EVIDENCE-BASED TREATMENT SERVICES

Therapy for adults with eating disorders

Therapy for adults with eating disorders

Admitting you need help with your eating disorder is courageous.  We are honored that you have chosen us as your guide on your journey.

Our experts are ready to help you break free from the constant chatter in your head about food, eating, exercise and your body. We will guide you with tools and strategies, and will support you as you make new choices on your journey to living your best life without your ED.  Whether this is your first time in therapy or a return, we use effective, structured treatments that allow flexibility and individuality depending on your needs. We know that using these evidence-based treatments in the way that they were designed is key to helping you find freedom and peace from the burdens you carry. We try to meet you where you are at while knowing that change can be difficult and very needed. We want to help you find a balanced perspective and response to your eating disorder because we know that this will help you spend more time with the more important things in your life.

Our first step together is a thorough assessment of the symptoms and behaviors that you are struggling with in your eating, mood, and overall mental health. We recognize that eating disorders often look different than the “black-and-white” categories we use to describe them as many of our patients fall just outside of those categories and suffer just as much. In addition to those with eating disorders, we also treat individuals who struggle with depression, anxiety disorders, and pre- and post-bariatric surgery support. For that reason, we start each relationship with an initial consultation and assessment.

Initial Diagnostic Evaluation and Consultation

Due to the unique nature of problematic eating and the individual who struggles with food, body image and weight concerns, our first session consists of an in-depth, 90- to 120-minute assessment of current and historical eating and activity-related behaviors, co-occurring mental health concerns and history, medical history and family history.

We will then collaborate on an individualized treatment plan which may consist of collaboration with a dietician, psychiatrist and/or physician. In addition, appropriateness of outpatient treatment will be assessed, and depending on the severity of your symptoms, a higher level of care may be recommended.

OUR FIRST LINE OF TREATMENT

Enhanced Cognitive Behavior Therapy (CBT-E)

Enhanced- Cognitive Behavioral Therapy (CBT-E) is the first line treatment for most eating disorders. CBT-E isn’t a “one-size-fits-all” treatment. Your therapist will individualize the treatment depending on what eating disorder symptoms and behaviors you are struggling with. There are four stages to CBT-E. The time and length of CBT-E depends on the complexity of your symptoms.

There are four stages to CBT-E. The time and length of CBT-E depends on the complexity of your symptoms. 

STAGE 1

Regulating eating patterns

During this stage, we gather information to identify triggers and to gain a mutual understanding of your eating challenges and concerns. We also collaborate on ways to change and regulate eating patterns. The therapist highlights information and education specific to your behaviors and symptoms and stabilizing weight is addressed.  Ideally, these sessions are twice a week; however, often in practice, they are held once a week due to mutual availability and cost.

STAGE 2

Progress check

During this brief stage, your progress with eating and behavior change is reviewed.  This ensures that you are receiving the individualized care that you need for your specific set of symptoms, behaviors and challenges and allows your therapist to tailor the treatment for your goals.

STAGE 3

Addressing maintaining factors

During this stage, we focus on the factors that are maintaining your eating disorder.  Usually, we identify how your concerns about your weight and shape relate to your eating concerns.  We also identify tools and techniques to increase your ability to manage your mood and stressors without relying on eating disorder behaviors to cope.  Additionally, we address how dieting and restricting foods, macronutrients and/or calories maintain your eating disorder behaviors.

STAGE 4

Preservation of progress and gains

As we transition into this phase, we start to focus on preserving the progress you have made as well as preparing for normal setbacks that happen after therapy has ended.

 

REVIEW / FOLLOW-UP SESSIONS

Follow up or “booster” sessions are a part of the progression of treatment.  Your therapist is available to check in with progress and address any potential set backs to help you maintain recovery.

Eating Disorders

APPROACHES WE USE

Enhanced Cognitive Behavior Therapy (CBT-E)

Dialectical Behavior Therapy is used with patients when standard treatments have failed, or when there are several co-occurring problems in which increased structure of therapy and support is needed. You can expect a structured, collaborative style of therapy, as well as practicing mindfulness and learning specific skills and coping techniques for emotional regulation, interpersonal issues, distress tolerance.

Specialist Supportive Clinical Management is a treatment that has shown efficacy for severe and enduring eating disorders. SSCM combines features of clinical management and supportive psychotherapy. SSCM is collaborative and the goals of therapy are led by the client and met with support by the therapist.

