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Toolbox :: Reaching In :: YOU :: Coping
Motivations :: Affirmations :: Body Image
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Types of Treatment

There are a variety of different treatment options available, but it is important to find what works for YOU.

Group Support
Types of Therapy
Individual Therapy
Inpatient/Outpatient
The Maudsley Method
Dieticians
12-Step
Additional Methods - (Physical and Occupational Therapy; Art, Movement and Yoga Therapy; Spiritual Guidance; Sensory Integration; Reiki Healing; Meditation; EMDR; Life Coaching; Touch Therapy; and EEG Biofeedback (Neurofeedback)


Group Support

Group support or therapy can take place within an inpatient program, an outpatient program, a therapists office, or within an independent support group. Support groups can vary in their objectives and it is important to find out the goals and methods of the group you wish to attend. Group support may be aimed at the sufferers getting support and understanding from peers, or it may be aimed at incorporating members of the family.

Group therapy is usually facilitated by a professional therapist. Support groups can be facilited by a professional therapist, intern, recovered person, loved-one of a person living with an Eating Disorder, or someone else interested in working to help others (and maybe themselves) recover.

There are many different types of groups... some will be held in private homes, others in a rented or donated space, and some in a treatment center, hospital, university, highschool, or therapist's office. Some support group topics may include: spirituality, art therapy, coping strategies, family issues, general discussion, communication, inner-child work, body image, nutritional groups, or any combination of the above. Find what appeals to you most and what you think will help you on your road to recovery.


Therapy

There are different types of people who can provide you with therapy... Counselors, Social Workers, Psychologists, and Psychiatrists. Most of them should have some kind of degree representing the type of education they have received. The therapist may or may not be licensed, but should have a degree in the theories of psychology, psychotherapy, social work or counseling. Whether a license is important or not comes down to your own decision. There are many good counselors and social workers who are not licensed medical doctors, but who can still provide you with good therapy. As long as they have a degree, the only technical difference is that they cannot prescribe or administer medications. What is most important is that you are in a comfortable and safe environment, conducive to recovery, and with someone who can counsel you effectively.

Psychiatrists (Ph.D) are generally more expensive and tend to focus on admissions, diagnosis, evaluations and medication administration. There are psychiatrists who do and do not provide psychotherapy. Not all psychiatrists are trained in practical psychotherapy unless they have sought some kind of post-graduate education.

Psychologists (Psy.D. or Ph.D.) are the ones who are trained in the theories of pyschotherapy. A licensed psychologist can prescribe and administer medication if it is necessary.

Marriage, Family and Child Counselor (MFCC), Marriage and Family Therapist (MFT) and Licensed Marriage and Family Therapist (LMFT) are not very different from psychologists depending on the state you live in (licensing issues vary from state to state). Most can provide the same level of counseling as a psychologist.

Marriage, Family and Child Interns (MFCI) or Marriage and Family Therapist Interns (MFTI) are exactly that... interns. They are working in clinical practice to fulfill requirements they need to be licensed. They can see clients and all work is usually supervised by someone already in a licensed position.

Licensed Clinical Social Worker (LCW) has a degree in social work with a strong clinical focus. They can make very good therapists because of the strong focus on psychoanalytic and pyschodynamic theories in their education.

A Licensed Professional Counselor (LPC) in some states, is equivalent to a MFCC or LMFT, and is trained in counseling.

Types of Counseling Your Therapist Can Provide
(Theories of Psychotherapy)


Individual Counseling -

The ultimate goal of your therapy should be to recover! To learn to be more confident in yourself, to make your voice heard through communication, to validate your own emotions, to learn to love yourself, and to learn better ways of coping with anger, sadness and stress (and not rely on your Eating Disorder). You will spend many hours talking to your therapist about your childhood, your experiences, and your day-to-day life, and all of this is important to your recovery. There are many ways a therapist can work with you individually, and different therapists have different methods. The name of the approach is not as important as the methods used, so it will be important for you to discuss with your therapist your goals in working towards recovery.

Psychoanalytic: This is a clinical approach through interpretation, dream analysis, free association, analysis of resistance and transference. This all assists the client in gaining access to their subconscious, to the internal conflicts they may not be aware of, and in gaining new insights. There is a strong focus on repressed conflicts and less focus on social, cultural and interpersonal factors.

