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NEDC e-Bulletin

Issue 3 | September 2012


Keynote presentations from the National Workshop

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After much preparation we finally held our Third Annual National Workshop on the 22nd August in Adelaide. The event featured three keynote presentations:

  1. Professor Howard Steiger - Director of the Eating Disorders Program, Douglas Institute, Canada
  2. Professor Mimi Israel - Psychiatrist-in-Chief, Douglas Mental Health University Institute, Canada
  3. Professor Pat McGorry - 2010 Australian of the Year, Chair of the NEDC, Executive Director of Orygen Youth Health (OYH)

By popular demand, we are making copies of these keynote presentations available to both NEDC members and e-Bulletin subscribers. We have also included short video excerpts of each session; full video of the sessions are available to NEDC members and are housed in the Members Information section of the website.

 
1. Setting the Scene - Professor Pat McGorry

In this presentation, Professor Pat McGorry provides the wider mental health context for the challenges involved in improving access and quality of eating disorders treatment in Australia.

2. Genes, Family and the Environment in Anorexia and Bulimia Nervosa: DNA, TLC or MTV? - Professor Howard Steiger

Professor Howard Steiger's keynote presentation reviews evidence suggesting that chances of developing an ED (and associated symptoms) are influenced by effects of genetic factors, life stresses, psychological traits, and in the end—dieting. This talk is designed to introduce people (professionals and nonprofessionals alike) to the new science of Epigenetics, and to the contribution it can make to the understanding and treatment of eating disorders.


3. How person-centered approaches can transform health-care service organization and delivery for Eating Disorders - Dr. Mimi Israël

Dr. Israël's keynote presentation discusses how a person-centred approach can be used to develop an integrated network that addresses the complex needs of people with Eating Disorders (ED), and their families. The proposed model advocates for close collaborations between first-line services, specialized programs, and community-based organisations to create a system that optimizes prevention, early detection, and evidence-based treatment for EDs.

Downloadable versions of all these files are available in the Members Information section of the website.

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New NEDC publications


We are very pleased to confirm that our National Framework and Communications Strategy have both been accepted by the Department of Health and Ageing. Previously only available to NEDC members these documents are now publicly available and have been placed on the NEDC website.

An Integrated Response to Complexity: National Eating Disorders Framework 2012 is the first national schema for eating disorders in Australia. Drawing on the evidence basis for these illnesses, it details the core principles for an integrated approach with a person centred, recovery focus. In addition to 7 principles for the prevention and management of eating disorders, there are 4 principles for implementation of the approach. These principles are aligned to the Mental Health Standards. Implementation of these principles for eating disorders will contribute to achievement of the mental health standards.

Its counterpart, Clarity in Complexity: Strategic Communication to Support the Prevention and Early Identification of Eating Disorders provides the evidence based approach for communicating about eating disorders, engagement in prevention programs and encouragement of help seeking.

The reports have been subjected to intensive scrutiny and review. They represent the collective view of those from across Australia who live with and fight eating disorders and, as such, they represent a unique collaborative view.

These documents have been attached below. Both documents, including their appendixes can also be viewed on the NEDC Publications page of the website.

These two publications are the product of an immense amount of effort and represent the collaboration at its finest. We would be delighted if you could take the time to look through these documents.

 

Research article review


The National Eating Disorders Collaboration collects and provides the latest evidence based research and information available on eating disorders from Australia and around the world. The topics included in our Research and Resources section are wide ranging and recognise the physical, social and emotional aspects and the broad spectrum of eating disorders. All information has been sourced from the NEDC Resources Review, NEDC Evidence Review, books, fact sheets, treatment guidelines, manuals or programs, reports, web-based programs, multimedia, academic peer reviewed journals and individuals working within the eating disorders sector.

Each month in the e-Bulletin we will be highlighting some of the research and information uploaded regularly on our website.

The Sequelae of Dropout

Dropout from treatment for the eating disorders has far-reaching consequences

In spite of improvements in treating eating disorders, research consistently shows that many are leaving the pathways of care without undertaking a full course of treatment, and as such, putting their recovery at risk. Those who drop out of treatment are unlikely to recover on their own and are more likely to have poor long-term outcome. In addition, high dropout rates significantly limit the validity, reliability and generalisability of treatment outcome research in the eating disorders.

