eNewsletter - February 2015

Behavioral Health Partners

A Values Based Treatment Approach to Eating Disorders: A Therapist’s Perspective
by Neha Pancholi, PsyD

Members of society may wonder what an eating disorder entails and why or how individuals can struggle with a basic necessity such as food. However, more times than not, emotional avoidance is the common denominator for most eating disorder patients.

As health care professionals, we utilize a variety of treatments for individuals with eating disorders including Cognitive Behavioral Therapy (CBT), Psychodynamic Theory, Internal Family Systems, Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT). The values based approach that we use at Arabella House, an residential eating disorder facility in Naperville, stems out of ACT.

ACT teaches individuals to simply notice, accept and embrace their personal experiences, whether positive or negative, especially ones that they have been avoiding for days, months or even years. The first step is acceptance and then the individual works towards clarifying the personal values that lead them towards recovery from their eating disorder.

Eating Disorder behaviors such as binging, purging and restricting can be perceived as behaviors to avoid current emotional experiences that can deter individuals from achieving their personal values. A value can consist of many things; one example is family. If an individual decides that they want to commit to recovery and their primary value is family, then family is what they keep in the forefront of their mind as they strive to accept the struggles they face during recovery.

When utilizing this approach it is important to allow the resident to select a value he/she is passionate about versus a value predetermined by the therapist or other parties.

For example, an individual may value recovery from his/her eating disorder but only if he/she is constantly with loved ones as opposed to doing recovery on his/her own. Instead of asking this individual to work through the eating disorder independently, which is ideal, the therapist recognizes that the individual has struggled for many years and that he/she needs to approach recovery systematically rather than being pushed to do something that he/she is not ready for and does not see as a value.

This individual would eventually need to get to a place where he/she wants recovery regardless of who he/she is with, but they need to get there on their own in order for it to be long lasting. It is important to meet the patient where they are at and support them throughout their entire recovery.

Eating disorders are complex and require acceptance and commitment from the therapist as well. Health care professionals can become frustrated due to months and months of therapy without seeing any progress; however, it is important to remember that if patients are rushed through the treatment process, then they are unlikely to sustain recovery moving forward.

At Arabella House, patients partake in a vast array of experiential activities such as learning how to cook and clean. They participate in normalized exercising, grocery shopping, restaurant outings, conquering challenging foods, etc. With these experiential activities, it is crucial that the resident value recovery at some level; otherwise, they will not have the motivation to participate in all of these activities.

If an individual's values are not at that level yet, a higher level of treatment may be a better fit for them. For example, in inpatient treatment, a patient may start off treatment with value for a spouse or a family member or their own medical health. These individuals often start off with these types of values and then, through treatment, develop a value for recovery and transition to outpatient therapy or a residential home such as Arabella House.

In brief, individuals have varying values, but in order for treatment to be effective it is important for the health care professional to support the individual in identifying their values and then support them through their commitment to action.

Neha Pancholi, PsyD
Neha graduated with her doctorate in clinical psychology from the American School of Professional Psychology in Washington D.C. where she also received her master’s in clinical psychology. Neha completed her bachelors in psychology at Loyola University in Chicago. In graduate school, Neha was the founder of a Mindfulness Interest Group and conducted various research studies in this topic area. Neha’s dissertation, also, pertains to the topic of Mindfulness and Emotion Regulation. For the past two years, Neha has been working with the eating disorder population at Linden Oaks. Last year, Neha was the pre-doctoral intern for the inpatient eating disorder unit at Linden Oaks. This year, Neha is the post-doctoral fellow at Linden Oaks’ Arabella House, a residential treatment facility for women with eating disorders and other comorbid illnesses.

Family Involvement in Eating Disorder Treatment
Laura Jaramillo, MS, LPC, NCC

Looking into the treatment of an eating disorder, one may feel that they are looking through a window into a house where things look “normal.”

Treating eating disorders in any type of setting is challenging and there are so many different levels of care choices for those seeking treatment for an eating disorder that it can be difficult to discern which treatment is appropriate. In addition, there are many different options when it comes to eating disorder facilities. Choosing a level of care and facility depends on the needs of the person who is seeking treatment.

While seeking treatment, it is important that the individual with the eating disorder consider a place that will encourage family support, educate those who are supporting the individual in treatment, and involve the family in the treatment process. In treatment, the definition of family does not encompass only biological family members, but also friends, colleagues, significant others, and anyone else that is significant in the person’s life.

