Posts Tagged ‘Minnesota’

By Dr. Mark Warren and clients at TEP

Recovery from an eating disorder is the clear goal of treatment, however, the scientific literature on clients’ experience of recovery is often defined in different ways. In general, the literature tends to focus on re-feeding, growth curves, medical stability, and resolution of behaviors. At TEP we fully endorse that these are the first steps towards recovery and without them no discussion of recovery can take place. That being said, recovery from an eating disorder can have various meanings for those who suffer from these illnesses. In general, there are psychological, social, and identity issues that also change when someone describes themself as being in recovery. We feel it is important to talk to our clients and their families to gain understanding of what recovery means to them. With this in mind we had a conversation with clients about this issue. We asked them to answer the question “How do i know if I am in recovery?” Please find their responses below:

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.

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.

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.

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.