Psychology Assignment Concerning Increasing Cases Of Anorexia Nervosa Female Students

Question

Task: Case Study – - Preparation and design of a behaviour change group program Scenario: A very large, suburban high school has identified a concerning upward trend in the number of female students presenting to the school counsellors with eating disorders. A number of cases of anorexia nervosa have been diagnosed and some students are undiagnosed but have concerning eating problems. The school counselling department has been able to attain a budget to address the issue. Your team has been approached to design a 10-week psychoeducation program (one term) that voluntary participants can attend once a week at lunch times. (1500 WORDS)

INSTRUCTION:
a) Describe and formulate the processes required to facilitate agreed change outcomes e) Apply behavioural techniques to support behaviour change f) Develop a process for program monitoring, recording and intervention, according to individual client needs. Context: Common life-problems are often treated very effectively in a group setting. Groups can be very effective in terms of resources (financial limitations; therapist to client ratio; etc.) and in terms of sustaining change and relapse prevention (participants can be supportive, not just the therapist, and can continue after the group itself has finished). When people with like-issues join in a safe place to deal with their problems, the group itself can be a significant element in ensuring members achieve their goals, providing a number of curative factors, including universality (Yalom, 1980). This assignment requires students to design a group to be rolled out over a set number of weeks to treat a pre-determined problem. Please see instructions about the scenarios.

Instructions: The purpose of this assessment activity is to identify a model, (say REBT, CBT, DBT or ACT, etc.) that would suit a specific client presentation and then apply this to a time-limited group setting that deals with the broad issues identified

1. You must briefly describe the generic problem being treated. This would include definitions supported by references.
2. Identify two models that could work, then, supported by research, justify why one was chosen over the other.
3. Develop a program that treats the issue based on the model selected.
a. Elaborate on the theory used to develop your program to underpin your choice.
b. Design and describe the course. This would include the target audience and the purpose (i.e. what problem is being addressed by the group).
c. Describe, in sequence, the areas to be covered throughout the program. This needs to follow a building or deepening of concepts that lead to supported
d. Describe structured exercises and why they would be used. Participants may be required to do homework, keep a journal etc.;
e. Discuss how the group itself can be used as part of the change process.
f. Finally, students must prepare potential participants for the end of the group and include relapse prevention measures

Answer

Introduction
Anorexia nervosa has been considered as one of the chronic psychological burdens to the human world that can invite several detrimental effects for individuals. By considering the seriousness of these eating disorders, this psychology assignmentis going to design a psychoeducation program that consists of 10 weeks. This program aims to help the female student to maintain a healthy lifestyle and promotes healthy eating habits. By participating in their program at lunchtime, the female students of this suburban high school can come out concerning psychological problems through counselling.

Description of the generic problems
As per Bhandari (2020), Anorexia nervosa can be termed as the life-threatening psychological disorder that is categorised by excessive weight loss and eating disorder. The amount of weight loss can result in 15% decrease on actual body mass weight. It has been evident from different research conducted by the US National Library of Medicine National Institute of Health that anorexia nervosa poses the highest mortality rate; it is one of the most common disorders, diagnosed mainly in teenage girls aged between 15 years. Gibson &Mehler (2019) opined that this psychological problem is directly associated with eating disorders that lead to abnormal bodyweight. With the rapid globalisation across the world, people, especially young females, are more prone to crash diets. In order to maintain low body weight, they try to lower the portion of food. This habit tends to bring serious detrimental effects to the body and results in abnormally lower body weights. The key psychological characteristic of these generic problems is associated with the evaluation of body shape and weight. This type of person generally imposes herself to lose bodyweight. Thus, they maintained stringent food restrictions. Even, it has been identified through the journal’s papers published in Pubmed; NICE, anorexia nervosa is also associated with over exercising and extreme physical activity.

Furthermore, some patients often followed self-induced vomiting, misuse of diuretics, laxatives, and slimming medicines to lose body weight. Thus, the International Classification of Diseases (ICD) has mentioned anorexia nervosa as one of the most prevalent psychological disorders in its 10th revision. However, researchers have cited different causes behind these generic problems. The key problems identified by different research papers are developmental challenges, peer pressure, family conflicts, transitions, etc. Sexual abuse, body growth due to the onset of puberty may lead to anorexia nervosa in some cases also (Calugi et al., 2018).