In a review of patient dropout, Mari Campbell (2009) identified an increase in people dropping out of treatment from 1991-2006. However, she suggested that the data is plagued by methodological issues, in particular:

  • The definitions of the criteria used to identify dropouts in the research literature are vague or missing, and therefore limit comparability and replication across studies
  • There is a lack of theoretically driven interventions to target dropout

In order to understand the scope of the problem and give people the best chance of engaging and remaining in care, Campbell indicates the need to learn from those clinicians who have succeeded in reducing dropout and use this learning to plan services and adapt treatments appropriately.

Campbell, M. (2009). Drop-out from treatment for the eating disorders: A problem for clinicians and researchers. European Eating Disorders Review, 17(4), 239-242.

A critical examination of the definitions of dropout used in research studies

A highly variable rate of dropout from treatment for anorexia nervosa has prompted current researchers at the Institute of Psychiatry, King’s College London, to investigate this phenomenon with the aim of increasing the consistency of dropout reporting and facilitating greater understanding of why patients leave treatment prematurely, and ultimately in increasing treatment engagement and completion in anorexia nervosa.

In a systematic review of treatment studies, DeJong, Broadbent and Schmidt (2012) found that the dropout rate in outpatient care for anorexia nervosa ranged from 4.8% to 100%. These rates were affected by factors such as illness severity and treatment approach.

These factors aside, the researchers have also identified that one of the greatest challenges in trying to draw conclusions around dropout from treatment in anorexia nervosa is the lack of consistency in how this concept is defined and reported across studies. DeJong et al., suggest moving away from the label “dropout” and adopting a less pejorative term such as “withdrawal”. In addition, they propose a reporting structure for withdrawal from treatment that they believe will facilitate better understanding of the factors that contribute to dropout.

DeJong, H., Broadbent, H., & Schmidt, U. (2012). A systematic review of dropout from treatment in outpatients with anorexia nervosa. International Journal of Eating Disorders, 45(5), 635-647.

Predictors of dropout from outpatient treatment for eating disorders

A recently published Australian study by Carter et al. (2012) collected data from referrals to a public specialist eating disorder service for youth and adults in Perth, Western Australia, between 2005 and 2010. Of this sample, 45% dropped out of treatment. The primary aim was to identify factors that increase a patient’s risk of dropping out from treatment for an eating disorder.

Based on the 45% of the sample that dropped out of treatment, the results identified both individual and process-based factors that were significant predictors of dropout.

The researchers argue that investigation of the time spent on the wait list for treatment is important because it may be easier to address and modify than individual patient characteristics. The findings suggest that implementing strategies and providing resources for eating disorder services to reduce waiting list times may provide a good opportunity to minimise dropout from treatment for eating disorders in the future.

Carter, O., Pannekoek, L., Fursland, A., Allen, K. L., Lampard, A. M., & Byrne, S. M. (2012). Increased wait-list time predicts dropout from outpatient enhanced cognitive behaviour therapy (CBT-E) for eating disorders. Behaviour Research and Therapy, 50(7–8), 487-492.

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New media resource: Mindframe guide to reporting and portrayal of eating disorders


The Mindframe National Media Initiative recently collaborated with the NEDC and Australian media professionals to develop a new resource providing practical advice for journalists, editors and other media professionals to guide best-practice reporting and portrayal of eating disorders. The guide was officially launched by Minister for Health and Ageing Mark Butler on the 22nd of August and can be found on the Mindframe website.

Mindframe is funded under Labor’s National Suicide Prevention Program and works to build a collaborative relationship with the Australian media and other sectors to encourage responsible, accurate and sensitive media representation of mental illness and suicide.

A recent critical review of media and mental illness commissioned by Mindframe, confirms that the media is a major source of information about mental illness, for both the wider community and members of the community living with a mental illness. In consultations conducted earlier in 2012, eating disorders were identified by journalists as an area they would like further information and advice about.

This has been a great project for the NEDC to be involved in and we hope this new resource will result in more accurate and sensitive reporting on eating disorders and mental illness going forward.

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Professional development events and resources

Our National Workshop and ANZAED's Annual Conference may be over, however there are still plenty of upcoming opportunities for professional development and information.

Advanced Skills Workshop - Family Based Treatment for Anorexia

Advanced Skills Workshop - Family Based Treatment for Anorexia will be held 27-28 September in Sydney at the Westmead Children’s Hospital.

This 2-day workshop is designed for clinicians who have experience using the Maudsley FBT and want to advance their skills to effectively implement the treatment and solve complex cases. Day 1 will focus on families not responding to treatment in phase 1 and Day 2 will focus on phase 2 and 3.