Nonpsychoanalytic (Jungian) Therapy: Self realization and learning to accept yourself as an individual, and to BE an individual is part of what this type of therapy is all about. It incorporates the idea of spirituality as an important role in discovering who you are. Generally, this approach is about making connections with your feelings and motivations and learning who you are. There is more a focus on the "big picture" and less of a focus on each day-to-day problem.

Cognitive-Behavior Therapy: This type of therapy works on the premise that thinking, questioning and doing (with practice) leads to the changes needed for recovery. Learning to change the way you think about yourself will result in changing the way you treat yourself. There is an eclectic combination of cognitive, behavioral and emotional techniques: changing negative thoughts to positive, and pessimistic words to optimistic words. Using humor, role playing, and homework and word-work in attacking shameful feelings and feelings of guilt are combined with the effort to make changes in thinking and behaviors. The focus with cognitive-behavior therapy is that it is a "move-forward" approach and often lacks exploration of the deeper emotional issues that led to negative behaviors and thoughts in the first place. There can also be Behavior Modification Therapy on its own where as the client focuses on changing behaviors through practice.

Eclectic Approach - Combining All Theories: This is my personal favorite because it combines many aspects of all the above theories. A therapist that uses this approach will be able to attack many different issues over your course of recovery, including self-esteem work, past and present emotional issues, and day-to-day coping strategies. This is also the most commonly used approach in practice today by therapists.

Marriage and/or Family Counseling may also play a role in your recovery depending on how important it is overall to involve your loved-ones. Some level of counseling can help you all learn to communicate with one another so that you will feel heard, and to be able to express your emotions to each other in a safe environment. Once you have started your own therapy you may wish to discuss these options with your therapist and whether or not you both feel it will be important.

Link: Types of Therapy


Dieticians

A Nutritionist and Dietician are sometimes referred to as the same thing. A Nutritionist may be someone who has completed some level of education in the area of Nutrition. A Dietician (or Registered Dietician, RD) has completed a 4-year college degree in nutrition and dietetics, has completed an internship, and has passed the American Dietetic Association's test for registration.

The goal of the Dietician will be to help improve your health and eating habits through nutritional counseling services. They will help you to incorporate healthy behaviors into your everyday life. Their goal should not be to "change" your habits overnight, but to teach you over a period of time how to promote a healthier relationship with the food you consume.

Dieticians can also play a role in the amount of exercise you do. They may work with you to slowly introduce more into your life, or to help you in realizing that you are overdoing it.

It is important to find a Dietician who has had experience in treating people with Anorexia, Bulimia and/or Compulsive Overeating. They should be sensitive to the issues that you are facing and should be aware of your history. It is usually best to go into a relationship with a Dietician under a "team approach", meaning that your therapist, medical doctor and dietician are all in contact with one another, either directly or indirectly, about your progress.


Inpatient and Outpatient Facilities

Places like Renfrew, Rader Programs, and The Remuda Ranch are all good examples of facilities that offer inpatient and outpatient facilities. Many of the larger Eating Disorders treatment centers can offer both, or may just specialize in one or the other. It is important to understand that each treatment facility is different, and not all programs consist of the same things, but the below descriptions will give you a general idea of what to expect from inpatient and outpatient services.

Inpatient: - When a person is "inpatient" it means that they will be living at the facility for a certain period of time. This can range from a couple of weeks to several months. The facility usually has medical doctors, registered nurses, therapists, dieticians and volunteers on staff to work with the people in recovery on a daily basis. It is intended to provide a safe environment in which to recovery from an Eating Disorder. Depending on the facility, the routine can vary, but it may include the following: group sessions, one-on-one therapy, medical evaluations, weigh-ins, nutritional counseling, art therapy, medication administration, spiritual exploration and prayer, meal times, and social or leisure activities. You make have weekly sessions with nurses, medical doctors, social workers, case managers and/or nutritionists. There may be involvement in projects, or times alloted for continuing education. Some programs may be more restrictive than others in their allowances for free time, and some may focus very highly on individual care (as opposed to a group approach). You will have to get information from each treatment center to find what works for you. Most programs will expect you to be somewhat medically stable before entering, meaning that if your health is extremely poor, you may require hospitalization before admittance.

