Counseling for Eating Disorders

Learning Objectives

  1. Define an eating disorder.
  2. State Gerald Russell’s description of “bulimia nervosa.”
  3. Briefly describe the behavior of someone with an eating disorder.
  4. Indicate the normal range for the body mass index.
  5. Describe the person who is anxious.
  6. List the physical toll on the body of the person who is anorexic.
  7. Describe bulimia according to Gerald Russell.
  8. State the average age of the bulimia sufferer.
  9. State the percent of bulimics who are male, according to Carlat and Camargo.
  10. List the psychological disturbances that bulimics may have.
  11. State the medical professional who may be first to diagnose bulimia.
  12. Describe the person with a binge eating disorder according to Wilfley.
  13. Briefly list the 5 characteristics of binge eating according to DSM-IV.
  14. List the medical causes for overeating.
  15. Describe Arthur Crisp’s work of 1980.
  16. State the common idea of all psychosomatic theories.
  17. State the food group that reduces negative mood states.
  18. Describe the anorexic family according to Minuchin.
  19. Describe how a person with an eating disorder attempts to bring control to a chaotic life.
  20. Define the systems theory.
  21. Describe the role of antidepressants in the treatment of bulimia.
  22. State the percent of anorexics and bulimics who suffer from obsessive compulsive
  23. Describe why ballet dancers and athletes are more likely to become anorexic or bulimic.
  24. Briefly describe the “restrained eater,” and state who proposed this concept in 1975.
  25. Describe 4 important aspects of cognitive behavioral therapy.
  26. List the 3 stages for treating eating disorders.
  27. Define the “early maladaptive therapy.”
  28. Describe Zen psychology.
  29. Describe the perfect body as viewed by young people.
  30. State why the bulimic has puffy cheeks.
  31. State the most attractive feature of cognitive behavioral therapy.
  32. List the one chief aim of cognitive therapy approach.
  33. Describe the most effective way to assess a person with an eating disorder.
  34. Define dysmorphophobia.
  35. Describe the group of people whom questionnaires are least helpful.
  36. List and describe the 6 stages of change as outlined by Prochaska and Di Clemente.
  37. State why record keeping is unsuccessful.
  38. State the average number of calories needed per day for the average healthy woman.
  39. List the fat-soluble vitamins.
  40. State where glycogen is stored.
  41. State the number of meals and snacks that should be included in a day’s meal plan.
  42. Define resting energy expenditure and its readings in the anorexic patient.
  43. Describe why bloating occurs during refeeding.
  44. List an example of a target that needs to be set by the counselor.
  45. State why clients should purchase clothes at their current size.
  46. List the three negative thoughts of people with eating disorders.
  47. Define core beliefs
  48. Define deconstructive language.
  49. Describe a continuum.
  50. State if there is a connection between prior events and bingeing.
  51. Describe the reason for poor outcomes for the bulimic patient.
  52. List another method used concurrently with cognitive behavioral therapy for people
  53. State how long the usual course of treatment will continue for bulimics.
  54. List the reasons for diet slips and “lapses.”
  55. State the main reason for a lapse into old habits.
  56. State the critical disadvantage of group work.
  57. State the critical BMI for the anorexic patient that requires hospitalization.

Course Contents

1 What is an Eating Disorder?
  • A note about psychiatric diagnosis
  • Recognition of eating disorder
  • The relationship between weight and eating disorder
  • Anorexia nervosa
  • Bulimia nervosa
  • Atypical eating disorders
  • Other cause of weight loss or gain or unusual eating behaviors
2 Causes of Eating Disorders
  • Psychosomatic theories
  • The family as a source of eating disorder
  • Eating disorder and other psychiatric diagnoses
  • Anorexia and bulimia nervosa as sociocultural phenomena
  • Eating disorder as learned behavior
  • Eating disorder as a corollary to dieting and food deprivation
  • The restraint hypothesis
  • Conclusions
3 A Cognitive Behavioral Approach to Eating Disorders
  • What is cognitive behavior therapy?
  • An outline of the characteristics of cognitive behavior therapy
  • The nature of cognitive behavior therapy as applied to eating disorders
  • A broad interpretation of cognitive therapy for eating disorders
  • The theoretical basis of cognitive behavior therapy in relation to eating disorders
  • The structure of cognitive therapy for eating disorders
  • The acceptability of cognitive therapy for eating disorders
  • How effective is cognitive behavior therapy for eating disorders?
  • Conclusions
4 Beginning the Counseling Process
  • The initial stages
  • Some questions to ask when assessing the person with an eating disorder
  • The use of questionnaires in the assessment of eating disorders
  • Presenting the cognitive behavior view and formulating the problem
  • Assessment of motivational stage in people with an eating disorder
  • Self-monitoring by the client
  • Setting the agenda for therapy
  • Psychoeducation
5 Nutritional Aspects of Helping the Eating-Disordered Client
  • Nutritional knowledge of eating-disordered clients
  • Nutritional counseling
  • The body’s need for good nutrition
  • Knowledge about energy balance and weight regulation
  • Information about the specific effects of bingeing and purging
  • Information about the effects of food and eating on metabolism
  • Establishing a normal eating pattern with obese binge eaters: to diet or not?
  • Establishing weight gain with anorexics
6 Behavioral Techniques
  • Self-monitoring
  • Target setting
  • Self-reward
  • Scheduling pleasant events
  • Behavioral techniques for controlling overeating (self-control)
  • Taking exercise
  • Practicing “normal” eating
  • Exposure
  • Assertiveness around food
  • Relaxation and stress management
  • Conclusion
7 Cognitive Techniques
  • Identifying negative thoughts
  • Answering negative thoughts
  • Homework
  • Identifying and dealing with dysfunctional assumptions and core beliefs
  • Modifying assumptions and core beliefs
  • Exploring the meaning of eating disorder symptoms
  • Getting “stuck”
  • Conclusion
8 Adapting to Complex Situations and Dealing with Endings
  • Working with severe and complex cases
  • The end of the counseling relationship
  • Preventing relapse
  • Involving family members in the counseling
  • Working with groups
  • Working in parallel with other treatments
  • Conclusion

Conclusion
Appendix 1: Eating Disorders and Their Effects
Appendix 2: Eating Problems: Resources for Clients
Appendix 3: Guidelines for Normal Healthy Eating
Appendix 4: The Effects of Strict Dieting and Starvation and of Giving Them Up
Appendix 5: Medical and Physical Problems Caused by the Symptoms of Eating Disorders
Appendix 6: Controlling What You Eat
Appendix 7: Giving Up Vomiting as a Way to Control Your Weight or Deal with Stress
Appendix 8: Learning to be Assertive about What You Eat: A Bill of Rights
References

Comments:

"I enjoyed this book. It will be a great book for future reference. The learning format is very convenient and you cant beat your prices!"

- J.C., LPC, LMHC, FL

"The patient examples were helpful."

- D.C., NBCC, IA