RO-DBT is a newer therapy that has been in development for over 20 years and focuses on helping individuals who experience too much self control. It was designed to help individuals with the tendency to engage in overcontrol behaviors, such as those who struggle with perfectionism or eating disorders where overcontrol with food and exercise are primary, such as anorexia nervosa or orthorexia.   RO-DBT emphasizes Radical Openness.  There are 3 important factors in being Radically Open: Flexibility, Openness, and Social Connectedness.

PTSD

APPROACHES WE USE

Cognitive Processing Therapy is one of the strongest recommended PTSD therapies by the American Psychological Association and the National Center for PTSD. CPT is a specific type of Cognitive Behavioral Therapy that is generally delivered over 12 sessions, with a range of 8-18 sessions. CPT can be delivered in 3 different ways: Individual CPT, Individual CPT + Account (CPT+A), and Group CPT. All three approaches have been shown to be equally effective. In Individual CPT, patients will identify thoughts and beliefs that have been developed as a result of the traumatic event, and have kept them stuck in guilt and shame. In CPT+A, in addition to the cognitive work, a detailed, written account of the traumatic event is processed.

For more information about CPT, click here.
To watch a video describing CPT, click here.

Prolonged Exposure Therapy is one of the strongest recommended PTSD therapies by the American Psychological Association and the National Center for PTSD. PE is a specific type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings and situations. Generally, PE treatment lasts 12 sessions, but can range from 8-15 sessions. Patients will confront memories and situations that they have avoided as a result of their traumatic event.

For more information about PE, click here.
To watch a video describing PE, click here.

Eye Movement Desensitization and Processing Therapy is recommended by the National Center for PTSD and is conditionally recommended by the American Psychological Association. EMDR is an individual therapy delivered 1-2 times a week for a total of 6-12 sessions. EMDR is focuses directly on the memory, and is intended to change the way the memory is stored in the brain.

For more information on EMDR, click here.
For a video describing EMDR, click here.

Chronic Health

APPROACHES WE USE
Cognitive Behavior Therapy helps you by identifying the connections between your thoughts, emotions and behaviors. Individuals who experience chronic health issues are at a higher risk of experience negative emotions. Often times, when we experience negative emotions, we tend to have more negative thoughts and can spiral.  These thoughts are interpretations that are influenced by our mood and more negative. By exploring all possible interpretations, we are able to have more balanced, helpful thoughts that lead to effective behaviors. You can expect a collaborative approach in CBT, with your therapist providing information and techniques for you to practice in-between sessions.

Chronic diseases are often associated with negative, uncomfortable internal and physical experiences. Acceptance and Commitment Therapy is a form of individual therapy that integrates behavioral and cognitive techniques and uses acceptance and mindfulness as strategies to help reduce both emotional and physical symptoms. The focus of ACT is not to change your thoughts, but rather to be more present with what life brings and use our values as a basis of how to respond and live life. ACT is an evidence-based therapy for many mental health disorders, including depression and anxiety disorders. A growing number of studies support the efficacy of ACT for chronic health conditions. There is evidence that ACT can increase psychological flexibility and improve management of your health condition.

Anxiety and Depression

APPROACHES WE USE

Cognitive Behavior Therapy helps you by identifying the connections between your thoughts, emotions and behaviors. Often times, when we are depressed, we experience more negative emotions which often lead to negative thoughts and hopelessness. These thoughts are interpretations that are influenced by our mood and more negative. By exploring all possible interpretations, we are able to have more balanced, helpful thoughts that lead to effective behaviors.  When we are experiencing anxiety, avoidance of the situation that causes fear is a typical response.  CBT helps you understand how avoidance actually maintains and strengthens your fear, and how to stop this cycle. You can expect a collaborative approach in CBT, with your therapist providing information and techniques for you to practice in-between sessions.

Acceptance and Commitment Therapy is a form of individual therapy that integrates behavioral and cognitive techniques and uses acceptance and mindfulness as strategies to help reduce symptoms. The focus of ACT is not to change your thoughts, but rather to be more present with what life brings and use our values as a basis of how to respond and live life. ACT is an evidence-based therapy for many mental health disorders, including depression and anxiety disorders.

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