274 Treating Eating Disorders
psychoanalytic psychotherapy. This focuses on the role of childhood
relationships and the function of symptoms within the context of the
therapeutic alliance between therapist and patient. Likewise, a cognitive
formulation translates into CBT with its emphasis on changing behavior
through self-monitoring and feedback and changing cognitions through
cognitive restructuring. Similarly, a family systems analysis results in
family therapy, which emphasizes the symbolic role of symptoms and
family dynamics. However, not all theories of etiology result in treatment.
Furthermore, most treatments involve a combination of treatment appro-
aches. In addition, while the above interventions are mainly carried out
on an outpatient basis, some patients require inpatient treatment. This focuses
on the development of an alliance between patient and nurse and aims to
restore weight. Some patients will, however, be exposed to a range of
therapies as their problem persists. For example, given the high relapse
rates and the prolonged nature of the condition some patients will have
both outpatient and inpatient treatments, will receive both individual and
group therapy, and will also become involved in self-help groups. At times
therapy will be given as a means to keep the patient alive without any
real hope of a complete cure. At other times the treatment approach will
appear to be the one which has been given to the right patient at the right
time and they will recover. Most patients therefore receive an integrated
approach to their problem. For some this may be integrated in terms of
the ranges of treatments given at any one time, but many will receive an
integration of different treatments given across different times.