All referrals to the Crescent Clinic Eating Disorders Unit should undergo an initial assessment consultation in order for it to be determined at what level treatment would best be provided. The assessment consultation will be provided by one of the team psychologists using internationally recognised and standardised assessment techniques to determine the most suitable mode of treatment that is required in order to bring about an early remission. Whereas many facilities are overly eager to admit patients into inpatient treatment, we have always followed the well documented and researched notion that inpatient admission should only be reserved as a final resort when either outpatient treatment has failed or the severity of illness suggests that inpatient treatment is immediately indicated.
The initial assessment consultation will usually not require more than a single 50-minute consultation. For adolescent and children, it is strongly advisable for parents to attend the initial consultation, but space will be provided for the patient to discuss matters one-on-one with the psychologist if some confidentiality is required to discuss sensitive issues. The consultation will explore the onset and course of the eating disorder, as well as any other difficulties that are being experienced by the sufferer or members within the family. Most importantly, the assessment consultation will be used to gather as much information as is necessary in order to determine an interim therapeutic plan to ensure that treatment may start immediately.
A separate dietetic assessment is provided by one of the specialist registered dieticians on our team. This assessment should preferably follow the psychologist’s assessment consultation, but the order is not essential. This assessment will focus more exclusively on the onset and history of the eating disorder, the severity of the disordered eating, and a weight and dieting history. Expectations for recovery will be discuss, and an initial meal plan might be provided once the dietician has explained the dietetic philosophy of the unit.
A psychiatric assessment will be recommended, where indicated. If admission to the inpatient programme is made, then a psychiatric assessment will be automatically provided by the unit’s psychiatrist or the patient’s existing psychiatrist if he/she will be retained as the treating psychiatrist during admission.
In circumstances where the prospective inpatient’s eating disorder includes significant medical complications, a physician’s report will be required by the team to ensure that the patient’s physical condition is safe enough to indicate treatment in a psychiatric unt, as opposed to admission to a medical facility.
The “Eating Disorders Assessment Questionnaire” (EDAQ) has been developed and updated over the years by the unit director, Graham Alexander, as a means by which to methodically cover all the relevant details pertaining to the eating disorder and other psychological and/or medical problems. Completion of the EDAQ should not replace the assessment consultation with a team psychologist, but can provide very pertinent additional information to ensure a comprehensive assessment. For prospective patients living too great a distance from Cape Town to attend an assessment consultation in person, the EDAQ has also been designed as a sufficiently exhaustive document to allow the team to make diagnostic decisions and an accurate treatment plan when visiting Cape Town is impractical. The EDAQ can be downloaded as a PDF file from the Downloads (it would make sense to have this word as a link) page.