Narrative Therapy, Eating Disorders and Groups: Enhancing Outcomes in Rural NSW

Abstract

The present paper reports on a study conducted with seven women who identified themselves as experiencing depression as well as an eating disorder and who live in a rural region of northern New South Wales. Self-referred, the women participated in a weekly group for 10 weeks, with a mixture of topics, conducted within a narrative therapy framework. A comparison of pre- and post-group tests demonstrated a reduction in depression scores and eating disorder risk. All women reported a change in daily practices, together with less self-criticism. These findings were supported by a post-group evaluation survey that revealed that externalisation of, and disengagement from, the eating disorder strongly assisted the women to make changes in their daily practices. Although preliminary and short term, the outcomes of the present study indicate that group work conducted within a narrative therapy framework may result in positive changes for women entangled with depression and an eating disorder.

Keywords:

• Eating Disorder
• Group Work
• Narrative Therapy

The authors particularly thank the women who participated in the group. The authors also thank the Northern Rivers University Department of Rural Health (UDRH) under the Commonwealth Department of Health and Ageing Strategy for Primary Health Care Research, Evaluation & Development, which provided funds and support for the dissemination of project results, as well as the Northern Rivers Division of General Practice, who provided the funds for the group.

Notes

1. Motivational enhancement therapy holds the view that people will move through different stages of motivation to make changes. It proposes that there are particular therapeutic strategies or responses to clients at different levels of motivation to optimise the movement towards change. Treasure and Schmidt (1993) suggest a number of exercises in their book that clients troubled by eating disorders could engage in to assist them to move to the next stage of motivation for change.

2. Rick Kausman's book explores a number of principles he developed that can be consciously applied if a person wants to develop a healthier relationship with food.

3. This is a resource book filled with ideas for working with women in groups who want to reclaim their lives from the influence of eating disorders.

4. Spirit-nourishing activities were active practices the women took up as homework. These included exploring the ideas of embracing risk, embracing choice, appreciating body parts for their function (e.g. my legs get me around all day long, what would I do without them?), identifying how they (the women) wanted to be in life, engaging in practices that had a spiritual connection. These ideas were taken from Maisel et al. (2004), Kausman (1998) and Black (2003).

Additional information

Notes on contributors

Mim Weber

Mim Weber (BA, Bsoc Admin), Coordinator of the Northern Rivers Eating Disorders Service in Lismore, is undertaking a PhD and this study is a part of the research she is undertaking

Kierrynn Davis

Kierrynn Davis (PhD), senior lecturer in the school of Nursing and Health Care Practices, Southern Cross University, supervised the research that is the subject of this paper

Lisa McPhie

Lisa McPhie (BSocWk), conducts a part time private practice