Macdonald P, Hibbs R, Corfield F, Treasure J. J Eat Disord 10, 32 (2022). Rather, transference is named, addressed in a way that will not challenge a persons defences (build resistance), to support the therapeutic relationship, demonstrate that the therapist is comfortable and accepting of the patients negative feelings and to promote change [15]. Hay PJ, Claudino AM, Touyz S, Abd Elbaky G, Hay PJ. Would you like email updates of new search results? 2019;42(2):18191. FOIA WebSpecialist Supportive Clinical Management (SSCM) is an evidence-based therapy designed for treatment of severe and enduring eating disorders. SSCM sets target symptoms in relation to and in collaboration with the individual patient and has shown adaptability to include other outputs such as quality of life [19]. Int J Eat Disord. In the Mosaic trial [17], the SSCM group improved more in terms of reduced obsessionally on the Obsessive Compulsive Inventory, than in the MANTRA armso SSCM may be a therapy that enables more flexibility by being flexible of itself. In addition, this paper positions SSCM as a treatment that may be strengthened by other modalities and may also be adapted to the treatment of other eating disorders (ED), not just AN. Bookshelf Specialist supportive care therapist manual 1997. ANZAED Virtual 2021 Workshop: An Introduction to Specialist While the model appears straight forward, SSCM requires the clinician delivering the treatment to be a skilled counsellor to ensure the person is positioned as central in the therapeutic process [28]. 2016, to include a more cyclical end-point [56] Given further understanding about AN and identity formation within the qualitative literature [57,58,59], an extension to Hays conceptual modal is proposed in Fig. Eating Disorders Recovering identity from anorexia nervosa: womens constructions of their experiences of recovery from anorexia nervosa over 10 years. Conclusion: It would be beneficial to understand SSCM better and how and why it may work, which this paper proposes. [Answered!] This is distinct from eclecticism [46] which borrows techniques without attention to how they fit within a revised conceptual model and underpinning theories. It would be beneficial to understand SSCM better and how and why it may work, which this paper proposes. SSCM adopts a person and a symptom focus. WebWere the peak body for eating disorder professionals involved in research, prevention, treatment and advocacy in Australia and New Zealand. Epub 2022 Mar 8. The .gov means its official. J Constr Psychol. Br J Psychiatry. https://www.health.gov.au/sites/default/files/documents/2021/04/a-national-framework-for-recovery-oriented-mental-health-services-guide-for-practitioners-and-providers.pdf. SSCM occurs on the polar end of a psychotherapy continuum, working with issues already conscious for the person. Keeping with the spirit of the flexible and responsive attribute of SSCM is significant considering the therapist is standing with the person in getting their life back from a disorder with control at its core [52]. The proposed re-conceptualisation of SSCM in the context of its evidence may strengthen it as a treatment overall, position it as adaptable for treatment of other eating disorders and make it more accessible to clinicians. Br J Psychiatry. The present paper has proposed a first step in a re-conceptualisation of SSCM as an evidence-based treatment within a revised model as presented in Fig. Adv Eat Disord Theory Res Pract. 2005;15(4):392471. 2009;42(2):6980. Unauthorized use of these marks is strictly prohibited. WebObjective: Specialist Supportive Clinical Management (SSCM) is a psychotherapy comprising a clinical management focus addressing anorexia nervosa (AN) symptoms and a supportive therapy component. 2016;3(2):17790. Gutierrez E, Carrera O. Anorexia nervosa treatments and Occams razor. In the most recent of these meta syntheses Karlson et al. In SSCM dietetic support is offered in a flexible way that is responsive to individual needsbe it to inform part of the assessment phase or included alongside the treatment intervention or the dietitian as consultant to the primary therapist. This paper clarifies areas of misunderstanding by describing what SSCM is and what it is not, particularly in relation to commentary about its constituent characteristics. Anorexia nervosa. Health Expect Int J Pub Part Health Care Health Pol. As such, some of the key philosophies and spirt of SSCM (e.g. Article The TA is a complex concept and measured in varied ways [32, 33]. It is a directional therapy, whereby eating disturbances are considered coping strategies, enlisted by a person to help them with life difficulties. An official website of the United States government. Jansingh A, Danner UN, Hoek HW, van Elburg AA. The underpinning aetiological conceptualisation of SSCM would require further consideration to support this, however based on theoretical suitability, testing in other ED populations is indicated. In the context of its flexible and person-centred orientation, there is also the possibility to engage the minutiae of food and nutrition with meal plans and self-monitoring to best serve the individual, per the patient therapist collaboration [42]. The https:// ensures that you are connecting to the