- Eating Disorders -

Mana Ake Workshop

Presenters - Louise Bennett, Clinical Dietician & Ursula McCulloch, Consultant Clinical Psychologist

Normal Eating - about 16% of NZers don't have breakfast and average 8 snacks a day.

When it becomes a concern -

weight
nutrient deficiency
restriction of food groups

Influences -

socio-economic
food environment
media/social media
peers
family/whanau environment
teachers/educators

How to help build a positive relationship with food -

modelling, be aware of influence
encourage a variety of food from the main food groups
avoid labelling food as 'good' or 'bad'
involve in food preparation and gathering

Picky Eaters -

normal food stage for children 1&1/2 - 4 years old

concerns -

eating less than 20 different foods
lack of nutrition
missing out entire food groups
particular about textures & stressed

The Whys of ARFID (Avoidant/Restrictive Food Intake Disorder)

sensory issues
super tasters
association with negative events eg choking
developmental concerns
anxiety issues
genetics
environmental and management issues

The Whys of Anorexia (many unknown)

low self-esteem
anxiety. perfectionism
genetics
environmental issues

As a result of the struggles the parent - child relationship is often fractured

Parents/Whanau may feel -

like a failure
judged
manipulated
over people giving them 'good advice'

Managing ARFID

What doesn't work

force-feeding
lengthy meal times
dishing up guilt
comparisons with peers
punishments & threats
ignoring
tricking your child

It takes 20x of tasting to get used to a food.

Children need to know sometimes you have to eat foods that are ok but not your favourite.

Get the child to use their senses to learn about food and gradually build up to tasting and then eating ....

Images might help the child to visualise their progress ...

Language

Challenge language around food. If a child says 'It's yucky," respond with "You are still learning about the taste. To me it tastes salty/or other." Say 'You can," rather than "can you." The child is a 'food explorer.

Implications for schools

don't judge lunchboxes
don't force feed or comparative shame
don't offer advice
do be empathetic
do allow the child to bring their preferred food
do celebrate success

Managing Anorexia

Myths around anorexia

attention seeking
passing phase
mum's fault
vanity etc

Externalise anorexia - it is in control not the child

Family Based Treatment - 3 Phases, generally lasts a year

1. Phase 1 - weekly visits to home environment

discussion
family meal observation
teach strategies

2. Phase 2 - fortnightly sessions in home environment

child gradually allowed to take more control
finishes when ideal body weight is reached

3. Phases 3 - monthly sessions

address other related issues

Gaming Addiction

a Werry Workforce lunchtime seminar

Presenter - Caleb Putt, Portfolio Manager for Mental Health and Addiction

There is many conflicting information as to whether or not it really is a problem. But recently the WHO has added Gaming Disorder as an illness to its list of diseases, although they have also said that gaming is a good way to spend your time during a pandemic. It is all very conflicting and it is complex.

Caleb is a gamer so has an insight. There has been a shift from geek to mainstream in the last few years. Gaming is now mainstream.

- Geek is the new Black -

The last few years have seen esports gain popularity. Drawing sports stadiums full of fans, with full fanfare. Eports games are generally shorter, have small teams playing each other and fast paced. In some countries high school give scholarships for gamers. NZ high schools have Esport competitions between schools.

Another type of game is MMO (Massively Multiplayer Online) roleplaying games. These are set in fantasy worlds and you take the role of a customisable character. There are multiple storylines/quests that can take hours to complete and are highly social with people becoming part of clans.

The gaming industry makes more money than movie and music combined. More people watch esport final than the NBA final. Some of the most popular games are free to play.

Gaming is mainstream. Most young people will game. Only a small percentage will develop Problem Gaming. Gaming might cause some problems eg, difficulty getting off but this does not mean a person is a Problem gamer.

Games employ Psychological Techniques to keep people gaming and spending more money eg, levelling up is easier at the start and then gets harder and selling things in the game. Games continue 24/7 there is no end - FOMO, others are leveling up etc.. They are always been updated so they don't become boring. Sometimes things are made purposefully frustrating so you need to pay to get passed the obstacle. Less than 2% are the biggest spenders, the rest spend very little.

There can be 'binge' problems at time like when a new game is released.

Why do people game?

Meet their needs; a sense of purpose, reaching goals, predictable, sense of achievement & mastery, sense of belonging, connections with others, friendships, freedom & escape, a sense of identity (more confident as your character, and as a confident gamer)

This becomes a problem if what you experience online is better than off line then that can be a problem. If a game meets needs we have outside of the game it becomes a problem.

Casual Gamer - Highly Engaged Gamer - Problem Gamer - Gaming Addiction

It's all about CONNECTION VS DISCONNECTION

Tips for tackling the problem;

ask what they do, be curious

find out what needs the game is meeting, how else can those needs be met?

connect them in with groups eg, robotics clubs etc, archery

promote connection over disconnection

educate them about problem gaming ie what do they think it is

if they identify that they have a problem put together a plan for them

What we see is the top of the iceberg - what sits underneath? self-worthlessness, confidence etc

Resources -

Gaming Questionnaire