What is the Enhanced Care Pathway?

The Enhanced Care Pathway (ECP) is a new, intensive service within the Oxfordshire CAMHS Eating Disorder team.

Most young people respond to our community interventions; however, some will need more intensive treatment, most commonly at the start of their journey towards recovery. The ECP will also be used as a ‘step-down’ for people being discharged from inpatient admission.

Who is it for?

• Have a restrictive type Eating Disorder (Anorexia Nervosa).
• Are at risk of admission.
• Have difficulty with regular eating or restoring weight.
• Are being discharged from inpatient admission and may need extra support.
• Are able to benefit from a family-based approach (individual support is likely to be available in addition).
• Are age <17years and 9 months (over this age considered case by case discussion).

Aims of the ECP

The ECP will intensify community treatment and aims to:

• Offer a 6-week intensive intervention to those who need extra support. This may be extended by a further 3 weeks if clinically indicated at a 6-week review.
• Prevent admission to paediatric and psychiatric inpatient beds.
• Improve treatment outcomes.
• Support quicker discharges.
• Reduce the referrals to crisis and home treatment interventions.

How was it developed

The service was developed after considering other intensive treatment models both in the UK and internationally. The Oxford model aims to offer an evidence-based individualised treatment package delivered by an experienced team consisting of a support worker, a systemic practitioner, a clinical psychologist and an assistant psychologist.

All ECP clinicians also work in the wider Eating Disorder Team which makes ongoing communication and transfer back to the team at the end of the ECP intervention much easier. We are a small team and hope to provide as much continuity and consistency for the families we work with as possible.

How does it work

You will be referred to the ECP by a member of your care team if they feel you need intensive support.

You will be offered an assessment with the ECP team which will allow us to determine the level of support needed and assess family functioning and parental capacity. We will ask you to complete a range of measures at the start and end of treatment.

Before treatment, a collaborative care plan will be agreed between you and the team in order to ensure motivation to recover and to identify personal goals.

During treatment under the intensive team, you will be offered a minimum of 2 contacts per week which may consist of:

• Family Therapy for Anorexia Nervosa (FT-AN)
• Medical monitoring
• Dietetic Input
• Dialectical Behavioural Therapy
• Distress Tolerance
• Other Psychological interventions (ACT-based, CFT-based and motivational interviewing)

The team will also offer a review at 3 weeks and 6 weeks during the course of intensive treatment.

Meet the team

Jane Liquorish, Enhanced Care Pathway Lead

Josephine Harris, Clinical Psychologist

Elisa Arnfield, Assistant Clinical Psychologist

Giulia Pulichino, Senior Support Worker