At Orri, we believe in treating the whole person, not just their diagnosis. In our recent CPD webinar for healthcare professionals, “Occupational Therapy at Orri: A Different and Dynamic Approach,” Service Director Maxine Jones, Head of OT Tegan Rix, and OT Kathrin Gioia explored how occupational therapy can help individuals reclaim fulfilling lives beyond an eating disorder.
The session, which can be watched here, covered practical strategies for meeting clients where they are in their recovery journey, reintegrating into education and work, rebuilding daily routines, and achieving personal goals. It also highlighted ways to support autonomy, independence, and transitions between treatment services. Rooted in our bio-psycho-social approach, this dynamic discussion underscored Orri’s commitment to addressing all aspects of a person’s life to support lasting recovery.
We were grateful to receive many questions throughout the webinar, and sadly we weren’t able to answer all of them! Below, we share answers to those we were unable to get to.
- What strategies can help clients stay present during meals?
Staying present during meals is a crucial step in eating disorder recovery, but it can be challenging for many people. At Orri, we believe in tailoring strategies to each person’s unique needs, using a compassionate trial-and-error approach. This process involves exploring different techniques to discover what resonates with the client and helps them feel grounded in the moment. Here are some examples:
- Meal focus and directive prompts: For some clients, simple, direct guidance can be incredibly effective. Questions like, “Can you take your next bite?” or “What’s the next step in this meal?” provide a supportive framework, helping them focus on the task at hand without becoming overwhelmed.
- Mindful eating: Encouraging clients to engage their senses can be transformative. By noticing the texture, temperature, taste, and smell of food, clients can connect with their meals in a more grounded way. Limiting distractions, such as phones or television, and allowing enough time for meals are essential components of this practice.
- Routine and planning: Establishing regular mealtime routines creates a sense of predictability and stability, which can reduce anxiety. This might involve setting aside specific times for meals and ensuring the client has a supportive environment during these moments.
- Setting expectations: Collaboration is key. We encourage clients to reflect on how they want to be supported during meals and communicate these needs with those around them. Whether it’s creating a quiet space or having someone present for encouragement, this helps to establish a safe and constructive environment.
- Grounding techniques: Strategies like deep breathing, focusing on physical sensations (e.g., the feeling of the chair beneath them), or noticing details in their surroundings can help clients anchor themselves in the present and manage distressing thoughts or emotions during meals.
Each of these approaches is designed to support clients with reconnecting with their bodies and their meals, fostering greater awareness and control over their process.
- What assessment tools do you use as part of your OT process?
At Orri, we’ve developed a bespoke assessment tool that serves as the foundation for our treatment planning. This tool was specifically designed by our Occupational Therapists to address the unique needs of our clients and ensure that their care plans are both thorough and effective. In addition to our in-house tool, we use a range of assessments, including:
- Sensory assessments: These help us understand how clients perceive and process sensory input, which can often impact their eating experiences and engagement in daily activities.
- Activity cycles: These assessments provide insights into how clients spend their time and identify patterns or behaviours that may need adjustment to support their recovery.
- Components of the Model of Human Occupation (MOHO): This framework allows us to explore clients’ motivations, routines, and roles within their environment, offering a holistic understanding of their needs.
- Community-based assessments: For example, our “eating out” assessment uses a top-down approach to evaluate how clients engage in external meal settings, such as restaurants or cafés. By identifying specific barriers in these environments, we can develop targeted interventions to help clients build confidence and independence in social eating contexts.
Together, these tools allow us to create a comprehensive picture of each client’s strengths, challenges, and goals, ensuring that their treatment plan is both personalised and effective.
- At what weight percentage should independent living skills, like meal prep, begin?
While weight for height percentages can serve as a guideline for assessing physical progress in treatment, we recognise that recovery involves so much more than numbers. At Orri, we use these percentages as part of a broader, holistic evaluation of a client’s readiness to engage in independent living skills.
It’s important to assess not just the client’s physical recovery but also their emotional and cognitive readiness. For example, if a multidisciplinary team (MDT) has determined that a client is preparing to return to school, we’d consider what skills and knowledge they need to function successfully in that environment.
Questions we might ask include:
- What are the client’s current responsibilities around food and meals?
- Are they consistently eating meals and snacks with minimal reliance on replacements?
- How are their energy levels and cognitive functioning? Are they able to follow instructions and manage emotions effectively during meal preparation?
By considering factors like emotional regulation, distress tolerance, and physical readiness, we ensure that these activities are introduced at the right time to support – not overwhelm – the client.
- Do you have advice for a student OT taking a client shopping for the first time?
Shopping, whether for food or clothes, can be a highly nuanced activity, especially for someone in eating disorder recovery. As a student OT, preparation and reflection are key to ensuring the experience is supportive and constructive for your client.
For food shopping:
- Begin by clearly defining the goals of the session. Are you focusing on portion estimation, managing emotions, or their relationship to nutritional labels? Breaking the task into smaller objectives can make it less daunting for both you and your client
- Conduct an assessment beforehand to understand your client’s specific challenges. For instance, do they struggle with decision-making in the store, or do they feel overwhelmed by the sheer variety of options?
- During the session, use yourself as a resource. If it’s their first time shopping, you might provide verbal prompts or guide their decision-making to build confidence
For clothes shopping:
- Consider the purpose of the session. Is it to prepare for a special occasion, address body image concerns, or simply purchase needed items? Understanding this context will shape your approach
- Plan ahead by identifying which stores to visit, discussing whether the client will try on clothes, and addressing sensitive topics like size labels. For some clients, covering size labels with stickers can reduce anxiety and allow them to focus on comfort and fit instead
- If body image is a focus, consider incorporating mirror work or encouraging the client to reflect on how clothes feel, rather than how they look
By taking the time to plan and reflect, you can help your client build the skills and confidence needed to navigate these everyday tasks with greater independence.
- What topics do you cover in the “Navigating Change” group?
The “Navigating Change” group is designed to support clients as they transition towards increased independence in their recovery. We cover a range of topics that empower clients to manage life’s challenges with confidence, including:
- Setting and achieving personal goals
- Identifying and managing triggers or stressors in the community
- Developing emotional regulation and stress management techniques
- Building a strong support system
- Returning to school, university, or work
These sessions provide a space for clients to reflect on their progress, share experiences, and develop practical strategies for coping with the changes and uncertainties that come with recovery.
To view the full recording of the webinar, click here.
At Orri, we’re here to support every step of the recovery journey. If you’d like to learn more about how occupational therapy can help you or a loved one build a fulfilling life beyond an eating disorder, please don’t hesitate to reach out. Whether you’re seeking guidance, resources, or simply a compassionate ear, our team is here to help. Get in touch with us today to find out more.
