Life Hack for Eating Disorder Recovery - Occupational Health Awareness Week 2022

The demand for healthcare services, particularly that of eating disorders, is in demand; whilst at the same time, there has been no parallel investment (Ayton et al., 2022). Data shows that despite treatment time standards for children and young people’s specialist eating disorder services, a significant amount of individuals still experience significant delays (NHS England, 2022). These delays can result in individuals becoming more unwell and impede recovery (Hamilton et al., 2022). Even with specialist treatment, evidence-based treatments do not yield consistently good outcomes (Byrne et al., 2017). The need for more effective and meaningful interventions within a treatment milieu branded ‘not a safe system’ has never been more apparent (Parliamentary and Health Service Ombudsman, 2017).

Within an eating disorder context, occupational therapists support individuals with performance and participation difficulties. They focus on an individual’s strengths, and promote choice and independence, so individuals become their own occupational therapists (Cowan and Sørlie, 2021). They offer a unique lens in the treatment of eating disorders, focusing on practical support, in the here and now, and fostering occupations and activities which are meaningful and contribute to long-term recovery (Gardiner and Brown, 2010; Biddiscombe et al., 2018). Occupational therapists seek to implement individualised strategies and support, so that change is meaningful, and implemented into an individual’s day to day routines. Therefore, in a climate of high-referrals and need, with calls for novel and creative approaches (Touyz and Hay, 2022) occupational therapy, can be key in supporting recovery in the long-term.

Occupational Therapy (OT) Week is a national annual event which seeks to promote occupational therapy. This year’s theme is ‘Lift Up Your Everyday’, which falls between 7th and 13th November. Although occupational therapy is an essential part of the multidisciplinary team in the field of eating disorders, they are often overlooked in favour of more established therapies. However, individuals in treatment often seek support to address the practical nature of recovery, such as preparing a meal, or supporting role development and establishing new occupations, which occupational therapists are skilled at facilitating (Lock and Pepin, 2019). Recovery is more than physical restoration. It includes psychosocial domains, fostering hope and social connection (Clark and Nayar, 2012). These are goals which occupational therapy also strive towards.

For this year’s OT week, the professional body, the Royal College of Occupational Therapists, is asking its members to create ‘OT Life Hacks’. These are referred to as small actions that someone can do to overcome challenges which prevent them from doing the things they need and want to do. These life hacks are designed to provide high impact for a low effort, have evidence, be fun, easy, and accessible.

When I attempted to create a life hack for eating disorder recovery and reflected upon this, my efforts seemed superficial and incompatible with the realities of recovery. Often, recovery from an eating disorder is gradual, and requires hard work; it is messy and complex and is definitely not always easy. Recovery is also determined by individual’s themselves, outside of medical markers such as weight and reduction in eating disorder behaviours, but on finding hope, connection, and engagement in new activities and occupations. Therefore, creating a generalised life hack, may not fit within an individual’s own journey.

Occupational therapists acknowledge this, and take a holistic approach, they work alongside; collaboratively supporting individuals to gain insight into why they do, what they do (Orchard, 2003). Client-centred practice is not so much about occupational therapists enabling occupations which are considered ‘healthy’ or right, but rather it is respecting an individual’s own knowledge and experience of recovery (Whalley-Hammell, 2015).

Therefore, my life hack for eating disorder recovery is a mindful ‘stock taking’. It is not a promise that things will be stress-free, but it offers opportunity to step back, to revaluate and to focus on what is in front of you, and through this, ‘lift up your everyday’. In a few simple words, this is my life hack:

Feeling concerned with tomorrow? Anxious about yesterday? Overwhelmed by what is around you right now? Take a breath. Focus on the present moment, and what is in front of you. Stop trying, stop doing, just be.

Life hacks are designed to short circuit time and make daily activities more efficient. This particular example may not eliminate or ‘short circuit’ the pain of eating disorder recovery, but it can create meaning, acknowledge one’s inner strengths, and refocus priorities.

To find out more about occupational therapy visit www.rcot.co.uk, or to find out about Esther Dark, this blogs author and Occupational Therapist working in CAMHS and PhD Student, follow her on Twitter @EstherDark3.

References

Ayton, A., Viljoen, D., Ryan, S., Ibrahim, A., & Ford, D. (2022). Risk, demand, capacity and outcomes in adult specialist eating disorder services in south-east of england before and since COVID-19. BJPsych Bulletin, 46(2), pp. 89-95.

Biddiscombe, R. J., Scanlan, J. N., Ross, J., Horsfield, S., Aradas, J. and Hart, S. (2018) 'Exploring the perceived usefulness of practical food groups in day treatment for individuals with eating disorders', Aust Occup Ther J, 65(2), pp. 98-106.

Brockmeyer, T., Friederich, H. C. and Schmidt, U. (2018) 'Advances in the treatment of anorexia nervosa: a review of established and emerging interventions', Psychol Med, 48(8), pp. 1228-1256.

Byrne, S., Wade, T., Hay, P., Touyz, S., Fairburn, C. G., Treasure, J., Schmidt, U., McIntosh, V., Allen, K., Fursland, A. and Crosby, R. D. (2017) 'A randomised controlled trial of three psychological treatments for anorexia nervosa', Psychol Med, 47(16), pp. 2823-2833.

Clark, M. and Nayar, S. (2012) 'Recovery from eating disorders: A role for occupational therapy', New Zealand Journal of Occupational Therapy, 59(1), pp. 13-17.

Cowan, M. and Sørlie, C. (2021) 'An Eating Disorder Intensive Day Service', in Twinley, R. (ed.) Illuminating the Dark Side of Occupation, International Perspectives from Occupational Therapy and Occupational Science: Routledge Advances in Occupational Science and Occupational Therapy, pp. 114-12

England, N. (2022) NHS treat record number of young people for eating disorders. Available at: https://www.england.nhs.uk/2022/03/nhs-treating-record-number-of-young-people-for-eating-disorders/ (Accessed: 16/09/2022).

Gardiner, C. and Brown, N. (2010) 'Is There a Role for Occupational Therapy within a Specialist Child and Adolescent Mental Health Eating Disorder Service?', British Journal of Occupational Therapy, 73(1), pp. 38-43.

Hamilton, A., Mitchison, D., Basten, C., Byrne, S., Goldstein, M., Hay, P., Heruc, G., Thornton, C. and Touyz, S. (2022) 'Understanding treatment delay: Perceived barriers preventing treatment-seeking for eating disorders', Aust N Z J Psychiatry, 56(3), pp. 248-259.

Lock, L., C and Pepin, G. (2019) 'Eating Disorders', in Brown, C., Stoffel, V.C. and Munroz, J. (eds.) Occupational Therapy in Mental Health: A Vision for Participation. Second Edition ed. Philadelphia: F.A. Davis, pp. 154-168.

Parliamentary and Health Service Ombudsman. (2017) Ignoring the Alarms: How NHS Eating Disorder Services Are Failing Patients. Parliamentary and Health Service Ombudsman.

Touyz, S. & Hay, P. (2022), "The future of eating disorders research: an editorial", Journal of eating disorders, 10, (1), pp. 10-10.

Whalley Hammell, K. R. (2015). Client-centred occupational therapy: The importance of critical perspectives. Scandinavian Journal of Occupational Therapy, 22(4), 237-243.