This Figure could also be further expanded to explicitly acknowledge trauma as an aetiological maintaining factor [60] requiring specific evidenced based treatment as identified at the pre-treatment assessment phase see Risk Factors in Fig. The currently available evidence-based outpatient treatments for adult anorexia nervosa (AN) have consistently returned disappointing results whereby outcomes are poor and dropout rates are high [1,2,3,4,5]. Am Psychol. Further consideration about the practicalities of translating this model from the clinical trial to treatment setting are required in order to adapt SSCM to the treatment setting and are shown in Fig. Unauthorized use of these marks is strictly prohibited. The delicate tension of establishing the treatment non-negotiable is supported within skilful person-centred care of SP with particular attention in phase one orientating to treatment (See Fig. Developments in the psychological treatment of anorexia nervosa and their implications for daily practice. Thus, there is more to learn about the contribution of TA to outcomes and with regards to different therapy modalities [6]. PubMed [Answered!] Eur Eat Disord Rev. 2021;9(1):1103. McIntosh VV, Jordan J, Carter JD, Luty SE, Carter FA, McKenzie JM, Frampton CM, Joyce PR. Two psychological therapies, specialist supportive clinical management (SSCM), and cognitive behavior therapy for anorexia nervosa (CBT-AN) have limited (one randomized controlled 2020;28(2):1569. For example, in response to a patient who offers an interpersonal dilemma within their SP, the therapist may appropriately use self-disclosure in describing an approach to interpersonal difficulties by setting boundaries. All authors read and approved the final manuscript. Some of the commentaries and descriptors used for SSCM, however, do not reflect the content or principles of SSCM. 3rd ed. Careers. 2008;18(1):22542. Specialist Supportive Clinical Management - Anorexia Nervosa https://dietitiansaustralia.org.au/wp-content/uploads/2021/11/Eating-Disorders-Role-Statement-2017.2.pdf. Specialist Supportive Clinical Management for anorexia Specialist supportive clinical management for anorexia nervosa: Analysis of therapy content and relation to outcome. ST is a mental health adviser to the Commonwealth Department of Veteran's Affairs. SSCM for Anorexia Nervosa - NEDC It may be helpful for individuals who have not seen success from standard eating disorder treatments. J Eat Disord. The proposed re-conceptualisation of SSCM in the context of its evidence may strengthen it as a treatment overall, position it as adaptable for treatment of other eating disorders and make it more accessible to clinicians. Furthermore, patient treatment preferences have affirmed its importance [36]. 2016;17(1):549. FOIA Clin Ther. 1for example Person Centred Therapy [28]. Alongside the SP sits clinical management (CM) of target symptoms the model defines as related to AN, a notion adapted from Joyce 1995 [29]. Touyz S, Le Grange D, Lacey H, Hay P, Smith R, Maguire S, et al. The .gov means its official. There has been speculation about how this relatively straightforward therapy works. WebDr Paul Robinson is a leading Psychiatrist for the treatment of Eating Disorders. Int J Eat Disord. Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. J Subst Abuse Treat. Accessibility What does the Maudsley Anorexia Nervosa Treatment for Adults involve? He has received honoraria from Hogrefe and Huber, McGraw Hill and Taylor and Francis for published books/book chapters. Hence, the conceptual model for SSCM can be used to frame the therapy, which may also be adaptable to other EDs by modifying the agreed target symptoms, within CM outputs. A more clearly defined theoretical framework as proposed by Fig. 2017;78(2):184189. MeSH -, Fichter MM, Quadflieg N, Crosby RD, Koch S. Long-term outcome of anorexia nervosa: results from a large clinical longitudinal study. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. WebEating Disorder Services for adults aged 18 or above which offer specialist, intensive expert help to people at a relatively early stage of their disorder are likely to be both effective and cost-effective in (a) providing early treatment, (b) reducing the need for long-term [10] sought to clarify misconceptions about SSCM [11,12,13]. For example, the spirit of motivational interviewing (MI), including partnership and collaboration, respect of personal autonomy and acceptance of the person (not the problem) aligns with that of SSCM. Norcross JC, Goldfried MR. 2022 Mar 7;10(1):32. doi: 10.1186/s40337-022-00557-2. https://doi.org/10.1186/s40337-022-00557-2, DOI: https://doi.org/10.1186/s40337-022-00557-2. Australas Psychiatry. Out-patient psychological therapies for adults with anorexianervosa: randomised controlled trial. Would you like email updates of new search results? Robinson P, Hellier J, Barrett B, Barzdaitiene D, Bateman A, Bogaardt A, et al. ANZAED Virtual 2021 Workshop: An Introduction to Specialist In addition to these studies in AN [4, 7, 17,18,19] Robinson and colleagues [22] have conducted a transdiagnostic RCT with SSCM as a comparative therapy in a study of 68 people with an ED (6% with AN) and personality disorder. A secondary meta-analysis endorses SSCM as