Two models for treating pre-determined problem
Recent research has shown that more than 3.2 million people in the United Kingdom suffer from eating disorders, most prevalent among adolescent girls (Schlegl et al., 2020). Thus, psychotherapists and counsellors have referred to different models of psychotherapy in order to help such patients. Thus, this study will focus on the two most popular psychotherapy models: CBT and DBT. According to Wenzel (2019), Cognitive behavioural therapy (CBT) is one such psychotherapy that is based on cognitive models of mental health illness. This model was developed by one of the renowned psychologists, Beck, in 1964. This model is based on individual behavioural techniques. The hypothesis behind these models illustrates that an individual's behaviours and emotions solely change on the basis of the perspectives of a particular event. In this context, three levels of cognition have been marked in this therapy: core beliefs, negative automatic thoughts, dysfunctional assumptions. Two types of techniques are used in these models. This includes cognitive techniques and behavioural techniques.

Dialectical behaviour therapy (DBT) is another key type of cognitive-behavioural therapy t5hat was developed in the late 1980s by Marsha M. Linehan (McCauley et al., 2018). This particular psychotherapy focuses on the psycho-social aspects instead of only behavioural aspects. The key hypothesis of these models states that individuals will react intensely, and it depends on their emotional situations. The key elements of a DBT model incorporate support-oriented practices, cognitive-based approaches, and collaborative features.

Justification for Cognitive Behavioural Therapymodel
By considering the seriousness of Anorexia nervosa, this study has preferred to evaluate the pros and cons of both CBT and DBT models. It has been evaluated that the CBT models use behavioural techniques. In contrast, the DBT models prefer in psychotherapy seasons, emotional regulations. Anorexia nervosa is one such psychological problem associated with individual behavioural aspects, such as eating disorders. As opined byHurst & Zimmer Gembeck (2019), the application of Cognitive Behavioral Therapy will be most suitable for these ten-week psychoeducational programs. These behavioural techniques have been used over the years to treat multiple common mental health disorders such as depression, panic disorder, anxiety issues; due to the incorporation of multidisciplinary approaches in this model, this psychotherapy has resulted in long-term benefits. Furthermore, another key advantage of this model is cost-effectiveness. Although the initial cost is pretty high, group-based approaches taken in this psychotherapy are considered one of the most cost-effective treatments for the patients.

Development of program
a) Theory
In order to develop an effective psychoeducational program, the study has been referred to the Cognitive Behavioral Therapy model. Moreover, the CBT model underpins Behavioural theory. This theory refers to individual behavioural aspects that the two models influence: Skineerian operant learning and Pavolian classical conditioning. Thus, both models illustrate that before applying any psychotherapy to the patients, it is imperative to study the individual learned behaviours, the changing patterns and the features that govern any modification. The key assumptions of behavioural theory state that individual human behaviour is learned over the years; it cannot be determined by genetic features. However, this learning process can be changed over time and is determined by environmental as well as contextual factors. In order to apply behavioural techniques, the counsellor must recognise that every client is unique and their covert behaviour (thoughts, feelings) can be changed by applying different principles.

b) Description of course
Gibson, Workman &Mehler (2019) suggested that the psychoeducational course will be based on the cBT module. This course has been designed for female students who desire to voluntarily participate in developing a positive mindset about themselves. The course has been designed so that it will help boost the self-esteem and confidence level of the individuals without concern about their body weights. No one is perfect. Thus, individuals must build the capacity to accept themselves confidently without concern about body shape and size.

c) Area to be covered
This psychoeducational course will be designed to cover the area of individual behaviour change. As per Atwood & Friedman (2020), the participants will be encouraged to participate in counselling programs to improve their mental health condition. Thus, participants will be encouraged to introduce themselves to the healthy dietary habits that lead to a healthy body mass index. Apart from this, individuals will be prompted to incorporate some behavioural changes to cope with these psychological disorders.

d) Description of structured exercise
In order to attain the desired objectives to treat the female students suffering from Anorexia nervosa, the following decrease will be conducted by the counsellors.

Week 1 and week 2: Self-talk and self-education: Self-talk will help the counsellor to evaluate the reason behind such extracting disorders. The counsellors will talk to every participant personally to console them about any negative thoughts and experiences.

