Registration will be in the Events Venue, Main Quad, UCL, Gower Street, London WC1E 6BT
Eating Disorders Sixth Joint NELFT/UCL Conference
Pathways to Recovery, Risks and Responsibilities
Friday 11th November 2016
Main Quad Events Venue, University College London, Gower Street, London, WC1E 6BT
The conference will include clinical skills workshops and service user presentations. It will be relevant for Psychiatrists, Nurses, Clinical Psychologists, Psychotherapists, Dietitians, Researchers, Students and any other professionals with an interest in eating disorders.
Keynote 1: Dr. Frances Connan
Clinical Director, Vincent Square Eating Disorder Service, Central & North West London Foundation NHS Trust.
Care Pathways – From Community to Intensive Treatment
Keynote 2: Dr. Mima Simic
Joint Head of Child and Adolescent Eating Disorder Service, South London & Maudsley Foundation NHS Trust.
Tensions, Challenges and Dilemmas in Working with Young People with Eating Disorders
Guest Speaker: Hadley Freeman, Guardian columnist and features writer.
Eating Disorders Sixth Joint NELFT/UCL Conference Programme:
Registration will be in the Events Venue, Main Quad, UCL, Gower Street, London WC1E 6BT
09.00 – 09.30 Registration - Events Pavillion, Main Quad, UCL, Gower Street, London WC1E 6BT
09:30 – 09:40 Welcome
09:40 – 10:20 Guest speaker: Hadley Freeman
10:20 – 11:00 Keynote 1: Dr. Frances Connan Care pathways – from community to intensive treatment
11:00 – 11:20 Coffee break
11:30 – 13:00 Morning workshops (a choice of four – to be booked at registration)
13:00 – 14:00 Lunch
14:00 – 15:30 Afternoon workshops (a choice of four – to be booked at registration)
15:30 – 15:50 Coffee break
15:50 – 16:20 Service users: Former-service users of the NELFT Eating Disorder Service will share their experiences and insights
16:20 – 17:00 Keynote 2: Dr Mima Simic Tensions, challenges and dilemmas in working with young people with eating disorders
17:00 – 17:10 Closing remarks
- Dialectical behaviour therapy for adolescents with comorbid self-harm and eating disorders by Dr. Mima Simic & Dr. Keren Smith
- Holding on to hope when the situation feels hopeless - Working systemically with young people and families experiencing an eating disorder by Enda Murphy
- Paediatric and adolescent medical complications in eating disorders - when to worry and what to worry about by Dr. Simon Chapman
- The importance of collaborating with carers to achieve good recovery outcome by Veronica Kamerling
- Dietetic support for anorexia nervosa by Ursula Phillpot
- A novel First Episode and Rapid Early Intervention service (FREED) for young adults with eating disorders by Dr. Amy Brown & Dr. Katie Lang
- Cognitive behavioural therapy for adults with eating disorders by Lauren Bloom & Canan Koc
- The Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) by Yael Brown & Dr. Omara Naseem
Guardian columnist and Features Writer
Hadley Freeman is a staff writer at The Guardian and the author of three books, the most recent of which, Life Moves Pretty Fast, was published by 4th Estate last summer. When she was 14 she developed anorexia nervosa and was admitted as an inpatient at the Priory Hospital in Roehampton for a year. After an emergency stay at the Cromwell Hospital she was placed under the care of Dr. Janet Treasure and was an inpatient at the Maudsley/Bethlem on and off for about a year and a half. She continued as an outpatient there for several years afterwards.
Dr. Frances Connan
Clinical Director, Vincent Square Eating Disorder Service, Central & North West London Foundation NHS Trust
Care pathways – from community to intensive treatment
Frances Connan is a Consultant Psychiatrist in eating disorders and has led the team at Vincent Square Eating Disorder Service since 2002. The service provides care pathways across the range of diagnosis and severity of eating disorders, and across a range of treatment intensities including outpatient, day patient and inpatient care. She has a particular interest in care and treatment for people with severe and enduring anorexia nervosa. She is currently chair of the Quality Network for Eating Disorders and a member of the NHS England Clinical Reference Group for eating disorders. She is clinical director for Child and Adolescent Mental Health Services and Eating Disorders at Central and North West London NHS Foundation Trust.
Outcomes from treatment for anorexia nervosa vary according to age, stage of illness and comorbid conditions. A variety of approaches is therefore needed for both outpatient and more intensive treatments, and importantly, for the flow between different intensities of care. Whilst the focus of research in eating disorders has tended to be on efficacy, less attention has been given to other important factors such as clinical and cost effectiveness and the adverse effects of treatment. A care pathway approach to treatment, underpinned by case formulation, supports an evidence based and cost effective approach to treatment that can be tailored to individual need.
