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Engaging in and Achieving Therapeutic (E.A.T) Meal Support Training

Module 3

Ending well: supporting patients following a meal

This module is about supporting patients after a meal, the final ‘B’ of meal support: Be prepared to try again. Supporting patients emotionally and behaviourally after a meal is just as important, if not more so than during the meal.

3.1

Module Aims

  • Understand the importance of supporting patients after a meal and how you can do this.
  • Learn how to rebuild a therapeutic relationship after a difficult meal.

3.2

Compensatory behaviours

Compensatory behaviours may occur directly after a meal, or they may be delayed. Compensatory behaviours are a result of anxiety associated with real or perceived changes in body weight or shape (or the avoidance of this occurring). Patients describe compensatory behaviours as “what my eating disorder tells me to do to reverse the damage of my eating”.

This could include self-induced vomiting (known as purging), or excessive exercise.

3.3

Learning from difficult meals

A therapeutic relationship is built on mutual trust and respect between the patient and healthcare staff. It involves open and honest communication, where the patient feels safe to express their thoughts, feelings, and challenges without fear of judgment. This relationship fosters a collaborative approach to treatment, where both parties work together to set goals, overcome obstacles, and achieve recovery.

3.4

Rebuild a therapeutic relationship

We have seen in the previous module that not every meal will be perfect and that’s okay. The next video will demonstrate how to rebuild a therapeutic relationship after a difficult meal. Observe how the clinician works with the patient to create an individualised care plan. Person-centred care is vital to treatment.

Key learning points to take away from the video:

  • Importance of repairing the therapeutic relationship, acknowledging and validating the patient’s difficulties.
  • The clinician to explore whether they could have done anything differently – have they made any mistakes?
  • Creating a plan and communicating this plan to the rest of the team.
  • Encouraging patient to continue to challenge particular ‘fear foods’

3.5

Quote from Expert by Experience:

“The thing that just encompasses everything is – BE EMPATHETIC. Just try your hardest to understand what that person’s going through, and I know that’s really hard. If you’ve never been through it yourself, it seems really weird. Really alien, because why would you be afraid of food? If you can’t understand what it’s like to be afraid of food, try and relate it to an experience you’ve had when you’ve been scared, and someone’s been trying to make you do the one thing that your brain is screaming at you not to do. And finally, treat each patient like a person and not like an illness, and separate the person from the illness.”

3.6

End of Module questions:

Module 3 Questions: Following a meal
1. Why is therapeutic support following meals important for patients? (select two)
Correct, therapeutic support after a meal is important for these reasons: to provide emotional support and reassurance at a time when patients may be feeling anxious or guilty; and to distract patients and ensure that they do not engage in compensatory behaviours.
Incorrect, just because patients have finished the meal does not mean that they are feeling okay. Some patients say that this is the hardest time, they may be feeling guilt or shame. Support after meals is important for recovery.
2. What do ALL patients find helpful following the meal?
Correct, although many of these options are helpful, it’s important to collaboratively create an individual care plan as different patients may find different approaches helpful after a meal.
Incorrect, although this may be helpful for some patients, it is important to highlight that it may not be the most effective support for ALL patients. It is important to work collaboratively with the patient to find out what works best for them.
3. What is needed to establish a therapeutic relationship for mealtime support?
Correct, these are the important factors to establish a therapeutic relationship for meal support: building trust, understanding and collaboration between the patient and the staff member. It’s important to highlight that this may take time and may need to be built outside of meal support – remember the 4 B’s.
a) Incorrect, it’s important to stick to the plan, the amount and type of food prescribed is not modifiable at meal support, but how we support people is.
b) Incorrect, it is appropriate to talk to patients during meal support. Some normal conversation can be helpful to provide distraction.

Complete Training

Summary