a promising treatment. Laura Kiely. Eating Disorder Role Statement. J Psychother Integr. SSCM Swift JK, Mullins RH, Penix EA, Roth KL, Trusty WT. WebDescription Specialist supportive clinical management (or SSCM) is a psychotherapy with a growing body of evidence, showing promising potential for the treatment of anorexia nervosa. Therapist qualities included empathy, flexibility, patience, acceptance, authenticity, accurate listening, emotional accessibility, and transparent and clear communication. Before J Psychother Integr. It requires an experienced psychotherapist to deliver it as SSCM addresses both the symptom of the ED (food and exercise behaviours) as well as life issues causing difficulty to a person (psychotherapy), as presented by the patient. Recovery from anorexia nervosa and bulimia nervosa at 22-year follow-up. eating disorder Specialist Supportive Clinical Management In this context, clinicians may also seek to fix the illness, which is frequently resisted by the person with a lived experience and poses a risk to the therapeutic relationship. Current evidence-based treatments for adult anorexia nervosa (AN) have limitations, with high attrition, very poor outcomes for 20% of people, and no clearly superior manualised therapy for adults with AN. 2020 Mar 24;11:206. doi: 10.3389/fpsyt.2020.00206. [31] offers a patient-constructed definition of therapist qualities and relationship attributes that patients experience as helpful. and transmitted securely. Assessing the distinctiveness of psychotherapies and examining change over treatment for anorexia nervosa with cognitive-behavior therapy, interpersonal psychotherapy, and specialist supportive clinical management. Current Therapeutic Approaches to Anorexia Nervosa: State of the Art. Severe and Enduring Anorexia Nervosa: Enduring Wrong Assumptions? Therefore, the applicability of SSCM for APDs with requisite ED experience in a contemporary understanding of dietetic training and practice, warrants further investigation. Eat Behav. Treatment Approach Shelly Beach Practice 2015;2018(2):CD003909-CD. Book The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Specialist Supportive Clinical Management for Anorexia Nervosa Federal government websites often end in .gov or .mil. Changing to a different therapy Diet advice Bone health If you have anorexia you should usually be offered a talking therapy. Therefore, progress is emphasised to be slow and steady rather than rapid and impressive, to promote ongoing self-efficacy. This may account for SSCMs potency. WebSpecialist Supportive Clinical Management (SSCM) SSCM for eating disorders emphasises the importance of a supportive therapeutic relationship that facilitates the gradual return to normal eating and weight. SSCM demands clinician sophistication to deliver upon its SP orientation including an understanding of treatment nuance to clearly delineate from its exploratory psychotherapy cousins [14]. He is Editor in Chief of the Journal of Eating Disorders. Maudsley Therapy for Adults with Anorexia Nervosa, Regularity, Adequacy, Variety, Eating Socially and Spontaneity, Specialist supportive clinical management. Schmidt U, Magill N, Renwick B, Keyes A, Kenyon M, Dejong H, et al. J Eat Disord. 2015;1:15074. An official website of the United States government. Effective psychotherapists: clinical skills that improve client outcomes. Behavioral interventions in the treatment of eating disorders. Your privacy choices/Manage cookies we use in the preference centre. Norcross JC. Your US state privacy rights, 2021;8:21524. Webwith people with eating disorders An ability to draw on knowledge that SSCM has two overarching components: clinical management (focused on normalising eating and weight gain, addressing other anorexia nervosa (AN)-related behaviours and effects, psychoeducation, and support to enhance adherence) A recent paper by Jordan et al. Specialist Supportive Clinical Management (SSCM) is a psychotherapy with Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, Australia, University of Sydney InsideOut Institute, Camperdown, NSW, Australia, School of Psychology, Western Sydney University, Penrith, Australia, Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, 2560, Australia, You can also search for this author in Miller WR. J Eat Disord. Behavioral Neurobiology of Eating Disorders;6:59-79. doi: 10.1007/7854_2010_78. Conceptualising specialist supportive clinical management SSCM has a specific view about transference and negative transference in the therapeutic relationship. [6]. It is less prescriptive than other manualised therapies and therefore could be offered to people more than once, building hopefulness. Dobrescu SR, Dinkler L, Gillberg C, Rstam M, Gillberg C, Wentz E. Anorexia nervosa: 30-year outcome. Psychotherapy. 2021;42(8):70919. official website and that any information you provide is encrypted In the delivery of SSCM, the therapist themselves also need to have capacity to tolerate its relatively less structured and uncertain nature [37] and discharge themselves from the role of expert, be comfortable within a directional but flexible therapy stance [38] and bring creativity in what could be framed as the art of psychotherapy.
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