Outpatient: - "Outpatient" means that the patient does not live at the facility. Outpatient programs are sometimes run by centers that do inpatient care, but can also be offered at Eating Disorders Clinics or Mental Health Clinics. Again, there is often a "team approach" with medical doctors, therapists, and dieticians on staff, with scheduled daily or weekly sessions depending on each individual's needs. One-on-one therapy and group sessions, daily activities and classes, art therapy, medication and medical evaluation, and weigh-ins may all be part of your schedule depending on the facility. You will have to get information from each treatment center to find what works for you.

Residential Housing: - The focus of residential care is usually to help with integration back into daily life. There is usually a required weekly time to meet with a therapist, social worker and/or case-manager, and for group sessions. There may be time alloted for schedule appointments with a dietician. Some programs offer the ability to get involved with volunteer projects and part-time jobs. The ultimate goal of residential housing is to help make the transition back into day-to-day life a little easier for those in recovery.

Generally, these types of facilities are meant to address treatment from a broad approach... not only teaching sufferers how to eat healthfully, but to address corresponding self-esteem issues, psychological diagnoses, coping mechanisms, behaviors, issues, and emotions. The way each facility does so, and their own treatment philosophy can vary, so it's important to ask a lot of questions and review as much information as you can about each program you are considering.

Link: Eating Disorders Treatment Centers


The Maudsley Method / The Maudsley Approach

Defining It...

  1. The first phase (Sessions 1-10) puts the parents in charge of the eating behaviour of the AN adolescent, making food the medicine to be administered to a patient. The first two sessions engage the family to determine their eating habits and assemble a picture of the AN impact on all family members. The therapist externalizes the illness by presenting the eating disorder as controlling the patient, freeing parents and patient from blame. The therapist then encourages the parents to find their own method to control the adolescent eating behaviours without using force or punishment, but rather through a system of creative measures that include functional rewards, such as "I cannot let you get your driving licence while you are too weak."

  2. The second phase (Sessions 11-16) transfers the control of the feeding process back to the adolescent, and addresses related family problems.

  3. The third and final phase of the treatment focuses on encouraging the processes of adolescent development that unfold as the AN wanes, and establishing new family relationships disentangled from the eating disorder.

Used appropriately, and as intended, the Maudsley Method is based on the foundation that where an Eating Disorder started matters little in its treatment. This isn't to belittle the issues a sufferer may feel in relation to their [possibly dysfunctional] family... This is to stop playing the blame game, and instead, for all members of the family to accept responsibility in "fixing what is broken."

When sufferers often feel "invisible" in their families, this type of intense involvement may suddenly act as a psychological facilitator in improving the overall relationship. It may help to make the sufferer feel seen, to feel cared about and loved.

While it seems on the surface that the focus of the Maudsley Method is to treat just the symptoms of the disease (behaviors/eating), you could make a lot of arguments that the impact of such involvement in teen treatment carries many hidden psychological messages. Getting family members (ie., parents) this inherently involved in their child's treatment obviously carries many hidden psychological messages and lessons.

Theoretically, Anorexia caught in an early stage (during developmental teen years), in a manner such as this, that [slowly] establishes appropriate boundaries, shows an immense concern from the family, provides proper nutrition, emphasizes that there is no need for shame (from either family or patient), teaches appropriate control, and reestablishes positive family relationships (in phase 2 and 3), responds well to this treatment for a variety of reasons, and does encompass many of the aspects of what more "traditional" treatments try to (and do).

As stated, this treatment is meant for dependent teens. It is important to determine if this is the right treatment for your child. It is important to consider your entire family dynamic when making this decision.

Without sounding like it's appropriate to put the "blame" on anyone, I often hear from sufferers things like my parents don't care, my family doesn't get it, they don't understand, they get so mad about my anorexia -- the Maudsley approach puts patient and parents into a mutual place -- one to battle the Eating Disorder together -- in an understanding, caring, nurturing way that does address issues (again, phase 2 and 3). That isn't to say that this specific approach is for everyone. One simple example... a child with a particularly controlling parent may resent this type of treatment all the more.

