Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.
By Drs Lucene Wisniewski and Mark Warren
Over the last 15 years Dialectical Behavioral Therapy (DBT) has gone from being virtually unknown to being a term utilized by many treatment programs. DBT is an evidence based therapy, initially designed for Borderline Personality Disorder, and more lately for other diagnoses including eating disorders (Wisniewski, L., Safer, D., & Chen, E.Y., 2007). With its increase in popularity among treatment providers it is important to be clear about what it means to "do DBT" so an individual knows if they're receiving evidence based care.
Comprehensive DBT treatment, initially described by Marsha Linehan, has four components: Individual therapy, skills group, 7 day week phone consultation availability, and consultation team for therapists known as "therapy for therapists". Unless all four of these components are present, a program is not providing comprehensive DBT treatment. Additionally, in order for a therapist to be capable of providing DBT, a significant training process is generally required. This training process necessitates a therapist taking a non-judgmental stance, the ability to encourage motivation and commitment with their client, extensive knowledge and understanding of the DBT skills and therapeutic techniques, and the balance of accepting where a client is while moving them towards change.
Articles tagged with: Ohio
Acknowledging the facts about eating disorders
In the not so distant past, eating disorders weren't recognized by society - or even some medical professionals - as legitimate diseases. In fact, binge eating disorder wasn't added to the eating disorder portion of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) until 2013, despite being the most common eating disorder in the United States.
Our 24/7 residential facility in Cleveland is officially open! Our staff have put in many, many months of hard work creating a warm, inviting environment for clients. We are pleased with the outcome and believe The Emily Program – Residential will provide clients with the resources, treatment, and space to begin to heal.
The Emily Program offers a full continuum of eating disorder care tailored specifically for male and female clients ages 10 - early 20s. From outpatient to 24/7 residential treatment, our staff can help young people learn skills to help them lead full, healthy lives. We offer a wide-spectrum of interventions, from Family-Based Treatment (FBT) to Dialectical Behavioral Therapy (DBT skills).
Our staff ensure that each person is provided the treatment that is best suited for their age and needs. A variety of programs are available at many of our locations.
By Dr. Mark Warren, chief medical officer at The Emily Program
One area that is a constant concern with those with eating disorders has to do with heart rate, in particular, low heart rate. This issue is generally observed at low body weight but can happen anytime there has been a significant amount of weight loss. In general, as one loses weight one loses muscle mass. With the loss of muscle mass there may be loss of heart mass as the heart is a muscle.
By Lucene Wisniewski, chief clinical officer
"How do Parents of Adolescent Patients with Anorexia Nervosa Interact with their Child at Mealtimes? A study of Parental Strategies used in the Family Meal Session of FBT." International Journal of Eating Disorders, vol 48, issue 1, p. 72-80 White, Haycraft, Madden, Rhodes, Miskovic-Wheatley, Wallis, Kohn & Meyer (2015)
This recent study examined the types of parental mealtime strategies used during a family meal session of Family-Based Therapy (FBT). Researchers studied 21 families with children between the ages of 12 to 18 who were receiving FBT for anorexia nervosa. They also were interested in the emotional tone of the meal, as well as the parents' ability to get their child to eat.
One of The Emily Program – Cleveland's adolescent clients traveled internationally to Cleveland seeking eating disorder treatment, taking on challenges not just in her recovery, but in the simple logistics that most in treatment take for granted.
Without effective treatment, eating disorders can be chronic and life threatening. Therefore as patients, we should be well-informed consumers of the treatment we receive. In fact, being armed with accurate information about what constitutes best practices in treatment could be the difference between life and death.
By: Mark Warren, MD, chief medical officer at The Emily Program
What is the best treatment at any given time when recovering from an eating disorder? This is one of the great questions providers, clients, and families alike struggle to answer.
We know there are significant scientifically based therapies that deliver positive outcomes, including weight restoration and behavior cessation. In fact, The Emily Program incorporates these therapies in our programs — Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Family-Based Therapy — and has experienced much success through them.
