On Wednesday, November 12, I traveled to Rockland Jewish Family Services with Dr. Evelyn Attia for her talk about teamwork and the treatment of eating disorders. On our ride from New York City to Rockland County, I thought about what it means to be a “team.” As a longtime athlete, including in college, this is not a new concept to me in the context of sports; I have always defined a team as a group of people that work together towards a common goal. Central to the lessons I learned at Dr. Attia’s talk was that my definition of “team” lends itself well to conceptualizing the treatment of individuals with eating disorders.
At Rockland Jewish Family Services, a variety of professionals arrived for the lecture—therapists, social workers, dietitians, counselors, health educators, pediatricians, and a rabbi. I quickly realized that these are the players on the treatment team. But, is there a head coach? What position does each player play in reaching the goal? What is the goal? And is the goal shared by all team members, including the patient?
I sat with these questions as Senator David Carlucci, chair of the NY State Mental Health Committee greeted us warmly and introduced the morning’s program. He detailed the risks of eating disorders and the importance of early intervention when possible. He proudly acknowledged NY State’s efforts to support comprehensive services by providing funding for the Comprehensive Care Centers for Eating Disorders. The Metropolitan Center, which services Rockland, includes the NY State Psychiatric Institute, NY Presbyterian Hospital and Cohen Children’s Hospital on Long Island, and is overseen by Dr. Attia.
When Dr. Attia began her talk about teamwork, I learned the answers to some of my questions:
Who are the treatment team players?
- Medical Practitioners
- Social Workers
- Registered Dietitians
Who is the head coach?
There is a common misconception that the psychiatrist plays the “head coach” role in the treatment of individuals with eating disorders. While this is, in some cases, true, there are also many instances in which the psychiatrist plays a less central role. Dr. Attia described several cases in which she, as psychiatrist, has not “led” the team because she met with the patient much less often compared to the other team members. This did not mean that her membership on the team was not critical, but rather that it did not make sense for her to be in charge.
Dr. Attia explained that the head coach position may be assigned for any number of reasons: maybe the nutritionist that has seen the patient the most, perhaps the primary medical practitioner that has known the patient since adolescence, or maybe the school therapist that is most trusted by the patient.
No matter who lands as head of the team, this leadership role involves coordinating care amongst team members so that there can be constant communication (and that this responsibility need not fall to the patient or patient’s family). Most importantly, the head coach keeps the team on target, with regular assessment and evaluation of progress towards the identified goal.
What is the goal?
Each player has his or her own job to do, whether that is the dietitian helping the patient learn about adequate nutrition, the medical doctor providing the patient with appropriate medications and/or medical monitoring, or the psychologist or social worker offering psychotherapy. The greater goal of the team is to work together to help the patient normalize their weight and/or eating behaviors, and to stay on a path to recovery.
It is important that the patient’s needs are kept in mind while crafting the team goals. The team must be strong in the decisions they make and form a supportive but firm structure so that the patient does not have to burden him or herself with the difficult decisions. And like any team confronted by a challenging opponent, the treatment team must be creative in its approach to defeat the illness.
Just as I’ve learned from my own experience, the strength of the teamwork mentality makes it a powerful approach. Simply put, we can do more together than on our own. This is especially true in battle against the behavioral, psychological, and physical problems associated with eating disorders. The competition may be tough and the battle long, but a comprehensive game plan by a devoted and varied team of professionals can certainly lead to victory over these conditions.