Due to the serious health consequences of eating disorders, such as anorexia nervosa, therapy may often be a lengthy process. Therefore, it is very important that the sufferer be given plenty of notice regarding an end date for their therapeutic treatment.
When to End Therapy for Anorexia
There are many different reasons why therapy sessions may come to an end, with financial costs often playing a part in therapy cessation. In addition, some approaches to therapy are time-limited, with a specific designated number of sessions agreed from the start. However, those who have been in long term therapy may find ending their treatment significantly challenging, particularly if there is a strong rapport between therapist and patient. The decision to end therapy will likely be made when significant progress has been made in terms of the individual's recovery. Maintaining at target weight for a period of time and the ability to cope better with daily life, such as work or education, together with having achieved goals set during treatment are all important indicators of progress. In Beating Your Eating Disorder, Waller et al. (2010) recommend revisting therapy goals to assess whether you have met those you wanted to and looking at how such goals may have changed during treatment. Waller et al. (2010) also highlight the importance of discussing ending therapy with relatives and friends.
How to Prepare for Ending Therapy Sessions
Once a date for termination of therapy has been confirmed or discussed, it is necessary for the therapist and patient to work together in preparation for such time. While some may feel relieved that their therapy is coming to an end, others may be absolutely terrified at the thought of not having access to such intensive support. If therapy has been weekly, it is likely that this will gradually be reduced to fortnightly, three-weekly, to eventually once a month. This will go a long way to helping those in recovery from anorexia test out how they cope without therapy and offer the opportunity to address any difficulties. It is also very important that a good support system is put in place prior to therapy ending, which may include family members, support groups and close friends. A relapse prevention plan is extremely useful, as it will help to identify potential pitfalls, triggers, warning signs and offer practical suggestions on how to turn things around again.
Fears Associated with Ending Therapy for Anorexia
Endings can be traumatic or challenging for anyone, but for anorexia sufferers who are typically very resistant to embracing change, ending therapy can cause much distress. There are multiple fears associated with therapy coming to an end, which may affect not only those in recovery from an eating disorder, but carers too. A major fear is that the lack of intensive therapy will result in a relapse. The fear of losing control and gaining over one's target weight band is also common. A good therapist will address fears or anxieties associated with therapy cessation and how these may be dealt with, helping the patient to take more responsibility for her recovery. A common fear of not having sufficient support may be addressed through identifying other present avenues of help, such as access to a Community Psychiatric Nurse (CPN). If you are due to end therapy in the near future, it is well worth taking some time to think about how this feels and note down any specific worries that spring to mind. This will help you to make the best use of the latter end of your therapy.
As highlighted above, ending therapy is a big step for those in recovery from anorexia nervosa. Therefore, it is very important to begin preparing for therapy termination through identifying potential pitfalls, as well as fears or anxieties in good time.
Source:
Waller et al. (2010) Beating Your Eating Disorder
Cambridge University Press
Kate Le Page - Kate Henning-Le Page writes about eating disorders, body image and recovery issues. She specializes in anorexia recovery.
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