Adult Eating Disorders Service

How you might feel

Many of the people we meet have mixed feelings and are unsure whether they are ready to address such problems. We appreciate this can be scary and difficult to trust someone you don’t know. We encourage you to make contact, have a chat and then make a decision about whether you want to work with us.

If you are unsure that you even need help then that is fine too. Don’t be put off asking for advice. Our specialist and caring staff are more than happy to just have a quick chat about your concerns. It is important however, if you do want help, that you contact us as soon as possible. The sooner we can talk to you, the less likely things are going to deteriorate further and get more serious.

What an appointment involves

The first meeting involves having a chat with one of the team and deciding whether the time is right for you to make changes. This gives us an opportunity to find out about a little bit more about you and the problems you are experiencing.

We respect everyone as an individual, and as such tailor the support we provide to your specific needs. We are not here to trick you in to eating. If weight is affecting your health, we will give you information and ideas on how you can make small changes towards better health.

What we offer

• Advice and consultancy
• Psychiatric assessment
• Liaison work with other services
• CBT-e (Cognitive Behavioural Therapy adapted for eating disorders)
• SSCM (Specialist Supportive Clinical Management)
• MANTRA (Maudsley Anorexia Nervosa Treatment for Adults)
• Dietetic consultation
• Occupational Therapy Assessment and Interventions
• Peer support work
• Community support - including enhanced community support work if deemed appropriate.
• Liaison with First Steps Voluntary Sector who work alongside the University of Lincoln

EDISS - Eating Disorders in Student Support

We are working with First Steps ED, a non-clinical specialist eating disorder charity to provide an education, assessment and support service through their Eating Disorders in Student Services (EDISS) provision.

The service provides fast, easy access to expert assessment, information, advice and support for students at the University of Lincoln.

EDISS supports early identification and intervention for university students who experience disordered eating or have concerns about their relationship with food.

This includes:

• Provision of fast, easily accessible and specialist screening for students who experience disordered eating or have concerns about their relationship with food.

• Information, advice and courses of psychologically informed support to prevent an escalation of symptoms.

• Brief intervention, and support for subclinical disordered eating.

• Advice clinics for those students with disordered eating or eating concerns.

• Collaborative working with other services to enhance the provision of support to students with eating related difficulties and complex emotional needs.

• Signposting and referring on to other organisations / services as clinically required.

• Ensure smooth transitions across pathways for those with clinical presentation of an eating disorder. This will include ‘step-up’ to and ‘step down’ from clinical treatment provided by LPFT’s Adult Eating Disorder Service.

• Deliver bespoke befriending and peer support as needed to support the student.

• Work jointly with the university’s student wellbeing service to identify any need for bespoke group work/psycho-education workshops for those they are supporting.

• Timely and appropriate information sharing between First Steps ED, LPFT and the university’s student wellbeing service and support individuals to engage with treatment or support services at an early stage.

• Data will be gathered and reported throughout the project period and will be used to   guide future service planning.

Students who feel they require support can complete an online referral form or speak with the Student Wellbeing Service at the university. 

Eating Disorders education and training

We are working closely with the charity PEDS (Personalised Eating Disorders Support) to deliver an education and training service in Lincolnshire. 

PEDS will develop a bespoke and targeted adult and young people eating disorder training and education package, which will be delivered for free both face-to-face and virtually to a variety of stakeholders including primary care clinicians, Lincolnshire Partnership NHS Foundation Trust (LPFT) services, substance misuse services, schools/colleges/universities, and the local community including other VCFSEs.

By working collaboratively with PEDS, we aim to embed a community footprint with local service design and delivery, developing relationships to identify opportunities for service collaboration and non-treatment interventions, such as VCFSE led groups and support. The aim is to upskill staff and partners in the early detection and identification of eating disorders and to improve eating disorder awareness, as well as deliver a range of self-guided interventions for sub-clinical eating disorders/disordered eating and other ways of supporting those with eating disorders to live well with their diagnoses.

Anyone interested in the training should contact Claire.hodgson11@nhs.net or Daniel.fonseca-oconnor@nhs.net for more information.

• Provide teaching into Doctorate Clinical Psychology Training programme on treating approaches for eating disorders

Referrals

We consider referrals for patients over the age of 16. The basic minimum information required is:

• Weight, height and BMI
• Blood tests
• A history of the eating problems

In more complex cases requiring formal CPA and Care Co-ordination, eg. dual diagnosis and/or other co-morbid health problems, the Eating Disorder Service will either jointly work or offer advice and support.  Care co-ordination should be provided by the local Community Mental Health Team.

