Exploring Skills for Carers Workshop Overview

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This workshop focuses on providing coaching support for carers facing various challenging situations in caring for loved ones with eating disorders. It covers carer goals, Nexus early intervention programs, gaining insight, understanding roles, communication skills like motivational interviewing, and using OARS techniques. The program aims to empower carers with strategies to support their loved ones and take care of themselves during the recovery journey.

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EXPLORING SKILLS FOR CARERS Alice Matthews & Suzanne McCulloch 19thMarch 2024

WITHIN THIS WORKSHOP Learn about our carer coaching programmeNexus Nexus Explore skills for carers

COACHING SUPPORT Carers that refer into our Nexus Programme face differing and challenging situations. The nature of the relationship with their loved one, family dynamics, caring responsibilities, comorbidities, and the Eating disorder vary

CARER GOALS

NEXUS Early intervention Anorexia Nervosa 1-1 Coaching support for adult carers of a loved one (13+) Binge Eating Disorder with disordered eating. Bulimia Nervosa OSFED A 12-week programme. Neuro divergence 12 weekly 40-minute telephone calls. Comorbidities Skills Based caring for a Loved One with an Eating Disorder The new Maudsley method.

NEXUS Gain a stronger insight into their loved ones eating disorder. Understand their role within the loved one's journey to recovery. Provide a safe space to talk openly about their situation, share their emotions and look for supportive strategies. Gain strategies to help them support their loved one, and take care of themselves, whilst living with an eating disorder. The ED voice Boundaries Stages of change & transitions Coaching skills Collaborative goal-setting Mistakes are a treasure Caring styles Accommodating & enabling Communication Self care strategies

SKILLS FOR CARERS Motivational Interviewing Animal analogies OARS A series of animal metaphors An important communication skill. Explains how automatic reactions can be Reflective and mindful conversations. unhelpful. Can be used to gain more information to May be the carer's default way of coping with understand any ambivalence in change. stress or part of an individual's natural Carers can then continue to help nudge their temperament. loved ones in the direction of considering change.

OARS O Open questions pen questions Skilful questioning style. Ask open questions. Not short-answer, yes/no, or rhetorical questions. A Affirmations: ffirmations: To build confidence, motivation & ability to change. Affirm the person. Comment positively on effort & intention. Statements & gestures that recognise EDI s strengths. Acknowledge behaviours that lead in the direction of positive change, no matter how big or small. Must be genuine and congruent.

OARS R Reflections eflections Non-judgemental listening style developing empathy. Reflect on what the person is saying: active listening . Important to clarify what you heard is what was being said. Interest in what the person has to say and respect for the person s point of view. Repeating or rephrasing: Making a restatement in which the speaker s meaning is inferred. Reflection of feeling: Emphasising emotional aspects of communication through feeling statements. This is the deepest form of listening. S Summary ummary Demonstrating your understanding and next steps. Collecting what the person has been saying and offering it back in a basket.S Helps to ensure clear communication between the speaker and listener. If possible, schedule the next conversation so that the Edi feels that you are really interested.

ANIMAL ANALOGIES Sufferer: I just get so frustrated with you all ...always nagging on about eat this, eat that... I want to tell you once and for all, Kangaroo Kangaroo there is absolutely nothing at all wrong with me so can both just get off my back! Expressed Emotion: Overprotection Overprotection Puts Edi in pouch, protect until better Carer: warm Ok we are sorry, why don t I go to the safe supermarket, and I will cook you that protecting meal you like. loving But... But... Infantilising Suffocates growth Prevents independence & mastery of challenges for self-confidence Gives message world is dangerous

Rhino Rhino Sufferer: Expressed Emotion: Over directedness Over directedness I just get so frustrated with you all ...always nagging on about eat this, eat that... I want to tell you once and for Shout, try to control and win ED arguments. all, there is absolutely nothing at all wrong with me so can both just get off my back! Strong Loving Wants to make them see sense Carer: We get frustrated with you, and we wouldn t have to nag if you just ate But... But... what we gave you but you can t so there is something wrong with you! Edi feels upset Can t turn to carer for support Arguing gives ED thoughts credence Chance to argue for ED counter argument I won t give in

Jellyfish Jellyfish Sufferer: I just get so frustrated with you all ...always nagging on Expressed Emotion: Transparent Emotional Response Transparent Emotional Response about eat this, eat that... I want to tell you once and for Overtly distressed, depressed, anxious, irritable & angry all, there is absolutely nothing at all wrong with me so can Weepy, tearful both just get off my back! Shows compassion, love Carer: But... But... Well, you are making me so upset, I Edi upset at hurting loved ones am just trying to get you better, but you are making me ill. I need you to Reduces self-esteem see what you are doing Avoids telling truth for fear of hurting others Creates a feeling of hopelessness

Ostrich Ostrich Sufferer: I just get so frustrated with you all ...always nagging on Expressed Emotion: Avoidance Avoidance about eat this, eat that... I want to tell you once and for Avoiding seeing, thinking & dealing with problem. all, there is absolutely nothing at all wrong with me so can both just get off my back! Head in the sand the hospital will sort it out Avoids getting over involved/emotional ED talk doesn t dominate Carer: Avoids arguments Ok if you say there is nothing wrong then I believe you. We will back off; we re hoping this is just a phase you But... But... are going through. Edi feels problems un-noticed unloved Can't turn to carer for support Carer role-modelling emotional avoidance

Dolphin Dolphin Sufferer: I just get so frustrated with you all ...always nagging on Imagine Edi is at sea and the eating disorder identity is their about eat this, eat that... I want to tell you once and for life vest. They are unwilling to give up the safety of this life all, there is absolutely nothing at all wrong with me so can vest while treading water in the sea of their eating disorder. both just get off my back! You are the dolphin, nudging them to safety, Just enough balance and direction An optimal way of helping someone with an eating disorder is Carer: to gently nudge them along. I can imagine you re feeling pretty Swimming alongside with encouragement angry, especially if you believe so strongly that there's nothing at all Swimming ahead, leading the way wrong with your eating and that we're always on your back Quietly swimming behind

OUTCOMES 100% of carers reported improvements in their understanding of factors and skills that can aid their loved ones recovery 92% of carers felt less impacted by their loved ones ED at the end of Nexus