"The treatment is not for everyone. Abusive parents are excluded from family therapy. The treatment is suitable only for minors living at home, where some degree of parental control is assumed. 'For young adult anorexics, individual therapy seems to work best,' says Dr. Loeb, an advocate of the method." (source: Columbia University)

Link: Maudsley Method: New Treatment for Anorexia: ANAD

Link: The Maudsley Approach: A new family treatment

Link: New Approach To Anorexia

Link: Anorexia Strategy: Family as Doctor


12-Step Programs

Twelve-Step programs, such as Alcoholics Anonymous or Overeaters Anonymous, are based on twelve "quotes" that are accepted and believed in moving towards recovery. The groups are typically spiritually based in nature and follow a tradition of finding "sponsors" who work as support-towards-recovery mentors. It is a group atmosphere that may meet once or more per week.

The Twelve Steps are (this is a generalization): 1. admitting powerlessness - that life is unmanagable; 2. believing that a greater power could restore sanity; 3. deciding to turn will and life over to the care of God; 4. making a searching and fearless moral inventory or self; 5. admitting to god, self, and another human being the nature of our wrongs; 6. being ready to have God remove all these defects of character; 7. humbly asking God to remove our shortcomings; 8. making a list of persons harmed and being willing to make amends with them; 9. making amends with people hurt except when doing so would hurt them or others; 10. continuing to take personal inventory and admitting our wrongs; 11. improving the relationship with God through meditation and prayer and praying for knowledge of the will to carry out the power of His knowledge; 12. having a spiritual awakening as a result of these steps, and carrying the message to other addicts to practice these principles.

Twelve-Step groups are help all over the world, for all different types of addictions. A twelve-step program may or may not be for you... as with anything else, it's not for everyone. Visit the link below for more information on Twelve-Step recovery.

Link: Overeaters Anonymous

Link: Eating Disorders Anonymous...

Link: Grant Me The Serenity...


Additional Alternative Methods
The following is a list of alternatives that can be used in addition to more traditional methods of treatment. They have been helpful to quite a number of people... finding what works FOR YOU is important.

Physical Therapy: Physical therapy consists of the evaluation and treatment of injuries and disease with the goals of pain relief, restoration of function and the return to your fullest level of activity in school, work, recreation and sports. The initial evaluation examines your posture, biomechanics, ROM and flexibility, strength and balance. The treatment is based on this evaluation and includes an individualized program of progressive exercises and activities, in conjunction with the use of physical modalities as needed.

Occupational Therapy: Occupational therapists (OTs) help people improve their ability to perform tasks in their daily living and working environments. They work with individuals who have conditions that are mentally, physically, developmentally, or emotionally disabling. They also help them to develop, recover, or maintain daily living and work skills. Occupational therapists not only help clients improve basic motor functions and reasoning abilities, but also compensate for permanent loss of function. Their goal is to help clients have independent, productive, and satisfying lives.

Art Therapy: Art therapy is a human service profession which utilizes art media, images, the creative art process and patient/client responses to the created art productions as reflections of an individual's development, abilities, personality, interests, concerns, and conflicts. Art therapy practice is based on knowledge of human developmental and psychological theories which are implemented in the full spectrum of models of assessment and treatment including educational, psychodynamic, cognitive, transpersonal, and other therapeutic means of reconciling emotional conflicts, fostering self-awareness, developing social skills, managing behavior, solving problems, reducing anxiety, aiding reality orientation, and increasing self-esteem. (more...)

Movement Therapy: Based on the assumption that body and mind are interrelated, dance/movement therapy is defined by the American Dance Therapy Association as "the psychotherapeutic use of movement as a process which furthers the emotional, cognitive and physical integration of the individual." Dance/movement therapy effects changes in feelings, cognition, physical functioning, and behavior.

Yoga: Yoga is taking on a wider role in modern life; an expansion beyond the Yoga classroom into all areas of our community as a vehicle for wellness, healing and personal transformation. Trained Yoga professionals help bring the ancient insights of Yoga into mainstream wellness programs. Because health is seen as a unity of body, mind and spirit, Yoga is a vehicle for deepening this experience of Unity and bringing it into the world as a resource for personal growth, healing and awakening. (more...)

Spiritual Guidance: This can be anything from counseling with a priest or pastor or exploring your beliefs with the help of someone versed in your spiritual area of interest. Spiritual Therapy assists you in this process of inner healing and spiritual growth. It leads you on the path from self-doubt to self-empowerment. It involved your beliefs surrounding the meaning of life, a higher-power and your own faith.

