The outpatient day clinic therapy program of the 8-week program includes:

• On average, 6 therapeutic hours per week (group and individual psychotherapy, occupational therapy)
• Physiotherapy and sports therapy, both individually and in a group, 4 hours per week
• Relaxation training according to Jacobson
• Self-confidence training according to Ullrich (learning to express wishes and needs, establishing social contacts) 1 hour per week
• Computer training methods 1 hour per week to objectify cognitive deficits.

We place special emphasis on:

• Weight gain (700g/week), otherwise Fresubin treatment or inpatient admission
• Building social behavior in the group
• Video confrontations (changing body image disturbances)
• Exposure exercises (eating in a restaurant) and attempts to activate and rhythmize eating behavior through food diaries
• Reducing hyperactivity (sports)
• Initiating socio-medical measures (changing living situation, detachment from parental home).

If indicated, medication therapies such as Fluoxetine (SSRI) may be used. This is done in consultation with the treating physicians before and after.

Individual Therapy Offer

Weight program and individual therapy as needed.

• Weight gain up to the defined target weight
• Weight stabilization
• Prevention of consequences through continuous medical treatment (ECG, lab tests, weight measurements)
• Motivation for inpatient therapy

For this, we initially work with the patient in the first phase of the process:

• On therapy motivation
• On compliance
• On a deeper understanding of the problem and disease connections
• On access to physical experience ability through sports and physiotherapy

This first process phase may extend over a longer period, often even for the entire duration of the 8 weeks. This means that symptom freedom may not be achieved, but awareness for further therapeutic steps has been established.

Depending on the personality structure and cognitive abilities, further work can be done on introspection ability, confrontational ability, and conflict resolution skills.

Scientifically expected success rate

According to the strict criteria (weight gain, improvement of social functioning, and psychosexual development) for outpatient therapies for anorexia nervosa, the following results are observed:

• Supportive medication helps little for anorexic patients (Walsh, 1992).
• Only 60% of anorexia nervosa patients are motivated for inpatient treatment (Crisp et al., 1991). 90% are motivated for partial inpatient or outpatient treatments. Individual therapy leads most often to therapy dropouts, while family therapy and group therapy can keep patients in treatment longer.
• One year after partial inpatient or outpatient treatment, a weight gain of 9-10.2kg can be expected for anorexia nervosa patients (Crisp et al., 1991).
• Partial inpatient or outpatient treatments are as effective as much longer hospitalizations for anorexia nervosa patients (Crisp et al., 1991).
• For younger patients with a shorter duration of illness, involving the family is essential (Russell, Szmukler, Dare, & Eisler, 1987).
• Cognitive behavioral therapy is not superior to interpersonal therapy or family therapy (Galsworthy-Francis, L. & Allen, S. 2014).