There are many different approaches to take when administering eating disorder therapy. Eating disorder treatment at St Louis Behavioral Medicine Institute combines individual treatment plans with a variety of treatment methods that will specifically address the issues of the individual seeking treatment. We highly value evidence based treatment and are committed to incorporating the latest research in our practice. Therapeutic approaches to treatment of eating disorders are aimed at enhancing self-understanding, self-acceptance, self-regulation, emotional awareness and tolerance, and interpersonal skills.
Dr. Laura Huff, Director of SLBMI’s Eating Disorders Program, discusses below on why treatment approach for eating disorders matter.
We understand that eating disorder symptoms may be interchangeable with other forms of self-injury or addictive behaviors in terms of functions they serve for the suffering individual. Therefore, treatment necessitates stabilizing and treating all maladaptive behaviors.
Psychological interventions can only be effective when individuals are medically stable and so we work collaboratively with physicians to provide comprehensive care. In the case of malnutrition and low weight, restoring nutrition and a healthy weight are critical first steps toward full recovery.
Family participation in understanding their role in maintaining problem behaviors as well as in supporting healthy change is also essential for recovery, especially in children and adolescents. Parents are viewed as having a critical role in helping their child recover, and are expected to assist with meal preparation, behavioral supervision, and emotional support. We also recognize that family and other close supportive relationships are critical protective factors to avoid relapse.
To design a treatment plan that is individualized for each client, we draw from an array of treatment approaches and modalities including:
Behavioral Activation (BA)- Structured behavioral goals to access positive experiences with associated changes in mood. Often found to be effective treatment for severe depression.
Positive Behavioral Support Plans for Recovery– The use of principles based on the science of Applied Behavioral Analysis to create pro-recovery plans that focus on functions of maladaptive behaviors, prevention of maladaptive behaviors and development of alternative replacement skills.
Behavioral Treatment- Exposure with Behavioral Response Prevention (AN-EXRP) is a systematic approach to overcoming anxiety about eating, food and related situations that are involved with maintaining eating disorders.
Cognitive Behavior Therapy (CBT) and Enhanced Cognitive Behavior Therapy for Eating Disorders (CBT-E) are evidence based treatments for bulimia nervosa, binge eating disorders, depression, and anxiety. Therapies based on CBT focuses on the mediating role of thoughts on emotions and behavior. Interventions focus on assisting to challenge and restructure maladaptive beliefs. CBT- E focuses on processes that maintain an eating disorder, with specific interventions focusing on low-self-esteem, clinical perfectionism, and interpersonal relationships.
Dialectical Behavior Therapy (DBT), is a form of CBT, that represents a blend of CBT and acceptance based strategies. This approach addresses dichotomous (all or nothing) thinking, often associated with eating disorders. Dialectical thinking is when extreme and even opposite ideas can be discussed and considered as true and held at the same time. Therapy based on DBT, helps validate emotions as well as supporting individual responsibility to change behaviors. Therapy sessions also emphasize the development of distress tolerance and emotional regulation skills to help cope with intense emotional states that contribute to the development and maintenance of eating disorders as well as other maladaptive coping behaviors.
Acceptance and Commitment Therapy (ACT)-Similar to DBT, ACT strategies are mindfulness based, and incorporates awareness of individual reactions to thoughts. A focus of therapy is changing this relationship rather than the thoughts themselves. Goals include acceptance for acting in ways that are consistent with personal values.
Interpersonal Therapy-This form of therapy addresses the significant role of interpersonal factors on development and maintenance of eating and mood disorders. Therapy focuses on enhancing interpersonal functioning by examining primary roles, role deficits, role disputes, role transitions, as well as grief and loss of important roles and relationships.
EMDR- Eye movement desensitization and reprocessing (EMDR) is a type of therapy for PTSD. Like other kinds of approaches to trauma resolution, it can help change how you react to memories of your trauma. While thinking of or talking about your memories, you will focus on other stimuli like eye movements, hand taps, and sounds. For example, your therapist will move his or her hand near your face, and you’ll follow this movement with your eyes.
Body Image Interventions– Having a negative body image that becomes a primary source of identity and worth is often first symptom to present and last to change in recovery. Interventions are often experiential and aimed at cultivating appreciation of one’s body, increased self-acceptance, and broadening definitions of health. We also work to challenge body distortions and educate clients about the impact of media messages on self-concept.
Spiritual Counseling and Guidance– Exploration is invited about the role of spirituality in both maintenance and recovery from eating disorders.