Dr Mima Simic
Joint Head of Child and Adolescent Eating Disorder Service, South London & Maudsley Foundation NHS Trust
Tensions, challenges and dilemmas in working with young people with eating disorders
Mima Simic is the joint Head of the CAMHS National and Specialist Child and Adolescent Eating Disorder Service (CAEDS) and Consultant Child and Adolescent Psychiatrist for the adolescent Dialectical Behaviour Therapy Service at the Maudsley Hospital, UK. For over twenty-five years, her clinical work has focused on development of new treatments for children and adolescents with an eating disorder and/or self-harm. She has led the development of manual-based cognitive-behavioural therapy and large scale multi-centre research into family treatments for eating disorders and self-harm. In 2010, Mima led the development of the novel Intensive day Treatment Programme (ITP) within CAEDS which offers an integrative treatment approach that combines cognitive remediation therapy, cognitive behaviour therapy, radically open dialectical behaviour therapy and family therapy.
Clinical work with young people who have eating disorders can present a number of challenges. The benefits and shortcomings of the role of inpatient admissions in this group will be explored, along with the impact of social media on their treatment. The use of prescriptive manuals in outpatient treatments, and the sparse evidence for effective treatments of bulimia nervosa and binge eating disorder in young people will be discussed. An overview of the most common comorbid disorders with eating disorders and their possible treatments will also be presented. In addition the challenges of comorbidities for community child and adolescent eating disorders teams will be discussed. Finally, the use of the medico-legal framework in treatment of young people with eating disorders will be outlined.
Workshop A (morning): Dialectical behaviour therapy for adolescents with comorbid self-harm and eating disorders
Dr. Mima Simic and Dr. Keren Smith
Mima Simic is the joint Head of the CAMHS National and Specialist Child and Adolescent Eating Disorder Service (CAEDS) and Consultant Child and Adolescent Psychiatrist for the adolescent Dialectical Behaviour Therapy Service at the Maudsley Hospital, UK.
This workshop aims to look at the core components of dialectical behaviour therapy (DBT) in its standard form and discuss how we are using them in our service to help young people with co-morbid eating difficulties and self-harming behaviour. We will also discuss our clinical experiences in assessing when radically open DBT (Lynch, 2015) may be a more appropriate treatment for adolescents with comorbid self-harm and eating disorder. Radically open DBT targets difficulties related to over-control as opposed to under-controlled behaviours which are commonly treated with standard DBT. However, both treatments can be useful in treating adolescents with comorbid presentations, but different personality traits.
The evidence for DBT as originally developed by Marsha Linehan for adult clients presenting with suicidal and self-harming behaviour has been recognised in the NICE guidance for borderline personality disorder. In more recent years, a body of evidence for the use of adapted DBT with young people under the age of 18 years has grown (Cook. et al 2016).
In addition, DBT has been increasingly utilised with co-morbid suicidal and self-harming behaviours and eating disorders. The core skills components of DBT which are emotion regulation, distress tolerance, interpersonal effectiveness and mindfulness can be helpful for people with eating disorders who are known to be emotionally sensitive and have difficulties in managing relationships. These clients may engage in self-harm, restriction and binge-purge cycles in an attempt to regulate their emotions.
Workshop B (morning): “Holding on to hope when the situation feels hopeless” - working systemically with young people and families experiencing an eating disorder
Enda Murphy is a Systemic Psychotherapist, supervisor and trainer and has been for many years. His main clinical practice has been with the Child and Family Psychiatry services in Cambridge. The main focus recently of his work has been with adolescents with eating disorders within an inpatient context. He also runs a private Systemic Psychotherapy Practice offering therapy, supervision and training to clients and outside agencies.
The workshop will consider the challenge to support young people and families who are experiencing an eating disorder. We will look at ways of helping the family to hold on to a sense of hope. The participants will be invited to engage in a number of exercises to apply in practice that might enable the clients and families to stay strong and to imagine a future. The ideas around feeling "hopeless" will be spoken about and we will consider ways that upport can be offered to enable people to heard.
Workshop C (morning): Paediatric and adolescent medical complications in eating disorders - when to worry and what to worry about!
Dr. Simon Chapman
Simon Chapman is a consultant paediatrician at King’s College Hospital. Since 2010 he has led the medical management of eating disorders at the child and adolescent eating disorder service at the South London and the Maudsley, and jointly leads Marsipan, a national group which publishes guidance on the physical health aspects of managing eating disorders. Outside this role he also runs the diabetes transition service for young people and King’s Surgical Weight Management Service.
Assessment of malnutrition in young people can be challenging. This session will look at the biology of starvation, and what implications this has for managing young people with eating disorders. It will contain practical guidance on how to assess and manage young people at risk.
Workshop D (morning): The importance of collaborating with carers to achieve good recovery outcome
Veronica is the mother of two daughters who both suffered from an eating disorder. She also spent six years looking after her brother who had schizophrenia. Veronica runs her own organisation and her work covers a variety of roles focused on the needs of carers in the field of mental health.
In 2013 she was awarded "Carer Contributor of the Year 2013" by the Royal College of Psychiatrists and in 2008 was awarded an Eating Disorders National Award from “Beat – Beating Eating Disorders” in recognition of her contribution to the world of Eating Disorders.
Veronica feels passionately that Carers should be recognised and supported.
The workshop will cover a short piece around "My Story". It will explore some of the difficulties that professionals meet when engaging with Carers. The anxieties and emotions that Carers have when dealing with services and how we can all work together to bring about good recovery outcomes.
