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Psychological problems associated with bulimia nervosa affect both the client and the family. The nurse practitioner is often in a position to refer the client to a therapist who has experience in treating clients with eating disorders. The nurse practitioner and the therapist, along with the nutritionist, if available, need to work from the beginning as a team. Each team member must have a distinct role regarding management of specific aspects of client care in order to avoid confusion and attempted manipulation by the client.