Child and Adolescent Eating Disorder Treatment Clinic at Washington University Child and Adolescent Psychiatry Center

The nature of patient care is interdisciplinary and includes individual, group, and family therapy, treatment of medical comorbidities by their primary care, psychopharmacology
and psychotherapy by a psychiatrist, and meal planning and weight restoration/weight loss by a registered dietitian.

• Fellows will conduct patient and family-centered evaluations of severe Anorexia
  Nervosa, Bulimia Nervosa, ARFID, Binge Eating Disorder and comorbid medical and
  psychiatric disorders.
• Fellows will observe and interpret family relationships and their pertinence to the child’s presenting problems.
• Fellows will appreciate the role of the family in the assessment and treatment of the
  patient, regardless of their age.
• Fellows will produce a differential diagnosis and bio-psycho-social case formulation of psychiatric symptomatology.
• Fellows will become familiar with developmentally appropriate, evidence-based psychopharmacological and psychotherapeutic treatment of severe eating disorders.
• Fellows will understand behavior modification and level systems in treatment.
• Fellows will understand group dynamics and group therapy structure.
• Fellows will plan dispositions to an outpatient or less restrictive care systems.

The fellow will gain medical knowledge through a combination of supervised clinical activities, mandatory divisional didactics, and supervised reading of pertinent related literature.

• The fellow will know the strengths and limitations of the current Diagnostic and Statistical Manual (DSM) of Mental Disorders diagnostic criteria.
• The fellow will understand the developmentally and age-appropriate use of laboratory testing and medical workup.
• The fellow will understand the appropriate use of adjunct medical consultation.
• The fellow will gain familiarity with the evaluation and treatment of common medical
  comorbidities in eating disorders in youth.

In addition to supervised clinical activities and self-initiated and suggested readings, the fellow will participate in supervision, including one-on-one supervision and other divisional supervision, including individual and team supervision.

• The fellow will continue to apprise oneself of current knowledge concerning the
  pathogenesis and etiology of eating disorders by reading and searching scientific literature on specific topics related to eating disorder etiology, pathophysiology, diagnosis, and treatment.
• The fellow will become familiar with the appropriate use of medical and psychological testing in eating disorder patients.
• The fellow will gain experience delivering evidence-based psychotherapies for eating
  disorders, including family and group therapies.
• The fellows will appreciate the historical, cultural, legal, and ethical aspects of eating
  disorder treatment.
• The fellow will engage in guided readings on etiology, epidemiology, and theoretical
  issues. In addition, with supervision, will engage in literature searches to understand
  evidence-based treatments relevant to patient care.
• The fellow will engage in independent literature searches and reviews regarding evidence-based treatments and will also engage in a literature review regarding etiology, epidemiology, and theoretical issues as they apply to patient care.

The fellow will demonstrate sensitivity and compassion to children, adolescents, and young adults affected by serious eating disorders and to their families or their caretakers. The fellows will continue to develop relationships with other professionals, including supervisors, colleagues, students, allied professionals, and/or other professionals in training.

• The fellow will develop intra-professionally by managing adaptively their emotional reactions to severe psychopathology.
• The fellow will demonstrate the ability to function as a cooperative member of a multidisciplinary therapeutic team.
• The fellow will demonstrate a commitment to continued professional development.
• The fellow will manage medical and psychiatric issues independently with the attending supervisor and will also manage their schedules independently by working with staff to schedule intake assessments and patient appointments.
• The fellows will interact with families and outpatient providers to coordinate care and disposition planning and to engage in weekly family contact to provide psychoeducational and family-based psychotherapy techniques.

The fellow will effectively communicate with patients, their families, and all other members of the treatment team.

• The fellow will conduct developmentally appropriate interview techniques, as well as a comprehensive mental status examination.
• The fellow will talk with and obtain a history from patients, family members, and all others involved in the caretaking system of the patient (outside providers, DFS social worker, teacher, etc.).
• The fellow will present cases succinctly and accurately.

• The fellow will understand the roles of other mental health and medical professionals, including psychotherapists, nursing staff, dietitians, educational therapists, and activity (yoga, dance) therapists etc.
• Fellows will appropriately interact with family, other caregivers, and social and legal
  agencies in the management of child/adolescent eating disorders.