Community Treatment of Eating Disorders

Dr Paul Robinson is a consultant psychiatrist in eating disorders psychiatry at the Russell Unit, Royal Free Hospital, Camden and Islington Mental Health and Social Care Trust. After postgraduate training in general medicine he trained in psychiatry at the Maudsley Hospital, was a family therapist and conducted research into control of eating behaviour at the institute of Psychiatry and Johns Hopkins Hospital, Baltimore. In the last eight years at the Royal Free he has built up a multidisciplinary team dedicated to the community approach to eating disorders, minimising use of inpatient care and developing safe and effective ways to provide treatment for these distressing, debilitating and at times life-threatening conditions. The team has twice been in the final of the Hospital Doctor Team of the Year Award. His present interests are the treatment of severe and enduring eating disorder (SEED), and the delivery of therapy via email, for which he reached the final of the Medical Innovations Award. He lives in North London.

About the Author vii Acknowledgements ix

Introduction xi

Chapter 1: Establishing a Home-oriented Service 1

Chapter 2: Staff 19

Chapter 3: Initial Outpatient Assessment 32

Chapter 4: Physical Assessment and Monitoring 57

Chapter 5: Psychological Interventions 80

Chapter 6: Day Care 103

Chapter 7: Liaison and Outreach 122

Chapter 8: Inpatient Care 141


Chapter 9: Rehabilitation: Dealing with Seed 165

Chapter 10: Technical and Academic Aspects 177

References 191

Index 193