A patient with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the patient to participate in measures to produce a specified weekly weight gain?
a. Severe anxiety concerning eating is expected, so objective and subjective data must be routinely collected.
b. Patient involvement in decision making increases sense of control and promotes adherence.
c. Because of risks of physical problems from refeeding, the patient's consent is essential.
d. A team approach to treatment planning ensures that physical and emotional needs are met.
B
A sense of control for the patient is vital to the success of therapy. A diet that controls weight gain can allay patient fears of too-rapid weight gain. Data collection is not the reason for contracting. A team approach is wise but is not a guarantee that needs will be met. Consent for treatment is a separate issue. The contract for weight gain is an additional aspect of treatment.
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