Having said that, however, we also know that many clients who are able to cease behaviors and achieve weight restoration may continue to experience physiological distress, urges, body dissatisfaction, and anxiety, among other eating disorder symptoms.
Further complicating the issue, eating disorders often occur in secret and many clients may not reveal the intensity of their behaviors, thoughts and feelings during treatment.
February marks our chance to amplify the work we do throughout the year. We have the unique opportunity to partner with colleges, universities, and other community members who also want to build awareness around eating disorders.
This month our staff will be working coast-to-coast to discuss eating disorders and their devastating effects on individuals, families, and communities. And to let people know that recovery is possible.
By Joanna Hardis, LISW-S at The Emily Program-Cleveland
As we enter a new year, everywhere I turn I’m seeing commercials for home video programs promising body transformations; I’m receiving countless offers for weight-loss and fitness programs; and I cannot open a magazine without being inundated with exercises guaranteeing a better, leaner body.
This year's second annual Cleveland NEDA Walk was a huge success. More than 100 of you joined us on Oct. 18 to raise our voices and funds in the fight against eating disorders. It was the biggest turnout to date!
We're grateful for NEDA (National Eating Disorders Association) and host Olivia Armand for coordinating this special event. By coming together as a community, we were able to shed light on this devastating illness and support NEDA's prevention, service and treatment programs.
A recent article on Cleveland.com reports on varsity volleyball player Veronica Gehring who was diagnosed with anorexia during her junior season. It began with an obsession to "become faster on the court and a stronger volleyball player," she said.
But soon she was exercising upwards of four times per day and barely eating anything at all. At times, she'd purge everything if she felt she ate too much.
After looking to the The Emily Program – Cleveland for help, she was soon hospitalized with a heart rate of 28 beats per minute during the day, falling to 17 beats per minute while sleeping. She was refed in the hospital and later released. The following months were a whirlwind of doctor visits and checkups, but she found herself on the road to recovery.
By Sarah Hrudka, Outreach Specialist at The Emily Program
As The Emily Program continues to expand treatment options across the country, it’s more important than ever to truly be part of and contribute to the richness of each community we join. To do this, The Emily Program has designated outreach staff who are able to take on this important community role.
By Mark Warren, chief medical officer of The Emily Program
In our conversations about eating disorders we sometimes forget to state the obvious, which is that it’s horrible to have an eating disorder. It is always horrible for the person that has it and the pain of the disorder often extends far past the individual to their family, friends and community. Eating disorders affect everything about us. They affect the way we think, the way we feel, our self image, our experience in our bodies, our minds, and who we are in the world. They destroy our health, our hearts, our brains, and ultimately can take our lives. Eating disorders affect our relationships, school, work, and ability to have the lives we want to have. They are illnesses in the truest sense of the word. They disable us and take our health and well being. Part of the awfulness of having these disorders is that they are not well understood or appreciated for how terrible they are and the pain they cause. Layered into all of this is that the treatment for the disorder often causes more pain. Trying to refeed, stop behaviors, change self image, and work on body image can take us to places that are both painful and frightening. Yet there is no other choice. So what do we do? We find strength from each other, find ways to feed ourselves and make our bodies healthy, and find a community that is healing. We need to believe in and seek out the evidence based care that can help us and trustworthy providers, family, and friends who will be there with us. In Marsha Linehan’s writings she talks about the pain of living in hell and how the only way out of hell is to get on our hands and knees and crawl through the fire until we reach the sunshine. So we acknowledge the pain and acknowledge how awful these disorders can be, but also know that if we keep moving forward we can find the light that will give us our lives back and let us escape the disorder.
Contributions by Sarah Emerman, Therapist at The Emily Program - Cleveland (formerly Cleveland Center for Eating Disorders)
How do I tolerate how terrible it is to have an eating disorder? originated on Clevelend Center for Eating Disorders blog Clevelend Center for Eating Disorders blog in July 2012.