It is most helpful if the family is involved in the formal treatment of an individual from the beginning to end. The individual will not find a quick fix in treatment but, many times the family will have this expectation initially. An eating disorder is not like a disease such as diabetes, where one may learn to manage it within a couple weeks. Recovery from an eating disorder can take many years. Typically, the length of time it takes to recover from an eating disorder depends on the length of time the individual has been struggling.

As a clinician, I have seen that education provided to an individual’s family is vital to their healing process. Reminding family that treatment will not fix their loved one can also be crucial to a person’s recovery. Many times family members are not aware of the treatment process and have unreasonable expectations for the individuals when they are discharged from any type of treatment program. This is not meant to discredit the work the individual has done in treatment, but the family should have the knowledge that there is a significant amount of work yet to be done once the individual starts outpatient treatment.

“My family is my strength and my weakness.” This statement came from a resident at Arabella House, a residential treatment facility for individuals with eating disorders in Naperville, and reflects on how her family is her biggest support system but they also have enabled her through many years of her eating disorder behaviors. While this individual eventually took time to realize that she had to take responsibility for all of her behaviors, she also voiced her needs to her family.

Most of the time an individual will leave treatment in a different state of mind and being making changes in their behavior, moving forward with recovery, and finding their voice. Their family will greet them with open arms, but then realize that their child, wife, son, daughter, friend is a different person. The eating disorder is no longer 100 percent in control of the individual who went into treatment. Dynamics between everyone can change dramatically and without the continued education, involvement, and support of a treatment facility, this individual may quickly fall back into damaging behaviors because of the lack of knowledge of the people around this person.

Being a healthy support person to someone working on recovery from an eating disorder is a challenge but it can be done. Communication between the person who is recovering and hus/her support system should happen every day and many times throughout the day.

It is important to learn what questions to ask and what not to ask, key words that are helpful and not helpful. All of these things are important to discuss when the person is in a healthy state of mind.

Many have heard the quote by Thomas Jefferson, “…knowledge is power, knowledge is safety, and knowledge is happiness.” This is key to an individual’s recovery from an eating disorder. Those surrounding the individual need knowledge to better understand the process of recovery and thus better support the individual.

Laura Jaramillo, MS, LPC, NCC
Laura holds a master’s degree in counseling from National Louis University. She has worked in behavioral health for eight years and has specialized in the eating disorders field for six years. Laura found her counseling passion when she five years old and always knew she wanted to help people. In the future, Laura expects to obtain a licensed clinical professional counselor (LCPC) certification, own a specialized and holistic practice, and continue helping those in need. Laura enjoys being outdoors, biking, yoga, all forms of dance including ballet and nia.

Cyberbullying Event
Featured Parent Series Presentation

Linden Oaks welcomes musician Jillian Jensen, American Idol and X-Factor contestant, to speak about an important behavioral health related topic: Cyberbullying.

"My Journey to Overcome Cyberbullying: A Night with Musician Jillian Jensen", is an event aimed at shining a light on bullying that occurs on the Internet and through, social media, and how to recognize and support pre-teens and teens who are struggling with cyberbullying.

The event scheduled for April 21, 2015 from 6-8:00 p.m. will be hosted in collaboration with North Central College and will take place in their Pfieffer Hall (310 East Benton Avenue, Naperville). This event is a featured Linden Oaks parent series presentation and will include an acoustic performance, meet and greet, and question and answer session for parents, students, and community members.

Resister online or call 630-527- 6363.

Art as Therapy Open Studios
Open to the Public Wellness Worshops

This winter, the expressive therapy team at Linden Oaks will host "Art as Therapy Open Studios" for the public. The classes are open to the public and help participants learn life skills such as stress management, mindfulness, and feeling expression through the creation of art. The cost per class is $10 and is held every Wednesday from February 4-April 29 at Linden Oaks Outpatient Center (1335 Mill Street, Naperville). The "Art as Therapy Open Studio for Teens" (12-18 years old) runs from 5-6:00 p.m. and the "Art as Therapy Open Studio for Adults" (18+) runs 6:30-7:30 p.m. Materials are included.

Register online.

For more information, contact wellnessworkshops@edward.org.