The STEPs service was set up in 1999 in
response to a growing need for specialised NHS treatment for people with difficulties around eating. We are currently based at the STEPs Unit at Southmead Hospital in North Bristol, and see people living in the Bristol area, South Gloucestershire, North Somerset and North-East Somerset. We work with people between the ages of 18 and 65, who are struggling with Anorexia Nervosa, Bulimia Nervosa or an ‘Eating Disorder not otherwise specified’ (EDNOS). (Please note that we are not currently able to see people with a diagnosis of Binge Eating Disorder). We are a dedicated team with an established reputation for working in a sensitive and individual way with each person we see.
THE STEPS PHILOSOPHY
At STEPs we follow a specific approach to working with each person we see. This is based around the ‘Transtheoretical Model of Change’ (Prochaska and DiClemente, 1982). Within this, change is seen as a process
associated with a number of distinct stages.
Within this the individual’s stage of motivation is key to effective and lasting change.
Therefore any form of treatment needs to be matched appropriately to each person with regard to the work they want to do. As a
result we aim to offer a therapeutic intervention for each motivational stage. This is either done individually, via a group or working alongside a secondary team worker supporting someone in the community. Consideration is given at all times to issues around medical safety and monitoring. We liaise closely with your GP and with other Health Professionals working with you.
For many people Contemplation Work is a good starting point in beginning to understand their Eating Disorder. This work is about weighing up the pros and cons of how things are at the moment, and considering how it might be to make changes. It focuses upon the functions an Eating Disorder can play in each person’s life. People are encouraged to explore the idea of recovery, without any expectation of change being placed upon them.
Contemplation Work is usually delivered as part of a group but can be offered on a 1:1 basis. where appropriate.
PREPARATION AND ACTION
Clients can actively work on their illness in a range of therapeutic groups and activities, with input from our team. We run several community groups, including, Compassion Focused Therapy, LEAP, exercise, cooking and art therapy.
We also offer group or 1:1 Cognitive Behavioural Therapy for clients with anorexia or bulimia in line with the NICE clinical guidelines for eating disorders (2004).
There are 10 inpatient beds available on our Unit at Southmead Hospital for people who require high levels of input in challenging their eating disorder. Clients on the ward are able to take part in a range of individual and group work whilst working on restoring weight and behavioural change.
Team members hold individual caseloads of people to whom they offer support and therapy. Community Psychiatric Nurses cover the areas of Bristol, South Gloucestershire, North Somerset and North East Somerset, and work with people on a 1:1 basis either at home or elsewhere in the community.
We offer family work to partners and family members who are close to someone being seen at STEPs. This can be one or a number of
sessions, and offers family members space to talk about their experiences. It is also an opportunity to learn more about Eating Disorders in an
impartial way. Family work is confidential, and involves meeting a member of the Team who does not work directly with the person receiving treatment. We also run bi-monthly groups.
OTHER WORK AVAILABLE
The STEPs Team brings together professionals from different disciplines and backgrounds. Other forms of support / therapy include:
Art Therapy, Dietetic input / support, Body Image Work, Cognitive Analytical Therapy, Outpatient work, Community exercise group, Meal preparation skills
HOW TO ACCESS STEPS
If you feel that some work with STEPs could be of help to you, you will need to visit your GP who will refer you to your local Primary Care Liaison Team. They will make contact with you to arrange an initial assessment. After this they will refer onto STEPs. You will be sent an opt in letter inviting you to call and book an appointment. This appointment will take around an hour, and is an opportunity for you to talk in a safe and understanding environment about how things are feeling for you at the moment and what, if anything, you would like to be different. You are welcome to bring a friend or family member along to support you. Having an assessment with us does not mean you are obliged to undertake treatment. Many people find that simply being able to think about their current circumstances and what the various options open to them are to be of help.
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Community Psychiatric Nurses cover the areas of Bristol, South Gloucestershire, North Somerset and North East Somerset, and work with people on a 1:1 basis either at home or elsewhere in the community.
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Please note that we are not currently able to see people with a diagnosis of Binge Eating Disorder.