Treatment Process

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Treatment for an eating disorder involves strength and courage and with the right support and professional guidance, a full recovery is possible. Eating disorders and co-occurring mental health disorders are complex and require comprehensive solutions. For this reason, the Toledo Center for Eating Disorders uses the following evidence-based therapies to help our clients successfully recover.

Developed by Dr. Aaron Beck in the 1960’s, Cognitive Behavioral Therapy (CBT) has been researched extensively and is the most widely used therapy for treating eating disorders, mood disorders, anxiety, and schizophrenia. CBT is a solution-focused, evidence-based treatment approach that emphasizes changing behavior by applying specific skills. CBT identifies, addresses, and teaches clients ways to challenge the core beliefs that contribute to the negative way they see themselves, other people, and the world, by focusing on the ways thinking influences emotions and coinciding behaviors.

Dialectical Behavior Therapy (DBT) was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). However, it has been proven to be successful in the recovery process for eating disorders, mood disorders, anxiety, and post-traumatic stress disorder (PTSD). DBT helps clients develop the skills needed to regulate distress and find a balance between thoughts and emotions. DBT helps clients to focus on developing skills, such as engaging mindfulness, becoming more effective in interpersonal relationships, improving emotion regulation, and increasing distress tolerance. Through this, clients can better manage impulsivity, suicidal behaviors/ideations, feelings of emptiness and hopelessness, feelings of abandonment, unstable interpersonal relationships, and engagement in dangerous or life-threatening behaviors. With the combination of commitment, motivation, and practice, Dialectical Behavior Therapy can assist people in eventually becoming more regulated and self-sufficient.

Acceptance and Commitment Therapy (ACT) was founded on the idea that most psychological distress is tied to “experiential avoidance.” It was developed by Steven C. Hayes, Kelly Wilson, and Kirk Strosahl as an attempt or desire to suppress unwanted internal experiences, such as emotions, thoughts, or bodily sensations. ACT focuses on helping clients learn to observe, recognize, and accept a realistic perception of self while learning to manage thoughts that may exacerbate anxiety or problematic behaviors.

Mindfulness training involves developing awareness of experiences in the moment, including thoughts, feelings, and the surrounding environment, as well as accepting emotions, and not passing judgment on the present. Mindfulness-based therapy can be helpful in learning how to manage external stressors that may be triggers for distress through binge eating, restriction, purging, excessive exercise, self-harm, etc. Utilizing therapeutic techniques helps clients learn to be more observant instead of reactive in the present and can aid in developing skills that allows emotions and thoughts to process.

Psychodynamic therapy believes that our experiences from the past influence the way we see and interpret the world. Clients gain insight on present-day problems, beliefs, and thoughts, through a healthy therapeutic relationship that allows them to identify and process through events, relationships, and patterns throughout life. As insight is gained, coping mechanisms are developed that can be implemented to manage distress and they learn to engage in different behaviors moving forward to inhibit the continuation of distress-inducing experiences.

Narrative therapy functions from the belief that our experiences contribute to our narrative or story, meaning the story that we develop about ourselves is based primarily on our interpretation of life experiences. It utilizes the power of people’s stories to discover life purpose. Because narrative therapy sees people separate from their problems, it works towards transforming the effects of the problem, instead of changing the person. Through narrative therapy, clients are empowered to re-define their stories.

Often used in treating anxiety disorders, Exposure and Response Prevention Therapy (ERP) exposes clients to the feared object or circumstance in the absence of danger to desensitize fear and distress while reinforcing safety. ERP helps the brain re-conceptualize the threat by gradually increasing the exposure to the fear at mild to moderate levels while reinforcing safety through affirmation and experience.
When treating eating disorders, particularly bulimia nervosa,  anorexia nervosa, and Avoidant Restrictive Food Intake Disorder (ARFID), ERP can aid in helping to overcome the fear of consuming certain foods and can also assist with anxiety-provoking experiences like being weighed, grocery shopping, or looking at oneself in the mirror.

Experiential therapy includes multiple approaches such as role-playing, group sculpting, use of props, guided imagery, art therapy, etc. Unlike traditional talk therapy, experiential therapy encourages clients to address hidden and sometimes subconscious issues through experiential activities and interactions.

Commonly used for treating health disorders, as well as eating disorders, motivational interviewing encourages collaboration between client and therapist to identify internal motivating factors that allow for change.

Internal Family Systems is the theory that we each have different internal components filling the needs we have for love, attachment, belonging, achievement, survival, etc. Working with a trained therapist, clients identify the root of conflict and ways to navigate the conflict in themselves and others by developing a deeper understanding of these components, their experiences, and their needs. Identifying and meeting the needs of these components dissolves our tendencies of meeting needs in other ways and equips us to identify and navigate conflict more effectively.

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