Sensory Integration: The senses work together. Each sense works with the others to form a composite picture of who we are physically, where we are, and what is going on around us. Sensory integration is the critical function of the brain that is responsible for producing this composite picture. It is the organization of sensory information for on-going use. Sensory Integration Therapy seeks to encourage the nervous system to process and integrate sensory input in more organized and meaningful ways, which will ultimately enhance the ability of the nervous system to function with more efficiency. Each adaptive response, as it provides feedback into the nervous system, encourages maturation and organization of the nervous system at increasingly higher levels. Ultimately the individual is able to interact with his/her environment in more successful and adaptive manners.

Reiki Healing: Healing is not the popular conception of removal of symptoms. Healing is full and complete resolution of the causes of the disease. Healing is returning to a state of alignment with your Higher Self or true way of being. In its simplest form using Reiki is simply the practitioner placing their hands on the recipient with the intent of bringing healing, and willing for Reiki energy to flow. There is a set of hand positions traditionally taught which give good coverage over the recipients entire body. It is not necessary to follow those positions, they are merely taught as a starting position from which the practitioner can learn. If there is a specific area of concern the practitioner can keep his/her hands right there for as long as necessary. (more...)

Meditation: Meditation Therapy is a bold approach to finding lasting solutions to our deepest problems and concerns. Combining the power of deep meditation practice with the insights of psychology, Meditation Therapy will help you to experience healing transformation in powerful and lasting ways. Genuine healing occurs only when we are willing to examine the deepest parts of ourselves and create positive new patterns of responding to life. You will learn how to transform your mental attitudes and activate your own innate healing power. (more...)

EMDR (Eye Movement Desensitization and Reprocessing): It is an innovative clinical treatment that has successfully helped over a million individuals who have survived trauma, including sexual abuse, domestic violence, combat, crime, and those suffering from a number of other complaints including depressions, addictions, phobias and a variety of self-esteem issues. EMDR is a complex approach to psychotherapy that integrates many of the successful elements of a range of therapeutic approaches in combination with eye movements or other forms of rhythmical stimulation in ways that stimulate the brainís information processing system. With EMDR therapy it is unnecessary to delve into decades-old psychological material, but rather, by activating the information-processing system of the brain, people can achieve their therapeutic goals at a rapid rate, with recognizable changes that donít disappear over time. (more...)

12-Step: See above

Life Coaching: A Life Coach listens to you when you most need it and will give you non-judgemental support and the tools to guide you to achieve the following: Change your lifestyle, Love the life you are living, Find your unique purpose in life, Identify your true vocation, Find the tools to relax and enjoy life, Bring out your spirituality. A Life Coach will help you discover what's really most important to you in your life, then help you design a plan to achieve those things. They'll work with you to eliminate any obstacles or blocks that stand in your way and partner with you all the way to success. (more...)

Touch Therapy: Through both light touch and the clearing of your energy system without touch, you are assisted in the release of stress and anxiety. You are also provided a safe and relaxing healing space. Touch Therapy is a wonderful assistance in your personal growth and self fulfillment. The positive effects of this type of therapy have been experienced by many people worldwide.

EEG Biofeedback: Neurofeedback, also known as EEG Biofeedback, is a learning procedure that enables participants to improve mental performance, normalize behavior, and stabilize mood. Neurofeedback is a technique in which we train the brain to help improve its ability to regulate all bodily functions and to take care of itself. When the brain is not functioning well, evidence of this often shows up in the EEG (Electroencephalogram). By challenging the brain, much as you challenge your body in physical exercise, we can help your brain learn to function better. A better functioning brain can improve sleep patterns. When you sleep more efficiently, you are more alert during the day. It can help with anxiety and depression, and with syndromes like migraine or chronic pain. Secondly, it can be helpful in managing attention - how well you can persist even at a boring task. Thirdly, it can help you manage the emotions. Emotions may feel like the real you, but your brain has a lot to say about how you feel and react. If the emotions are out of control, that's trainable. If they aren't there---as in lack of empathy, for example---that, too, is trainable. (more...)


:: IN ENGLISH :: EN ESPAÑOL ::

:: Toolbox :: Reaching In :: YOU :: Coping ::
:: Motivations :: Affirmations :: Body Image ::
:: Treatment Types :: Questions :: How Will I Pay ::
:: Helpful Books :: Treatment Finder ::

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