Struggling with an Eating Disorder or discovering that your loved one is struggling can be such a confusing time. It’s hard to even know where to start. This often provokes more stress and anxiety for people. As an Eating Disorder Therapist in Tyler, Texas, I consider it my primary responsibility to bring some initial calm to a very stormy situation. I seek to do this by providing the best, evidence based approach to Eating Disorder Treatment. Your first step is to get adequate care and there are so many phenomenal providers out there. Sometimes you have to do some filtering to determine whether you have found the right care. Here are some tips to help you know you are on the right track:
- Eating Disorder Therapists need to do a thorough assessment. Remember this is your time to interview the therapist so don’t be afraid to ask questions about their training, qualifications, and experience. An assessment usually lasts about 60-90 minutes and should cover all past history, food and body history, and behaviors.
- Eating Disorders have a nutritional and medical component. Many therapists are equipped to deal with the underlying anxiety or reliance on the Eating Disorder Behavior as a Maladaptive coping skill but may not be aware of the medical issues. This can be dangerous. Many people, including counseling professionals, wrongly assume that they can determine a client’s medical status by looking at them. This is false. A trained Eating Disorder Therapist will know their limits and be aware of the serious health complications that are often present and refer clients for regular medical evaluations and dietetics appointments.
- Eating Disorder Treatment occurs within a team. Because of the medical and nutritional aspect, your eating disorder therapist should be referring you for medical evaluation and dietetic services. This is part of my initial assessment with each and every client. If your eating disorder therapist is giving nutritional advice or telling you what you should and should not be eating, this can be life threatening. If any therapist is doing this they are operating outside of their scope of practice. No Therapist has received the training to manage this important aspect of care and doing so could be harmful and even deadly for a client. I take this very seriously. I don’t care if your therapist had previous training in nutrition, has an online certification, or has a sister who is a dietitian, they should be referring to an EATING DISORDER DIETITIAN who is highly trained and skilled in working with individuals who struggle with an eating disorder.
- An Eating Disorder Therapist should have specific and ongoing training in treating Eating Disorders. This training should be up to date. I also intentionally choose therapists that are active and involved in professional associations such as the International Association of Eating Disorder Professionals (IAEDP) because these organizations oversee standards for training within the treatment community.
- An Eating Disorder Therapist should be trained in treatment methods that have been proven to be helpful in treating eating disorders. Acceptance and Commitment Therapy (ACT) and Dialectical Behavioral Therapy (DBT) are both great treatment approaches. I know this can seem overwhelming but I also encourage people to ask what specific training a therapist has received, reading a book or two in a specific therapy approach is not enough training to treat an eating disorder.
- Your Eating Disorder Therapist should not be promoting weight loss, “weight management,” or “obesity” treatment. Some clinicians believe this “attracts” clients that might need help but I believe it is false advertising and harmful. I am not alone in this thinking. So even if your therapist is only advertising these services to attract clients that are struggling this is not being honest. If your therapist is promoting weight loss and eating disorder services, this is very harmful. Weight loss has been proven to be ineffective and evidence has shown that dieting and weight loss actually lead to weight gain and increase the likelihood of developing an eating disorder. Also, it is unethical and harmful to prescribe for one set of people what we diagnose in another. If we are promoting fat phobia, which is a system that supports eating disorder development, in our practices how can we possibly give our clients freedom from their Eating Disorder?
- Your Eating Disorder Therapist will have time for you and your care. For every hour I spend with clients I can spend up to one-two hours following up with their dietitian and medical provider to assure that they are being given the best treatment possible. This ensures the likelihood of recovery. If your therapist is seeing 35 clients a week, that will leave little time for these other aspects of care. I have to set aside a few hours every week in my schedule to make these phone calls, attend team meetings, and follow up with my client’s that are in treatment facilities. A good sign your therapist is too busy, is if they can’t remember important details and events you have discussed with them. It is always okay to ask how many clients a therapist sees on average per week.
- Your Eating Disorder Therapist should have boundaries and good business practices. They shouldn’t be accidentally double booking clients, running late all the time, or canceling last minute. Look…Life happens! And when it happens to my clients I give them grace. Occasionally, I may have a sick child or a miscommunication in my scheduling. This should never be the norm though. I consider it my duty to interject calm in the midst of the chaos of recovery. I do this first by having good business practices.
- Your Eating Disorder Therapist should be understanding and patient. Recovery can take anywhere from 2-7 years. This isn’t a brief- solution focused game. This is serious dedication and commitment. Walking alongside a client during recovery means understanding recovery is not linear, while also believing that recovery is 100% possible. If your Eating Disorder Therapist is promising quick results be cautious.
- Your eating disorder therapist shouldn’t joke about your eating disorder. Oh! I have heard it all “I wish I got to eat cookies for snack everyday!” “I wish I could not eat.” These comments are belittling and hurtful. They are dismissing the very difficult reality of an eating disorder. They are also weight centric and fatphobic.
- Your eating disorder therapist shouldn’t make you feel shame about your eating disorder behaviors. You should feel comfortable talking about these things without fear of judgement in session.
- Be cautious about Therapists that “do it all.” Even when I am looking for my own therapist I am skeptical of people who say they treat dozens of different issues using dozens of different modalities. Here’s why: Believe it or not we therapists don’t learn everything in Grad School. We continue to learn across our lives, at least the best therapists I know do. There is no way to know how to do everything and to be skilled at a certain therapeutic approach often takes six months to a year. Here is how I usually explain this to non therapist-y types: If I want heart surgery I go to a cardiologist. I would be really concerned if my general practitioner tried to do open heart surgery. Therapy is a specialty field and I want my own therapist to be highly trained in whatever struggle I am having.
Eating Disorder Therapists are the best! I might be biased because many of them are my closest friends but they are some of the most amazing warriors I know and are usually passionate about activism and speaking out against our disordered culture. We have an active and involved Instagram community and love to walk alongside you during this difficult struggle. Find the best help possible. This will make a difference in your recovery.