If you are aged 16 and over and are registered with a GP practice within the county of Lincolnshire, you can also complete a self-referral form if you believe you have a mild to moderate eating disorder. More information about this, as well as a link to the form itself, is available on this webpage.

Patients under 16 years of age should be referred to CAMHS Eating Disorders Service. The Eating Disorders Service will work with CAMHS EDS to ensure the smooth transition of patients to adult services as appropriate.

In general the referral protocol should be followed, however, we will consider each case individually. Please feel free to telephone the service on 01522 421632.  You can email the service on lpft.eatingdisorders@nhs.net 

Information for carers

Skills workshops for anyone caring for a loved one with an eating disorder

Caring for a loved one with an eating disorder can be exhausting, distressing and disorientating. Many carers feel they are drowning as though they have tried everything and don’t know where to turn next.  

National Health Service Workforce Training and Education Directorate has worked in partnership with Charlie Waller Trust  to train facilitators to be able to deliver the New Maudsley Approach carers skills workshops to parents and carers who are supporting a loved one with an eating disorder.   

Based on the New Maudsley approach, these courses have helped so many families to navigate their way through a seemingly impossible task and offer professional techniques for becoming a ‘Change Coach’ including: 
•    Dealing with challenging behaviour 
•    Specialised communication skills 
•    Avoiding traps that may maintain the disorder 
•    Supporting recovery  

The aim of the New Maudsley Model is to lower anxiety and distress in family members and to give carers communication tools, skills and techniques that help them engage their loved one to improve their self-esteem and develop the resilience to embark on change. 

The courses are broken down into five, two-hour workshops and are full of practical tips, real life scenarios and case studies.   

Please see the links below inviting you to take a look at the courses and decide if it would be of help to you.  
 

https://www.charliewaller.org/what-we-offer/projects-in-partnerships/the-new-maudsley-approach

https://www.charliewaller.org/what-we-offer/new-maudsley-training-course-dates

Get involved! Join our Adult Eating Disorders Involvement Group

We are inviting people with lived experience, families and carers to help us shape our Adult Eating Disorders Service. 

What is the Adult Eating Disorders Involvement Group? 

The Adult Eating Disorders Involvement Group is a space for staff, people with lived experience of an eating disorder, carers and family members to work together to monitor, advise, and improve future practice by discussing topics and gathering experiences.

Including people who have used services, as well as families and carers is important to us. Your views are extremely valuable, and you are the best people to hold the Adult Eating Disorders Service to account, ensuring care is at a high standard and meets and represents as many people’s needs as possible.

The group currently meets monthly remotely via MS Teams.

If you would like to join the Adult Eating Disorders Involvement Group or speak to a member of the team, please email lpft.involvement@nhs.net or call 07773 206341.

Feedback from group members

"We all work together to achieve the best outcomes for the service, patients, families and carers." - member of the Involvement Group

"This is a great, non-judgemental friendly group where everyone's opinions and ideas are discussed,
considered and acted upon, with a joint goal of improving the lives of those with eating disorders." -
member of the Involvement Group

Testimonials

"The Eating Disorders service has been an absolute lifeline on my journey to recovery. The friendly, compassionate and dedicated team tailored personalised treatment that not only addressed my physical health but also my emotional well-being. Thanks to their unwavering support, I've emerged stronger and have been able to rediscover the happier, healthier, fun-filled version of myself that I thought was lost forever." - Service user.

"When I first made the decision to begin my journey, after my eating disorder nearly took my life, it was a very scary place to be.  But from the moment I walked into the unit, I felt as though I was being wrapped up in a big warm blanket and from that moment I just knew I was going to be ok ! I have to say that my personal experience was made much more bearable when I was greeted my the most amazing person with a great big smile. It was then that I knew recovery was possible for me. I’m not for one minute saying that it was easy and, personally, the hard work does have to come from yourself. I do still have my difficult days but with the coping strategies that I have learned from the LPFT means that I can now “live” not just “exist”. So I would urge anyone that is in the grips of this terrible illness to just reach out your hand and I assure you that someone will be there to take it and wrap you up in your very own warm blanket. ​​​​​"​ - Service user.

"When I first started working with the Adult Eating Disorders group I was a bit nervous and didn't have any idea what to expect. My nerves soon went out of the window when I met Ali - he put me at ease and it was like talking to a friend. The modules we did really got me thinking about myself and my attitude. 

