Treatment approach

YOUR INITIAL ASSESSMENT

Psychology assessment

The aim of your initial assessment appointment with one of our registered Psychologists (up to 90-minutes) is to understand your current challenges and their context, together with relevant background factors. This extended appointment allows for an in depth assessment of eating difficulties and consideration of relevant diagnoses, in addition to giving time for you & your psychologist to determine whether there is a “good fit” for ongoing treatment/therapy.

Personalised treatment planning takes place following completion of the assessment. This process allows your Psychologist to have a full understanding of your challenges, so that treatment recommendations can be tailored to your unique situation.

Please arrive about 5 minutes early to complete a personal details form in the waiting room. Typically, you will be emailed some online clinical questionnaires to complete before your first appointment, to give your psychologist a broad snapshot of your current situation.

Psychiatry assessment

An initial assessment appointment with our Psychiatrist is indicated for those with more complex mental health concerns, and/or those where medication may be indicated as part of your treatment plan. A 60-90 minute initial consultation allows your Psychiatrist to assess & consider diagnostic clarification, medical risk management (including re-feeding and comorbidity oversight), psychopharmacological treatment, and integration of neurophysiology and neuropsychiatry into your care as needed.

Liaison with your treating psychologist (and any other clinical team members) is standard, supporting a multidisciplinary approach within your care team. Ongoing follow-ups including medication review are arranged on an as-needs basis.

Specialist medical assessment

A consultation with our eating disorder specialist GP or Paediatrician (Wellington only) has a specific focus on the multiple physical risks and symptoms of an eating disorder, including those that may be overlooked by a non-specialist doctor. Any eating disorder in any sized body can pose an acute risk to your physical health and have potential long-term consequences for growth, fertility, bone and brain health. A specialist medical appointment provides an opportunity to consult with a doctor of many years' experience (with both general practice and eating disorders), to help determine and manage these physical impacts.

A 60 minute initial appointment allows space to compassionately assess these medical parameters in depth and without time pressure, and discuss any concerns or questions you may have about your physical health. Following the initial assessment, you have the option of continuing eating disorder medical monitoring with our GP or Paediatrician (30 or 15 minute follow-ups), or keeping your care with your usual GP.

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ONGOING PSYCHOLOGICAL TREATMENT FOR EATING DISORDERS

We provide evidence-based treatment for the full range of eating/weight/shape concerns across all ages & stages of life: 

• Bulimia Nervosa

• Anorexia Nervosa

• Binge eating disorder

• Purging disorder

• Orthorexia

• Body image/body confidence concerns

• “Subthreshold” or mild/early cases of disordered eating (EDNOS/OFSED)

• Chronic dieting or weight fluctuations

• Fussy eating (typically in childhood)

• Avoidant-restrictive food intake disorder (ARFID- clinically significant fussy eating)

  Eating disorder treatment for adults (18+)

Therapy sessions with our registered psychologists are 50-60 minutes long. We draw heavily on evidence-based psychological interventions (or therapies) when planning individual treatment. These are treatments that have strong evidence for their effectiveness from high quality research trials involving people with eating disorders, anxiety, or mood concerns from around the world.

In many cases, a client may be a good fit to sit within one specific treatment framework, such as cognitive behavioural therapy-enhanced for eating disorders (CBT-E), or a specialist therapy for anorexia nervosa (e.g. MANTRA/SSCM). In other cases, your Psychologist may decide to additionally draw from a number of complimentary approaches including dialectic behaviour therapy (DBT), motivational enhancement therapy (MET), and acceptance & commitment therapy (ACT) to enhance your treatment plan.

We liaise closely was appropriate with other in-house community-based professionals (e.g. endocrinologists or psychiatrists) involved in your care.

We are fortunate to have an in-house dietitian with specialist training in working with eating disorders as part of our team. The addition of dietetic work may be recommended alongside psychology sessions - this can be discussed with your Psychologist.

Eating disorder treatment for children/adolescents/teens

With children & adolescents, the family (parents/guardians) are typically a key part of the treatment team, and fully engaged in assessment & treatment delivery. With younger children, parents are typically in session with their child.

With adolescents & teens, we have two main approaches for eating disorder treatment depending on the current difficulties. Our typical approach is working either simultaneously or in tandem with the young person and their parents.

Maudsley family therapy (FT-AN, sometimes called Maudsley FBT) is a well established treatment model that harnesses the strength of the family system to support recovery from anorexia nervosa. This involves working with all members of the family together in session, supporting parents to support their child toward appropriate nutritional intake and weight restoration/stabilisation, in order to achieve physical recovery through behaviour change.

Adolescent & Parent Treatment (APT) is an emerging treatment model that brings together the research evidence-base from both family therapy and individual therapy, to support the young person to recover physically & psychologically from the eating disorder. This involves
1- parent work to support re-feeding the adolescent at home (as in Maudsley family therapy, plus optional dietetic support)
2- individual psychology work with the adolescent/teen, to support distress & address underlying psychological difficulties, and
3- family work, to bring together the parent-focussed and adolescent-focussed elements of treatment

Nurture Psychology is the official provider (& trainer) of APT in New Zealand. You can read more about APT in an academic journal article co-authored by our Clinical Director - please click here.

In some cases with older teens, we may work primarily on an individual therapy basis (as with adults). In this model, there is typically still a role for parent/s, including being regularly looped in on treatment focus & progress.

As with adult cases, all treatment planning involves evidence-based treatment models, and is also individually tailored to the young person & their family. Details of the approach recommended for your family/young person are discussed following completion of the initial assessment appointment.

Please note that due to the constraints of private practice, we are unable to see clients that are high medical risk (including being at a very low body weight), are engaging in notable self-harm, or have current suicidal ideation. 

In this instance, please contact your GP or the hospital emergency department for support.

TREATMENT FOR ANXIETY & MOOD CONCERNS

Alongside our focus on eating disorders, we also offer evidence-based treatment for the following mental health challenges (either in the context of eating disorder treatment, or as standalone treatment):

• Anxiety & anxiety disorders, such as:

• Generalised anxiety

• Social anxiety

• Health anxiety

• Clinical perfectionism

• Specific phobias

• Persistent worry & stress

• Trauma

• Depression, low mood & other mood disorders

  Clients can vary considerably in terms of their needs when seeking psychological support for anxiety and mood disorders. As detailed above, we would start with a comprehensive assessment of your current difficulties, so that a personalised treatment plan can be tailored to your needs.

  Treatment will be most likely based in Cognitive Behavioural Therapy (CBT) as it is the leading evidence-based treatment for anxiety and mood concerns. Depending on your situation, your psychologist may draw from “third-wave” evidence-based therapies such as Acceptance & Commitment Therapy (ACT), and dialectic behaviour therapy (DBT).