EATING DISORDERS: Key skills and strategies to increase your confidence and enhance client outcomes. (Melbourne)

Eating Disorders is often thought of as a complex psychiatric illness that can feel challenging to treat.  This workshop will help participants build confidence in working with clients with Eating Disorders by developing the skills to deliver evidence-based treatment strategies. Morag brings her clinical experience as a therapist and manager within a hospital for people living with Eating Disorders where, in that role she devised the eating disorders program. The main therapeutic strategies from that successful program will be shared as part of the workshop content. 

The day will commence with an overview of the different types of eating disorders, the important nature of the complexity of client presentations and how the therapeutic relationship is paramount to motivation and change.  Attention will be given to ways in which a good therapeutic relationship can be developed from the start. Assessment skills will be covered, and an assessment form used in Morag's clinical work will be provided.  

Clients with eating disorders are often ambivalent about their symptoms as they experience some benefits to their eating behaviours, thus difficulties in motivation can be prevalent. Low motivation to change is a predictor of high drop-out rates and lower treatment outcomes (Assessing motivation to change in eating disorders: a systematic review. Journal of Eating Disorders volume 1, Article number: 38 (2013). For this reason, some strategies to assess and motivate clients to engage in treatment will be provided. Prochaska and Diclimente’s stages of change model will be discussed. A live role-play from Morag will demonstrate the key strategy of assessing the pros and cons of change. Other motivational strategies that will be covered include values identification and imagining a day being recovered.

The importance of formulation in treatment will be discussed and a clinical example of this will be explored. The formulation will be based on CBT-E and a longitudinal CBT formulation will also be given.

 Research has shown that CBT is an effective treatment for people with Eating Disorders (Evidence based clinical guidelines for eating disorders: International Comparison Curr Opin Psychiatry. 2017 Nov; 30(6): 423–437, National Institute for Health and Care Excellence (2017). Eating disorders: recognition and treatment. London, UK: National Institute for Health and Care Excellence).

CBT-E is a transdiagnostic model developed by Chris Fairburn. In the afternoon session, Morag will detail the main strategies in the CBT-E model.  Within this will be examples of how she presents the strategy to clients and how to address any challenges. The CBT-E strategies will include food diaries, regular eating, binge analysis and alternatives to binges, tackling over-evaluation of appearance, body and mirror checking, dietary rules and food avoidances, feeling fat and comparisons, self-esteem and perfectionism.

Morag will provide a few bonus strategies from other models including distress tolerance and mindfulness from DBT.  A video demonstration with a current patient of the empty chair technique used in schema therapy will be shown and discussed. This will demonstrate a dialogue between the eating disorder voice and the healthy self which will encapsulate the main aims of the overall treatment – to increase the power of the healthy voice over the eating disorder voice. The workshop will end with a short video interview with a current patient about her eating disorder and her therapy journey.