On the scheduled date, a family therapy session was conducted onsite with Asanda and her parents. The therapist initiated the meeting by establishing guidelines aimed at fostering a secure and constructive space for dialogue. This structure is vital in not only ensuring transparency but also facilitating effective communication among participants.
The primary objective of this session was to:
The therapist offered an overview of Asanda’s treatment journey, particularly emphasizing her commendable efforts to confront her fears surrounding food and engage in the recovery process. This conversation set a positive tone, showcasing Asanda's determination and resilience in her treatment journey.
During the session, Asanda articulated a poignant inquiry regarding her biological parents, stating, "I always wanted to know about my family back in South Africa; it feels like you all are trying to protect me by not telling me more about them." Her parents responded to this concern empathetically, reassuring her of their support and commitment to assist her in uncovering more about her familial roots.
Subsequently, Asanda expressed feelings of anxiety and sadness, particularly during the holiday season. She reflected on the passing of a close friend who had committed suicide approximately one year prior, underscoring the profound impact this loss has had on her mental state. Additionally, Asanda disclosed a recent episode of self-harm that involved using rocks and pulling out her hair. She explained her anxiety associated with an upcoming meal, identifying it as a "fear food."
Asanda characterized self-harm as a “coping skill,” acknowledging her ongoing battle with negative thoughts surrounding food. The acknowledgment of her coping mechanisms served as an essential point of discussion, highlighting the need for further therapeutic intervention to replace these behaviors with healthier alternatives.
Asanda’s parents voiced their concerns regarding her potential transition home after completing her treatment. They expressed a preference for her to reside in an independent living facility located near their home in Austin, Texas. Asanda responded positively to the notion of independent living, indicating a willingness to maintain proximity to her family while pursuing her recovery journey.
The therapist addressed the inconsistencies in Asanda's meal plan adherence and her ongoing struggles with body image. Asanda candidly shared, "I will do good for a few days and then restrict again because I do not want to gain weight. I can feel the difference with my weight, and then the guilt of eating kicks in as well." This admission highlights the cyclical nature of her struggles, reflecting the complexities of her relationship with food.
In conjunction with therapeutic interventions, Asanda’s medications were reviewed and adjusted by the medical provider. Notably, her lithium dosage was increased to 300 mg last week, and lab results from December 23 remain pending. The provider also made adjustments to her Prozac dosage, reducing it to 20 mg for five days, with plans to transition her to Pristiq at a dosage of 50 mg aimed at addressing anxiety and depressive symptoms. Furthermore, Seroquel was increased to 50 mg twice daily, with a bedtime dose of 75 mg.
The session concluded with a collaborative focus on Asanda's ongoing treatment and familial support mechanisms. Both Asanda and her parents demonstrated a commitment to her recovery, fostering hope for positive change moving forward. The therapist will continue to monitor Asanda's progress and adapt treatment strategies as necessary to ensure her emotional and psychological well-being.