Transitioning from Child & Adolescent Eating Disorder Services to Adult Eating Disorder Services is known to be a challenging time for both patients and their families.
But now, with the social distancing measures in place due to COVID 19, patients and their families are facing increased pressure, at home, under ‘lockdown’.
Our clinical practice continues, with our therapists hosting sessions via encrypted video conferencing technology, and we are hearing lots of the same concerns from both young people and their parents.
So today, we would like to talk a little around this subject. We’d like to offer our professional guidance to you if you’re going through this stage at home, or if you’re currently supporting a loved one transitioning from Child & Adolescent Eating Disorder Services to Adult Eating Disorder Services.
Why is the transition from Child & Adolescent Eating Disorder Services to Adult Eating Disorder Services so challenging?
Transitioning from Child & Adolescent Eating Disorder Services to Adult Eating Disorder Services is particularly tricky as their approaches can be very different. So first of all, let’s cover some of the main changes that are likely to be experienced during this transitional step.
- In Child & Adolescent Services, the patient’s parent or carer is involved in every stage of treatment, from the initial assessment, through to making and attending appointments, setting routines and boundaries at home, and preparing meals. In most cases, when the patient reaches 18 years of age, the primary responsibility for recovery switches from the family to the patient themselves.
- Child & Adolescent Eating Disorder Services are well resourced – the level of support can often feel very different when a patient steps into Adult Eating Disorder Services.
- When a patient approaches their 18th birthday, if they decide – with their treating team – that they still require support, a detailed referral letter will be sent to the appropriate Adult Service. The service will get in touch with the patient and their care will be transferred to the Adult Eating Disorder Service. Patients can often feel angry and frustrated at this stage as it is perceived as ‘starting over’. They will have to complete a new initial assessment, build relationships with new therapists and get used to the differences in the way the services are delivered. Unfortunately, these frustrations can often manifest as unwillingness to engage in treatment, but they are really just normal responses during this stressful transition.
How is COVID 19 impacting patients transitioning from Child & Adolescent Eating Disorder Services?
Ordinarily, outside of the global pandemic that’s upon us, there would be another side of the coin. These young patients would be transitioning into a new and exciting phase of their lives, perhaps leaving home to go to university, going on a gap year or embarking on the first stage of their career. Whatever path it may be, life and its opportunities allow young people to move forward with their lives and make their eating disorder less of a priority. This vital time enables a moving away from an identity so entrenched in an eating disorder, to one that is robust, healthy, and filled with life enhancing activities and experiences.
However, we are speaking with young patients who – instead of being at university or travelling the world on their gap year – are now living back at home with mum and dad during the COVID 19 lockdown. They feel demotivated, a sense of loss and unfairness.
As we are unable to go outside and go about our daily lives, patients are struggling with feeling more sedentary. The young people we are speaking with are concerned about how this might impact their weight and they may be more likely to turn back to unhealthy habits to control this.
Patients who are progressing well with therapy are typically rewarded with more independence over their daily routine, their eating habits and time spent socialising with their peers. This functions as additional motivation to recover and return to normal life. However, as is the case for all of us, our movement is currently heavily restricted by the COVID 19 lockdown and these things are not possible.
The way we currently live our lives has changed beyond recognition. COVID 19 has stripped away our normal day-to-day routines and we’ve been forced to figure out a ‘new normal’. This means that young people are now living in close proximity with their families during a critical stage of their recovery.
Supporting your transition from Child & Adolescent Eating Disorder Services during COVID 19
If you are struggling during this transitional phase of your eating disorder, or are a parent or carer concerned as to how to help a loved one at this time, please let us offer you some support.
- Crucially, don’t feel that there is a right or wrong way to feel right now. We are all going to face difficult emotions, but don’t feel as though you should have all the answers. It’s ok to feel these emotions. Share your emotions, take the time to listen and just sit with those emotions rather than feel you need to remedy them somehow. It is important not to put any additional strain on ourselves, now more than ever. Be kind to yourself and to others.
- Use the people around you as resources. Your family and friends have been on this journey with you. They will know the signs of when things are becoming more difficult and will have ideas about what has helped in the past. They are there to listen; you do not have to do this on your own.
- Go back to basics – create a new daily routine including mealtimes and activities. Make sure that this includes activities that will give you a sense of enjoyment and achievement and tasks that allow you to be connected to others.
- Why not try something new? We understand the reluctance to try new things due to possible judgement from peers, or the fear of not being ‘good enough’, but with social distancing, it’s up to you what you share with others (for example on social media) and you have more time and space to do something just for yourself. With time on your hands and no fear of judgement, now is the perfect time to try! And persevere! You never know if you like something the first time you try it. The newness and the novelty of the activity often get in the way. Our advice is to give it a go at least three times to find out if you enjoy it.
How to support a loved one transitioning from Child & Adolescent Eating Disorder Services during COVID 19
As a parent or carer, let us remind you how much you know, and that you know best how to support your child. Stick to what you know works best. Be encouraging and help to provide that all important routine. Take a walk together, play with the dog, look for healthy distractions.
Being in lockdown at home does create a contained environment from which you – as parents and carers – can spot the signs of old habits striking up again and step in quickly, implementing the skills and knowledge you have learnt to be able to support your child.
It’s now become a cliché, but we really are all in this together, and quite often, a shared experience can bring people closer. We hope you are doing ok and that this post has offered you some reassurance. Should you wish to speak with one of our specialist therapists, please do not hesitate to get in touch.
Take care and stay safe.
Dr Melissa Lotmore