"When I first started there was no way I was going to go out and eat a meal in public but I'm so proud of myself I've not only eaten one meal out I've actually had three! One was a wedding and one was a birthday. The thoughts that were going around my head when I knew these events were coming up would usually have had me in a right state. But with doing some of the things I learned from the modules made me feel that I could do this and it was something to look forward to instead of the usual dread.

"Don't get me wrong I do still have bad days but just having those few things which probably seem like nothing to anyone else made me feel like I can do this. If you are lucky enough to get the chance to work with the Adult Eating Disorders team please do. They are caring and actually listen to what you have to say. I'm so grareful for my time with them and feel much stronger in myself." - Service user.
 

‘Through K’s recovery so far, I have to admit how hard it is from a parent's perspective to watch your child suffer with an eating disorder when you know their potential. You wish you could do it for them, but all you can do is guide them to make the right choice for their future. It’s like she became two different people. It can be difficult to understand something that you haven’t experienced but I had to remember that she didn’t choose the eating disorder. But I knew she needed help and thankfully her treatment team gave her a lifeline when I didn’t know what to do. They’ve not only given her the best advice, but also helped me to understand more than I did. It’s like we’re both in recovery. It affects everyone in the household but being part of the programme has really turned things around for her and we are both forever grateful for the support she’s had throughout her treatment." - Parent of a service user.

Jargon buster

You may come across many acronyms and unfamiliar phrases and terminology. Here's a guide to explain what they mean. 

AMHS (Adult Mental Health Services) - If needed, when a young person reaches 18, their CAMHS team will help them prepare to move (transition) to Adult Mental Health Services. There may be some instances where this may be earlier than 18, or later than 18, depending on individual circumstance.

Behavioural Activation - Behavioural activation is an evidence-based treatment often used to treat depression/low mood. It encourages a person to develop or get back into activities which are meaningful to them.

CAMHS - CAMHS is an acronym for Child and Adolescent Mental Health Services

CAMHS EDS - The EDS Service is a separate service within CAMHS for young people who are experiencing an eating disorder, such as Anorexia Nervosa or Bulimia.

Care Plan - A Care Plan is a treatment plan that is tailored to suit individuals' specific needs, personal goals and symptoms. It specifies the care a person needs to develop socially, emotionally, physically, and intellectually. This Care Plan should be agreed on with both the Lead Professional and patient, and can be reviewed and changed if needed.

CBT (Cognitive Behavioural Therapy) - CBT is a talking therapy that helps manage problems by helping you challenge the way you think and behave. CBT is mainly used to treat anxiety and depression but it can also be used to treat a variety of other difficulties. There are also lots of variations of CBT including Trauma-focused CBT and CBT-E (Cognitive Behavioural Therapy for Eating Disorders)

EDE – Q - An Eating Disorder Examination Questionnaire is a questionnaire all about how an Eating Disorder affects you day-to-day. By completing it at the start of therapy, and then every 28 days, it tracks your recovery.

Formulation - A formulation aims to help a person understand and make sense of their difficulties and symptoms, considering their environment, relationships, social relationships and past life events. A formulation can then be used to develop a care plan and treatment.

Graded Exposure - Graded Exposure may be recommended as a part of CBT if people are struggling with issues such as anxiety or phobias. Graded exposure may start with writing down a ‘ladder’ of feared situations /objects/activities that a person might be avoiding (least feared at the bottom, most feared at the top). The clinician will then help the person work up the ladder, helping expose them to these feared situation in a safe way in order to overcome anxiety.

Initial Assessment - An Initial Assessment is usually the first appointment a young person will have with a service. For more information, visit our website page 'my first appointment' detailing what sorts of things you may be asked in that appointment.

MDT - An MDT is a group of different professionals (e.g. nurses, social worker, psychiatrists) who discuss and make decisions on recommended treatment together.

Pathway - In Lincolnshire treatment 'pathways' help a clinician build or guide a person’s care plan and are based on recommended treatment and medical guidelines. There are a number of different pathways depending on what a person is struggling with e.g. low mood pathway, social anxiety pathway and eating disorder pathway.

PSW (Peer Support Worker) - PSWs are members of staff with lived experience of mental health difficulties, who use their personal experiences and insight to support people in mental health services. Because of their lived experience, some describe PSWs as ’bridging the gap’ between the clinician and patient. A PSW may help plan and deliver care, help people attend groups or go out in your community to help promote recovery.

Referral - A referral is a formal process that happens when a person asks a service for help. People may get referred to mental health services by a doctor, or other health professional.  To do this, paperwork needs to be completed describing the issues a person is experiencing and what they need help with.