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By: Judy Scheel, Ph.D., LCSW
The
end of the summer marks a transition for many.
The transition from high school to college for individuals with
eating disorders brings with it a unique set of circumstances and
challenges. Usually this means
that there will be a transition from the therapist at home to a new
therapist at school. Loss
and separation, fear of change, enthusiasm and concern about settling into
treatment with a new person are the issues that surround the treatment
during the summer before college.
For the eating disorder therapist who is assisting in the process
of transition to a new therapist there is a check list of items to
address: logistical concerns
(proximity of the therapist to the campus,) coordination of care (is the
therapist working with a nutritionist and physician?) and clinical issues
(type of treatment and theoretical approach of the new clinician – are
they suitable to the patient?) The
type of treatment and therapist is the choice of the patient. What most
likely will be a strong determinant regarding who the patient chooses as
the new therapist is how well is the fit.
In other words, does the patient feel comfortable, feel like the
therapist is knowledgeable, feel like she can be honest and authentic and
feel like the therapist has something to offer.
Helping patients become “educated consumers” about the
differing types of treatment and theoretical orientations available is
generally good practice and can provide support to someone in the midst of
this process.
Assisting a patient in this process requires the therapist to be
knowledgeable about the various eating disorder treatment approaches and
the various etiological theories. How does the potential new therapist
view the etiology of eating disorders?
Genetically based, culturally caused or influenced, resulting from
intra-psychic, interpersonal or familial issues, rooted in faulty
cognition? All of the above?
I generally instruct parents or patients to ask these questions
when ‘shopping’ for a new therapist:
How does the therapist view the cause of eating disorders?
What is treatment like? Do you work with a team i.e. physician,
nutritionist, psychiatrist if needed?
Often, families are confused and overwhelmed, however, helping them
understand and navigate through the myriad of treatment modalities when
faced with the transition from one therapist to another, is a necessary
component of care.
How well do therapists understand the range of etiologies and
treatment modalities when it comes to eating disorders?
Many seasoned therapists, who do not consider
eating disorders their specialty, but who may be treating some people with
eating disorders, are unaware of the myriad of etiological and treatment
choices. Sometimes, they sign
on to one approach that they have learned over time and remain unaware of
the plethora of other theories that may be useful or transforming in their
practice about how they view and therefore treat eating disorders.
Despite copious clinical material available, many health, mental
health, and educational professionals as well as the general public have
limited knowledge or narrowly defined views regarding eating disorders.
Many continue to view it solely in the realm of societal or
culturally caused. Some see
eating disorders as separate and apart from other mental health issues.
Eating disorders are an umbrella disorder.
There is almost always a co-morbid diagnosis contained within –
Axis I or Axis II is usual – depression, anxiety, familial,
interpersonal and/or intra-psychic conflicts are generally involved.
Eating disorder specialists are also general mental health
practitioners. Eating
disorders are intertwined within the greater constellation of
psychological and psychiatric issue and cannot or should not be treated as
separate and apart from other mental health issues.
This misnomer reinforces for patients and their family that the
eating disorder is running on its own track and has nothing to do with
their internal and relational world.
CEDAR Associates is committed to training and education.
To this end, we are sponsoring The Eating Disorder Foundation’s
(a 501©3 organization dedicated to the education, prevention and research
in eating disorders) 2nd Conference – Etiologies of Eating Disorders: A
Deeper Understanding to be held later this fall.
This year’s conference focuses on understanding the etiologies of
eating disorders and on various treatment models.
The conference will also help participants understand eating
disorders within the context of other co-morbid diagnoses.
The conference will not focus on the basics of eating disorder
diagnosing but rather on understanding theoretical models like
Psychodynamic, feminist psychoanalytic, cognitive/behavioral and how these
models are transformed into treatment.
The conference will include didactic presentations, a role play
session between therapist and patient based on a combination treatment,
medication update and management in the treatment of eating disorders and
understanding the role of the nutritionist and the interplay between
patient, nutritionist and therapist.
Please look for additional information in the coming months.
This conference is open to all health, mental health and
educational professionals. We
hope that you can join us.
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