17 year old wants to stop treatment for anorexia

[Lizzie2110]

My daughter will be 18 in a few months and wants to leave CAMHS (child and adolescent mental health). She has come so far in the past few months but deeply dislikes her nurses (I'm not too keen on them either), she always comes back more upset which creates problems with food but the week or two she doesn't have an appointment, she's fine and eats the recommended amount for her to gain weight, something she really wants to do as she has realised how underweight she was. Her BMI is now over 17 and I think I should point out it was months before we were seen by the service and she had already began to gain weight and feels that they aren't telling her anything she doesn't already know. Sorry for the essay but I don't know what to do!

If she is not going to consent to any treatment and is not on board with any treatment plan then it seems pointless to continue (unless she would benefit from being sectioned and it sounds like that would not be appropriate).

Can you monitor their treatment plan yourself and have an agreement with your daughter that if she sticks to targets and is seen to managing her illness well then she can opt out after x amount of weeks,etc.

She feels she could continue with her recovery without them but is still seeing a dietitian who helps her with her diet. She has a great support network of friends and family. Once she gets to their "ideal" weight can she just leave without being referred anywhere else i.e adult mental health?

I think she can leave and if they have no immediate concerns then she can rely on a normal referral from her GP if necessary as the GP will still have records.

They will rely on her as an adult then to seek help if she needs it.

Sounds like she is doing well but I too would be cautious about absence of formal support. She will have to rely on her network to keep her on track with her consent (otherwise it becomes nagging and over protective).

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i would speak to camhs, it could be she doesnt like them as they cant be controled like others. The eating disorder is a control thing and therefore if she cant control them = dont like them.

She might find adult services to be of more help now, but yes, why not take a break its best not to be too black and white about it. She can get help as an adult in the future. Referral to adult (or for CBT which might be worth some thought) would probably take a while. If she presents a good rationale for discharge, and identifies the factors that would show she needed to seek support in the future, and you support it, then it can be part of a planned discharge. I would suggest - consider continued monitoring of weight periodically and bloods by GP; for her to identify goals around developing her life outside the eating disorder (assuming this is an issue...it is for many sufferers); watch out for transitions such as going to college etc or finding a job which can trigger a relapse...prepare for these well and supportively. A note of caution - psychological treatment for an ED is generally likely to increase distress, so coming away from sessions more upset is not necessarily a bad thing, although it may feel counter productive. If she can increase her weight and move on with life, then that's great, and I would suggest she gives it a go, but if it keeps coming back to bite her on the backside because she is avoiding addressing the emotional triggers, then she may have to do more work in the future.

We too found that by the time we saw CAHMS my DD2 was already improving by herself..and the dietician made her worse not better;/. Decided to just see how it went and while we have had ups and downs my DD2 has done amazingly well.. not that I think EDS always go away, but they can recede and normal life resume:)

It sounds as though your DD's BMI is in a good place now and hopefully with that her insight has returned.. maybe time to let her try go it alone with the proviso that she seeks help if she/you notice her slipping.

I'm now in the horrid beginning place with DD1..the last person I would ever thought would develop anorexia..she was fine until a hideous first year at Uni (homesick, bullying) and is coming home with a BMI of 14 :(:( She became anorexic through stress rather than thro wanting to be thin (has always been very slim) but is now in its hideous grip and at 19 we have to access adult services which I'm hoping will be better... I know we can beat it but can't believe both my beloved girls have suffered:(

Hope it goes well for your Dd and that she continues to do well:):)