaches illness from a transdiagnostic orientation, addressing the dynamics and needs demanded by the comorbidities and at the same time responding effectively in a way that reduces the influence of the eating disorder.The treatment described involves a five-phase journey: Preliminary phase (choosing a shelter of understanding); Phase 1: from partial recognition to full acknowledgment; Phase 2: from acknowledgment to clear cognitive stance against the eating disorder; Phase 3: towards clear stance against the “patient” status; Phase 4: towards re-authoring life and regaining self-agency; Phase 5: towards recovery and maintenance. ResultsIn a longitudinal study of patients with a severe and debilitating eating disorder treated with this approach. The drop-out rate was less than 10%. This was during the first two months of treatment for those diagnosed with bulimia nervosa, and this was higher than in those diagnosed with anorexia nervosa. At the end of treatment (15 months to 4 years later) 65% of those treated with anorexia nervosa and 81% of those treated with bulimia nervosa were either in a fully recovered state or in much improved. At the four-year follow-up, 68% of those diagnosed with anorexia nervosa and 83% of those diagnosed with bulimia nervosa were categorized as either fully recovered or much improved. All patients who completed the program were gainfully employed. ConclusionsThe collaborative work, which is the heart of the described model increases the patient’s and family’s ownership of treatment and outcome and strengthen the therapeutic bond, thus enhances recovery.
机译：背景技术在当今越来越多的疗法和干预手段中，人们似乎常常对结果感兴趣，而不是对过程感兴趣。本文着重于一个多学科团队在从反对到改变，从饮食失调中恢复的过程中所使用的过程。概述的方法与那些患有严重和持久疾病的人最相关。方法本文描述了从饮食失能残疾到健康恢复的五个阶段的过程，这种过程发生在社区机构的患者身上。这种整合模型使用了编入传统方法的叙述性和动机性面试辅导。它从诊断的角度处理疾病，解决合并症所要求的动态和需求，同时以减少饮食失调影响的方式有效应对。所描述的治疗方法包括五个阶段：初步阶段（选择避难所）;阶段1：从部分确认到完全确认;第二阶段：从承认到对饮食失调的明确认知态度;第三阶段：对“患者”身份采取明确立场;阶段4：重新创作生活和恢复自理能力;阶段5：恢复和维护。结果在对使用这种方法治疗的严重而虚弱的进食障碍患者的纵向研究中。辍学率低于10％。对于诊断为神经性贪食症的患者来说，这是在治疗的前两个月内，高于诊断为神经性厌食症的患者。在治疗结束时（15个月至4年后），神经性厌食症患者中的65％以及神经性贪食症患者中的81％处于完全恢复状态或明显改善。在四年的随访中，被诊断为神经性厌食症的患者中有68％和被诊断为神经性贪食症的患者中有83％被归类为完全康复或好转。所有完成该计划的患者都得到有偿雇用。结论协作工作是模型的核心，可以增加患者和家人对治疗和结果的拥有权，并加强治疗纽带，从而提高康复能力。

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