Psychosocial Element



|Psychosocial Risk & Protective Factors |Action /tools/considerations | |

|Individual |Suicide |Elicit degree of risk using semi structured interview and |

| |Self Harm |risk assessment tools e.g.: Worthington scale, Dices. |

| |Substance misuse |Explore perspective of other family members if appropriate. |

| |Absconding | |

| |Treatment resistance/ motivation | |

| |Compliance with self care including refeeding. | |

|Family | |Work with the family and /or sufferer to |

| | |Identify patient and family’s: |

| | |Experience of family functioning, life events /transitions. |

| |Past and current family functioning |Ideas re: precipitating & perpetuating factors of the ED |

| |Contribution to the exacerbation and /or |Impact of ED on family. |

| |Perpetuation of ED. |Understanding of ED and risks |

| |Family’s potential as a resource to treatment and |Protective /resilience factors |

| |recovery. |Description of frequency and types of crises |

| |Family’s experience of and response to crisis. |Response to crises, |

| |Past / current physical, sexual, emotional abuse. |Assessment of family members’ capacity to develop new ways of|

| |Family’s ability to recognise and manage risk, |coping with crises. |

| |access support and guidance |Low tolerance areas |

| | |Motivation for supporting treatment |

|Work |Identify significant stressors. |Identify patients: |

| |Identify risk re: impaired physical and cognitive |Typical working day. |

| |functioning in work place. |Machinery / driving involved |

| |Explore work as perpetuating the ED e.g. |Relationships with /responsibilities for colleagues. |

| |Striving for perfectionism |Drivers/motivation for work. |

| |A means of food avoidance |Estimate energy input output equation within a normal working|

| |A means of increasing energy output. |day. |

| |A mask for the existence of the ED |Explore return to work as a motivating factor for treatment |

| | |compliance |

|Social /cultural |Identify significant risks in respect of self | |

|influences |harming behaviours in relation to context and peer| |

| |group and duration of influence. |Explore detail of risk and protective / motivating factors |

| |Explore any significant vulnerability to cultural |with patient and family if appropriate. |

| |/media pressures and the reactive eating disorder | |

| |behaviours. | |

| |Identify degree of risk from social | |

| |integration/isolation | |

| |Identify impact of relationship with ED on social | |

| |functioning | |

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