La Maison des adolescents de l’Hôpital Cochin propose un programme d’éducation thérapeutique (ETP) axé sur la prise en charge des troubles boulimiques. Son contenu a été modifié au fil des ans afin de mieux répondre aux besoins. Nous décrivons les différentes phases de développement de ce programme et l’importance en particulier de l’intégration des parents au sein de ce programme. Nous avons pu utiliser divers outils cliniques : un circle test pour déterminer la place des troubles dans la vie du patient, l’échelle Boulimic Investigatory Test d’Édimbourg, des entretiens motivationnels individuels avec des tableaux de gestion de crise à remplir, et des groupes de discussions thématiques, avec ou sans support narratif. L’introduction d’outils utilisés en thérapie multifamiliale a semblé particulièrement bénéfique et originale dans le cadre d’un programme d’ETP. Chaque jeune et ses parents ont pu faire le retour de réapproprier activement un suivi de soins plus personnalisé et continu dans la suite de l’ETP.

The Maison des adolescents of the Cochin Hospital offers a therapeutic education program focused on the management of bulimia nervosa. Its content has evolved over the years in order to better address these patients’ needs.

We describe the development of the program and the most relevant intervention methods. We were able to use a variety of clinical tools: a circle test to determine the place of the disorders in the patient's life, the Bulimic Investigatory Test of Edinburgh, individual motivational interviews with crisis management charts to fill in, and thematic group discussions, with or without narrative support. We based our work on the transcripts of the quarterly focus groups between the professionals (nurses, psychiatrist, psychologist, dietician, paediatrician, child psychiatrist, nurse manager) involved in the implementation of this program.

Monthly discussion groups with parents, alternating with monthly discussion groups with adolescents, were added to the individual interviews and were key points in structuring the treatment. The introduction of tools used in multi-family therapy seemed to be particularly beneficial. This program enabled the co-construction of an appropriate, personalized and more meaningful care plan. The young person and their parents were able to take active ownership of the care program.

This program, characterised by a multidisciplinary approach and the important involvement of parents, could be formalised in the form of a research program, as there is yet little documentation about effective treatment for bulimia nervosa.