Hunger for Understanding

Alison Eivors qualified as a clinical psychologist in 1999.During her training she developed an interest in eating disordersand completed her doctorate in this area. She conducted aqualitative study that investigated reasons for dropout fromservices for anorexia nervosa. This gave her the opportunity tointerview women about the meaning of their eating difficulties andgave her an invaluable insight into the very functional roleanorexia can play in people's lives and the enormous battlethey face to overcome the disorder. Alison currently works as Principal Clinical Psychologist at aspecialist adolescent mental health service in Leicester. This posthas provided her with the opportunity to work clinically with youngwomen suffering from eating disorders. For the past two years Alison has been part of a multidisciplinaryteam to review her local service for young people with eatingdisorders. The review involved researching the evidence base,interviewing previous clients and visiting other specialist unitsaround the country. This has drawn her attention to the need forcreative and varied therapeutic techniques (such aspsychoeducation, motivational-enhancement and cognitive-behaviouraltechniques) in the treatment of young people with anorexia. Sophie Nesbitt developed a special interest in workingwith young people with eating disorders while working as a traineeclinical psychologist. Her doctorate research investigated the roleof exercise as a risk factor in the development and maintenance ofeating disorders. She was also able to work clinically with youngpeople with eating disorders at an inpatient unit. Much of thiswork involved working and communicating effectively with youngpeople, and she developed a particular interest in the developmentof psycho-education information for this client group. Sophie is currently working in a multidisciplinary outpatient team.This provides her with the opportunity to work with other types ofdisorders, such as developmental disorders and emotional disorders.However, as part of this post she is also involved in trainingother healthcare professionals in generic mental health issues. Bynecessity, a large part of this training has focused on raisingawareness of eating disorders within primary care settings. Sophie is also currently involved in a preliminary research studyaimed at evaluating the Hunger for Understanding workbook.The main aims of this study are to investigate whether the workbookimproves understanding of anorexia nervosa, increases motivation tochange and enhances the therapeutic relationship. Findings fromthis study will be reported in due course. The Hunger for Understanding workbook was initiallydeveloped as a therapeutic tool that could be used by therapists atan inpatient service. Often, the young people who are referred tothe service have chronic difficulties with food and weight and havehad a diagnosis of anorexia nervosa for some time. They tend to be difficult to engage in treatment and therefore theaim of the workbook was to provide guidance and structure totherapeutic work. The workbook is based on ideas and techniquesthat Alison and Sophie have used in therapeutic work, which wereinfluenced by their research and training in this area, and mostimportantly by talking to patients who have undergone extensivetreatment for anorexia nervosa. Their experience of using theworkbook to date has been very positive and the feedback receivedhas helped develop and refine the content and structure of thetext.