The workshop is for anyone who works with Carers looking after adults or young people with eating disorders.
Workshop E (afternoon): Dietetic support for anorexia nervosa
Ursula is an Advanced Practice Dietician and Senior Lecturer with a specialist interest in disordered eating, family health, mental health and all types of weight management. She runs a private practice for eating problems in Leeds, and features regularly on BBC radio and television news.
Ursula specialises in producing guidelines, pathways and consensus statement within the area of eating disorders and mental health. She is a member of: the NICE Guidelines Development group; the NHS England-Clinical Reference Group for Commissioning services in eating disorders; the British Dietetic Association’s Mental Health Group and the Quality Eating Disorders Standards group
The workshop will focus on dietetic/nutritional support for AN. The talk will present the latest evidence and practical approaches for:
- Weight gain and predicting weight outcomes in nutritional rehabilitation
- Refeeding rates, routes and options including MARSIPAN
- Dietary approaches for managing binging and/or purging
- Supporting patients in nutritional rehabilitation at different stages of illness
- Managing IBS, food allergies and sensory issues
Workshop F (afternoon): A Novel First Episode and Rapid Early Intervention Service (FREED) for young adults with eating disorders
Dr. Amy Brown and Dr. Katie Lang
Amy Brown is a senior clinical psychologist at the South London and Maudsley Eating Disorder Service. She has extensive clinical and research experience within the eating disorders field. Since September 2014 she has been involved in setting up and evaluating a new early intervention service for young people with a first episode eating disorder.
Katie Lang is a postdoctoral research associate working on the FREED-UP (First Episode Rapid Early Intervention for ED) team, section of eating disorders, Institute of Psychiatry. Prior to this she completed her PhD at the Institute of Psychiatry, which focused on the neuropsychological and socio-emotional processing profile of children and adolescents with anorexia nervosa.
Eating disorders predominantly affect adolescents and young adults. Untreated symptoms have lasting effects on the brain, body and behaviour. Evidence supports the need for effective intervention in early stage illness. However, individual and service-related barriers often prevent the early detection and treatment of eating disorders. The aim of this workshop is to describe our experience setting up and running FREED, a novel service for young people (aged 18-25) with recent eating disorder onset (< 3 years), embedded in a specialist adult UK National Health Service Eating Disorders service. Data on the feasibility, acceptability and clinical outcomes of FREED will be presented. We will also consider the practicalities of setting up and running this service and exploring the challenges of early intervention in different settings.
Workshop G (afternoon): Cognitive behavioural therapy for adults with
Lauren Bloom and Canan Koc
Lauren Bloom is a Cognitive Behavioural Therapist at the NELFT Eating Disorders Service with a background in Occupational Therapy. She has worked in the field of Eating Disorders in day and outpatient services since 2007 and delivers CBT for Eating Disorders (CBT-E) both on an individual and group level.
Canan Koc is a Cognitive Behavioural Therapist at the NELFT Eating Disorders Service working with both adults and children using CBT-E. In addition to her clinical work with eating disorders Canan has experience of treating anxiety and mood disorders using cognitive behaviour therapy. Canan is interested in third wave therapies and has experience of designing and facilitating pre-therapy compassionate mind training groups for severe and enduring anorexia nervosa.
This workshop will aim to summarise the structure and process of, and evidence base for, CBT-E. We will use clinical examples and interactive methods to demonstrate some top tips for delivering effective CBT-E.
Workshop H (afternoon): The Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA)
Dr. Yael Brown and Dr. Omara Naseem
Yael Brown is a Senior Psychotherapist at the Eating Disorders Service Maudsley Hospital, who has worked for 15 years in the eating disorders out-patient service and has been involved as a therapist in the Mosaic study comparing MANTRA to specialist supportive clinical management. She will be joined by her colleague, Dr. Omara Naseem - Counselling Psychologist who has worked in the Eating Disorders Service for the last 4 years.
MANTRA is one of the newer treatments for anorexia and has been developed by lead clinicians and researchers of the Eating Disorders Service at the Maudsley Hospital in London. The treatment model tries to address factors that are known to maintain the anorexia in the individual. These factors are linked to frequently present underlying personality traits like being more quiet, sensitive and shy, anxious and perfectionistic; a thinking style often characterised by inflexibility and excessive attention to detail and fear of making mistakes and a tendency to avoid emotional experiences.
Once the anorexia is present, these traits tend to get magnified and further maintain the illness and the person tends to develop positive beliefs about how the anorexia helps them manage their life. In MANTRA, the client and therapist together explore the strengths, resources and goals and values of the client and develop a formulation of how the above factors might maintain the anorexia in their individual situation. This formulation then informs a treatment plan, which includes behavioural experiments to change some of these patterns and to develop new skills. The approach is very collaborative and motivational, and includes monitoring of risk, addresses nutrition and also involves families and close others, should that be considered helpful. This workshop will introduce this treatment; provide an overview of this model and how to apply it to work with patients. Clinical examples will form part of the workshop.