ABN8595 - Anorexia Nervosa and Bulimia Nervosa: An Introductory Guide to Eating Disorders
ANOREXIA NERVOSA AND BULIMIA NERVOSA: AN INTRODUCTORY GUIDE TO EATING DISORDERS
by Iréné E. Celcer, MA, LCSW
Iréné Celcer, LCSW is a Licensed Clinical Social Worker with over twenty years experience working with eating disordered clients. She is a member of the Board of EDIN (Eating Disorders Informational Network), an organization based in Atlanta whose mission is to educate and prevent eating disorders, and the author of two books and numerous articles on eating disorders. Additionally, Ms. Celcer has delivered a number of workshops and presentations to other clinicians and the public on the subject of eating disorders.
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The objective of this course is to provide the mental health clinician with a comprehensive introductory overview of Anorexia Nervosa and Bulimia Nervosa. When the trainee completes this course, he/she will:
- Understand the classification of the main eating disorders according to the DSM-5
- Know the prevalence of anorexia nervosa and bulimia nervosa and the rising incidence among males.
- Comprehend causes and mechanisms underlying eating disorders.
- Understand the socio-cultural aspects of eating disorders
- Learn additional factors that have shaped the manifestations of some eating disorders.
- Grasp the multiple meanings that an eating disorder may have for patients from different cultural backgrounds.
- Know mental disorders commonly associated with eating disorders.
- Comprehend the different treatment modalities effective in eating disorders, including the appropriate use of medications.
This course is primarily designed for clinicians in the earlier stages of their career, or for more advanced clinicians reviewing basic concepts in this area.
8 contact hours: Core clinical
TIPS ON PREPARING FOR THE POST-TEST
Post-test questions will be heavily focused on material that is helpful for clinicians as they evaluate clients for eating disorders and prepare to engage in relevant psychoeducation with clients and families. Pay special attention to the Factoids presented throughout the course, as these will hold important information for each clinician to know and understand.
Section I: Questions and Answers about Eating Disorders
Section II: Examination of the Socio-cultural Aspects of Eating Disorders
Section III: Intervention with the Eating Disordered Client
Section IV: Clinical and Practical Ways to Talk to Your Patient (Part 1)
Section IV: Clinical and Practical Ways to Talk to Your Patient (Part 2)
Section V: Making a Successful Referral
Section VI: The Treatment Process
Section VII: The Therapist’s Role
Section VIII: Tips for Eating Disorders Therapists
Section IX: Hands-On Exercises for Patients suffering from BN, AN, ED NOS and Body Image Problems
References and Test
Most clinicians who work with individuals, couples, or families will be confronted at some point in time with one or more clients whose problems include the presence of an eating disorder. At that point in time, the clinician will be in a position of responsibility towards that client's well-being.
There will be two groups of clinicians for whom this course will be appropriate. The first group is the larger group: those clinicians who will not become eating disorders specialists, but who will need a solid foundation in the nature, course and treatment of eating disorders in order to possess both skill and knowledge when a client with eating disorders appears as part of their practice.
Because this represents the more usual circumstance, the course will have as its focus providing this target group with the most useful information possible.
For this group of trainees, this course does not pretend to serve as a comprehensive training of the sort that would allow a clinician subsequently to present himself or herself as a specialist and expert in the treatment of eating disorders. Rather, it will provide a solid foundation for knowing how to proceed with eating disorders cases when they arrive on the clinician's doorstep. This knowledge base – for the non-specialist – will need to include how to make successful referrals to clinicians who do specialize in eating disorders.
The second – and smaller - group will consist of those clinicians who may indeed wish to become eating disorders specialists, but who are just at the beginning phases of preparing themselves for that path. The hope is that this training course will also provide for them a solid and detailed foundation for their professional journey, with some direction about other areas of study that may be required on the way to expertise in this kind of work.
There are a number of facts about eating disorders that both groups of trainees must understand. Clients with eating disorders can be very secretive about their symptoms, as well as very resistant to treatment. Additionally, there is a very high mortality rate with certain kinds of eating disorders. For these reasons, it is very important that all clinicians have a solid knowledge base concerning eating disorders, so that the client may be successfully identified, engaged in treatment, and directed towards appropriate specialized services.
This knowledge base will need to be fairly broad, as many aspects of this knowledge base will have an impact on whether the clinician can successfully perform his or her key role at the point of initial contact - inviting the eating disordered client into accepting treatment services. The clinician must first have enough awareness to determine that an eating disorder is present. This will require a substantial amount of knowledge of what to look for and how the symptoms will present themselves.
The clinician must then have knowledge of what forces are operating in the client's overall symptomatology. In order to circumvent the client's resistance to acknowledging and confronting the problem, the clinician must be prepared to address each factor that contributes to the eating disorder at the level at which it is operating in the client.
Next, the clinician must have a reasonable overview of what approaches are used by specialists to intervene with eating disorders. If the clinician is going to be successful in referring a generally resistant client, that clinician must have sufficient knowledge to answer the client's questions about what treatment will involve.
For this reason, two sections will be presented concerning treatment. One of the sections will provide an overview of treatment models used to address eating disorders. The other section will present some information about interactional styles that may used by eating disorders specialists, and intervention content and how it is used. This will allow the non-specialist to both answer pertinent questions of what awaits the client and to align the initial assessment interventions with the larger shape of treatment.
As we will see, eating disorders are multi-faceted and complex. The motivations of the client to either get well, or remain bound to the eating disorder, must be understood in their full complexity to get certain clients to even acknowledge a need for treatment. Given the high mortality rate of certain groups of eating disordered clients, it is vital to be prepared to intervene with knowledge and skill if these clients arrive at your door for treatment.
This course has been developed to provide the fundamental knowledge base that will allow a clinician to operate with some confidence and competence. Some sections, like those covering recent statistics on incidence and prevalence, are designed to provide the clinician with important overview information that may correct common misperceptions in the field.
Other sections, like those covering socio-cultural factors contributing to eating disorders, will be useful in shaping the dialogue with the client when it comes to building motivation for change. Still other sections will cover more concrete skills that will be useful in identifying and responding to eating disorders.
The common thread throughout is that each section has been composed with an eye towards offering the most complete and useful information for the clinician. Every attempt has been made to be as brief as possible, while including all of the substantial information necessary to provide a comprehensive overview.
Eating Disorders Factoid
Eating Disorders are currently the third most common chronic medical illness in adolescent girls.
Source: Adolescent Medicine Committee, Canadian Paediatric Society