For more information contact Annaleise Robertson.

 

ACMHN's 38th Annual Mental Health Nursing Conference


Attendees of this year's AHMCN Mental Health Nursing Conference, held 3-5 October in Darwin will have the opportunity to attend a workshop titled Knock Knock – Who’s there? Patients with Eating Disorders, please let us in.

Run by NEDC steering committee member Elaine Painter, this workshop will help participants to explore eating disorders from different perspectives including; the person with a lived experience, their family and supporters, and the health care professionals that work with them. This understanding of eating disorders, coupled with Queensland’s access pathways and state wide management guidelines, will guide the group to assess and develop individualised treatment plans for the case studies provided.

NEDC staff will also be manning an exhibition stand at this event so drop by to say hello!

Please visit the conference website for more details.

 

 

ANZOS 2012: Annual Scientific Meeting

The Australian and New Zealand Obesity Society (ANZOS) takes great pleasure in inviting you to attend the 2012 ANZOS Annual Scientific Meeting, held 18-20 October in Auckland, New Zealand. This year’s Meeting theme is “For Our Children’s Children.”

The ANZOS Annual Scientific Meeting is designed to bring together clinicians, scientists, dieticians, researchers, psychologists, exercise physiologists, public health practitioners, guideline developers, students, educators, policy makers, administrators and patients to work toward an integrated approach to improve the management and prevention of obesity in Australasia.

For more information visit the ANZOS website.

 

At Home with Eating Disorders


At Home with Eating Disorders, the 1st Australian Eating Disorders Conference for Families and Carers will be held on May 23-25 2013, in Brisbane. The event promises two days of robust evidence-based treatment options, strategies to empower and support families and carers and a forum for exploring the barriers and enablers to best practice treatment in Australia. Keynote speakers include:

  • Professor Daniel Le Grange, professor of psychiatry and behavioural neuroscience and Director of the Eating Disorders Center, University of Chicago Medicine
  • Professor Janet Treasure, professor of psychiatry at King’s College London and Head of the Eating Disorders Unit, South London Maudlsey Hospital NHS Trust

Visit the event website for more details.

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Opportunities to get involved


Become a member!

The NEDC welcomes and actively encourages people who are interested in joining the collaboration.

NEDC membership is a mutually beneficial relationship and a vehicle for partnering, shared learning and ensuring everyone has a voice in the discussion of strategic priorities for improving approaches to prevention and treatment of eating disorders in Australia. With the assistance of our members, it is the aim of the National Eating Disorders Collaboration (NEDC) to help ensure:

  1. Eating disorders are a priority mainstream health issue in Australia
  2. A healthy, diverse and inclusive Australian society acts to prevent eating disorders
  3. Every Australian at risk has access to an effective continuum of eating disorders prevention, care and ongoing recovery support

To become a member you just need to fill out our quick online membership form

Becoming a member is free but the participation and support of our members is priceless! If you are not yet a member we would love to have you involved.

 
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Participate in the Clinician's e-Network

Every month we use our Professional Collaboration Network to address specific questions for the 2012 Gap Analysis Report. This report will play an essential role in identifing any priority gaps or opportunities for further development of the eating disorders sector in Australia. If you are a professional in clinical practice with an interest in eating disorders and haven't joined our e-Network yet we would love to have you involved.

This month's question is:

What would help you feel better prepared to address eating disorders in your role?

Join the e-Network now to participate in this and other discussions with other clinical professionals.

 

NEDC Gap Analysis Report

The purpose of the NEDC Gap Analysis is to identify opportunities for practical action to implement a nationally consistent approach to eating disorders that can be implemented in the context of current policy, resources and practice.

This is a great opportunity to get involved and there are still opportunities available to contribute, particularly for services and clinicians working with clients who have or are at risk of an eating disorder.

If you would like to contribute information about your service to the NEDC service review participate in our Service Provision Review.

If you would like to share your experiences as a clinician working with eating disorders participate in our Clinician's Experience with Eating Disorders survey.

We want to hear from you!

Our website has been live for five months now and our aim is to build it into the best resource possible for practitioners and those touched by eating disorders in Australia. We're planning on creating some new information resources for key audience groups but before we do though we would love to get some feedback on how we're going so far. If you have a spare five minutes it would be much appreciated if you could fill out our short website survey.

Any other feedback or questions can be directed to nedc@thebutterflyfoundation.org.au. We try to respond to all enquiries within 48 hours.

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