Week 3: Cognitive reframing:This will help the student change their thought process and eliminate the negative ideas.
Week 4: Exposure therapy:This special therapy will; be utilised in order to help particular respondents confront their fears.
Week 5 to Week 7: Behavioral activation: The counsellors will identify the behaviour that participants generally avoid to cope with their anxiety. This behaviour will be reactivated through activity rescheduling.
Week 8 and Week 9: Anxiety management: The therapist will educate the participants about the rationale behind anxiety and stress management to promote better eating behaviours. They will be guided with realistic stress management strategies.
Week 10: Journaling and roleplaying: In order to promote positive mental health conditions, every participant will be encouraged to practice journaling at least twice a week. This will help them to task their thought process. Some Group activities will be arranged to boost their confidence level to practice social skills.

e) Groups participation in the change process
In order to embrace the change process, different group activities will be conducted during this program. For instance, the participants will be divided into small groups to cook healthy meals (Hurst et al., 2019). In order to encourage them, the counsellor has planned to conduct cooking competitions. This not only encourages them to maintain healthy dietary habits. This also boosts their self-confidence level that tends to reduce peer pressure.

f) Potential participants and preventive plan
Psychotherapist, Paediatrics, Nutritionist to successfully conduct this ten-week psychoeducational programs. According to Hayes & Hofmann (2018), the list of potential participants includes the counsellor. Further, the relapse prevention plan will include the distal risks (family history analysis, social support), coping behavioural plan (self-regulation, cognitive coping). Furthermore, every participant will be encouraged to prepare a Smart action plan before participating in this course to define the objectives and desired outcomes.

Conclusion
Eating disorders are one of the serious psychiatric problems found prevalent among teenage girls. In this case scenario, it has been highlighted that the school counsellor has mostly identified a concerning number of cases of anorexia nervosa among female students. This study has briefly illustrated the course modules, models, and exercises to be followed in the 10-week psychoeducational programs. It can be safely concluded that the active participation of both students and faculty will contribute to the success parameters to treat anorexia nervosa.

References
Atwood, M. E., & Friedman, A. (2020). A systematic review of enhanced cognitive behavioral therapy (CBTE) for eating disorders. International Journal of Eating Disorders, 53(3), 311-330. https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.23206 Bhandari, S. (2020), Anorexia Nervosa. WebMD. https://www.webmd.com/mental-health/eating-disorders/anorexia-nervosa/mental-health-anorexia-nervosa
Calugi, S., Franchini, C., Pivari, S., Conti, M., El Ghoch, M., &Dalle Grave, R. (2018). Anorexia nervosa and childhood sexual abuse: Treatment outcomes of intensive enhanced cognitive behavioural therapy. Psychiatry research, 262, 477-481. https://www.sciencedirect.com/science/article/pii/S016517811730731X
Gibson, D., &Mehler, P. S. (2019). Anorexia nervosa and the immune system—a narrative review. Journal of clinical medicine, 8(11), 1915. https://www.mdpi.com/570000
Gibson, D., Workman, C. &Mehler, P.S. (2019). Medical complications of anorexia nervosa and bulimia nervosa. Psychiatric Clinics, 42(2), pp.263-274.https://www.psych.theclinics.com/article/S0193-953X(19)30014-0/abstract
Hayes, S. C., & Hofmann, S. G. (Eds.). (2018). Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. Psychology assignmentNew Harbinger Publications. https://books.google.com/bookshl=en&lr=&id=J0tHDgAAQBAJ&oi=fnd&pg=PT10&dq=Process+of+CBT+therapy&ots=pQOPV_MEz2&sig=BmdS5Ymlp_Q25C3GVrimJjlNvHE

Hurst, K. & Zimmer Gembeck, M. (2019). Family based treatment with cognitive behavioural therapy for anorexia. Psychology assignmentClinical Psychologist, 23(1), pp.61-70. https://www.tandfonline.com/doi/abs/10.1111/cp.12152 McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., ... & Linehan, M. M. (2018). Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: a randomised clinical trial. JAMA psychiatry, 75(8), 777-785. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2685324

Schlegl, S., Maier, J., Meule, A., &Voderholzer, U. (2020). Eating disorders in times of the COVID 19 pandemic—Results from an online survey of patients with anorexia nervosa. International Journal of Eating Disorders, 53(11), 1791-1800. https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.23374

Wenzel, A. (2019). Cognitive-behavioural therapy for beginners: An experiential learning approach.
Routledge. https://www.taylorfrancis.com/books/mono/10.4324/9781315651958/cognitive-behavioral-therapy-beginners-amy-wenzel