Eating Disorders Counselor Certificate Training Part 8

Dr. Dawn-Elise Snipes PhD, LPC, LMHC, CRC, NCCClinical Director, AllCEUs.com

Unlimited CEUs $99 per year Copyright AllCEUs.com

APA Guidelines Eating Disorders 2005


Amelioration of the most disabling symptoms Re-establishment of previous emotional equilibrium Development of the patient’s understanding of the current

disturbance Development of better coping skills in the future


Brief

More active and Directive

Focus of treatment is negotiated

Little interpretation of underlying issues. Focus is on understanding what the behavior is a solution for.

Traditional Therapy

More passive Treatment focus is

often dictated by the therapist

Much interpretation of underlying “issues”


Focuses on:◦ Strengths◦ Resources◦ Competencies

In what ways does interpretation play a part in brief therapy?

What is the purpose of understanding the “underlying issues” if that is not a focus of brief therapy?

Do you need to address the underlying issues? ◦ If yes, how within this framework?◦ If no, Why not?


What does being “hungry” mean? What is it a solution too?

What does being “fat” mean? What is it a solution too?


When we talk about addictions and eating disorders, we often speak of “disease”

How can you transform the way you look at these disorders from a “disease” to a solution?

With the high relapse rate, how can we get away from the “disease” concept? (Hint: think strength of reinforcer)


What place does nutrition counseling have with ED◦ Not invalidating the client’s concern about food and

weight too soon◦ Helping clients understand the function of food in their

lives◦ Helping clients increase their awareness of food choices

and rate of consumption


The focus of therapy is◦ Generating exceptions◦ Picturing a new life [with] the client◦ Validating that change toward that end is becoming a

reality

Three simple rules◦ If it ain’t broke, don’t fix it◦ Do more of what works◦ Do not keep doing what does not work


Typically ◦ Have significant cognitive distortions◦ Focus on their inabilities◦ Perceive the world dichotomously

Improving ED client’s sense of self-efficacy is one goal of the process

Another is assessing whether clients have the necessary resources and competencies to solve their own problems◦ When you are not binging, what are you doing?◦ Has there ever been a time you got upset and you didn’t binge? What

did you do?◦ What have you tried to control your bingeing?


After eliciting competencies, strengths and resources, the therapist can use these to individualize the solution to assist the client in achieving her goal.◦ Enhance exceptions◦ Highlight strengths◦ Mobilize resources

The client and therapist work together cooperatively with the client functioning as “expert” in her treatment and defining the goals of therapy

Change is viewed as inevitable and constant and one small change in any area produces reciprocal changes


Treatment focuses on what is changeable and possible

The therapist is an active participant whose goal is to identify, reinforce and amplify change

Conversely her role is also to ignore, fail to reinforce and reduce negative behaviors

Ways to increase treatment compliance◦ 3x5 cards◦ Coin Toss◦ Leverage


Try to work with the client to agree upon mutually acceptable goals even if that means negative reinforcement such as avoiding hospitalization


Focusing on other parts of the client besides her “bulimia” or “anorexia” brings to light that the client is multi-faceted and forces her to acknowledge that there are other parts to herself---she is not JUST a bulimic


Goals—what you ultimately want to achieve in 6 months or less

Objectives---mini goals that must be accomplished to get to the larger goal

Interventions---how you are going to accomplish the larger goal

Motivations (Decisional balance exercises)◦ Reasons for and against change◦ Reasons for and against staying the same


Brief Therapy seeks to help clients identify the motivations for their behaviors and desires for change

Helping the client identify their current strengths and resources helps them feel more self-confident

The focus is on the purpose of the behaviors in the present


Health & Medicine

Eating Disorders Counselor Certificate Training Part 8