Eating Disorder Case Study: Chhaya

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Chhaya is a senior in high school whose self identity problems began as a child with her mixed ethnic background. She blames her parents’ constant fighting (and threats of divorce) on her own behavior and, in turn, strives to become the perfect daughter. Chhaya consequently throws herself into her schoolwork where she repeatedly increases her goals despite the lack of disapproval of others. Social relationships and leisure activities are thrown to the wayside because Chhaya feels guilt whenever she experiences pleasure in non goal-directed activities. Although Chhaya has seemingly tried to control many aspects of her life, this tendency turned into an eating disorder, anorexia nervosa, after two major life events: finding out she did not receive valedictorian and the relationship with her first male interest ending. These events occurred within one month of each other at the end of Chhaya’s junior year in high school. Aside from her self-esteem and self-confidence plummeting, Chhaya also felt worthless and out of control of her life. When she discovered that she is very good at losing weight, she began using restricting her dieting to an extreme. She has been hospitalized and is now receiving occupational therapy at the children’s hospital.

In order to learn more about Chhaya’s roles, expectations, occupations, and the affect of these life aspects on her eating disorder, the occupational therapist used the Adolescent Role Assessment (Black, 1976) to interview Chhaya. This assessment is meant for clients who range in age from 13 to 17 years and has shown sufficient internal consistency reliability (0.75), test-retest reliability (0.91), and content validity (via a literature review of multiple areas of study) (Burke & Lomba, 200...

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