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Finding the Needle in the Haystack of Eating Disorders Care-Providers
Reprinted
from Eating Disorders Today
By Walter Vandereycken,
MD, PhD, and Ellie Van Vreckem, MA
Spring 2007 Volume 5, Number 2
©2007 Gürze Books
I recently received an email from the
mother of an 11-year-old child which
spoke poignantly to the needs of parents
seeking expert professional care for their
child. Recognizing the pressing nature
of her venture, this mother was painfully
aware that she had no idea about
what to look for, or how to identify the
qualities of a truly expert practitioner.
She wrote: “My problem is that we live in Tokyo
in Japan and I am unsure of how to
find a professional who can help us. If
we choose just any psychiatrist or psychologist,
I am afraid that they may
make the problem worse if they are not
experienced in eating disorders. Do you
have any advice which you could give
me as to how to find help?” Though parents can feel wholly confident
putting their child in the hands of
highly trained mental health generalists
for other conditions, the treatment of
eating disorders requires uniquely skilled
and knowledgeable professionals. Eating
disorders are complex, diverse, and
multi-faceted diseases, affecting every
aspect of personality and life function,
including emotions and behaviors,
cognition and mood, nutrition and
physiology, relationships and self-image.
Treatment leaves little margin for error;
if not dealt with in a timely and effective
manner, these diseases are debilitating
and can even be fatal. When treated
properly, full recovery can be anticipated
in 80 percent of cases.
The Therapist’s Treatment Style
Expert caregivers need to be eclectic and
versatile in what they know and how they
use themselves in approaching treatment
for an eating disorder. Within the course of
treatment, effective eating disorder practitioners
will show themselves to be: “Big picture” thinkers, with the capacity
to hold fast to the vision of a far-reaching
recovery even as they systematically
attend to the small details of ongoing
treatment.
Integrationists, with a firm grasp on the
wider implications of disease, and functioning
as part of a multi-disciplinaryteam of professionals. Practitioners need
broad-based diagnostic acumen, diverse
practice skills, and the capacity and
willingness to access varied treatment
support resources.
Activists, urging parents and families
to participate in treatment, educating
clients, and shepherding the healing
process forward. Bottom-liners,
with an outcomedriven
approach,
expecting and demanding
that the
recovery progress
keeps up with the
pace of a disease that is perpetually on the
move. (If the patient is not getting better,
you can be assured she is getting worse.) Loving caretakers, who are unafraid to
use themselves creatively and openly
as strong connectors, and who build
self-esteem and inspire the motivation
to heal. The Initial Telephone Inquiry
Once a parent has recognized a problem
and confronted the child, the next
challenge is to find a practitioner who
can effectively connect with child and
family, and direct the recovery process.
The best referrals will come from people
you know: friends, your child’s pediatrician,
school counselors, or from national
eating disorder organizations such as
NEDA or ANAD. In addition, a reliable
and internationally-based referral source
is the Internet, through web sites such as
www.EDReferral.com or www.Find-a-Therapist.
com. In assessing the qualifications of
potential therapists, the knowledgeable
parent needs to be prepared to conduct
an informal telephone interview. Your
child’s practitioner should be willing to
engage with you on the phone to answer
your questions, thereby beginning the
education process. This first meaningful
interchange should reveal elements
of the therapist’s personality, treatment
approach, and willingness to be forthcoming,
inclusive, and educative. The phone conversation might begin
with the question, “Is this a good time
for me to ask you a few questions?” If
not, make arrangements to call back at
a more convenient time. Don’t hesitate
to ask about his or her professional back-ground and experience in treating eating
disorders. Notice whether the clinician
is listening closely to you. The best
therapists have a way of listening with
a “third” ear, of providing answers not
only to the questions you ask, but also
to those that you may not yet have the
words or knowledge to formulate. The
therapist should give you the sense that
by becoming your ally, he or she is becoming
your child’s recovery advocate.
Expert caregivers will be knowledgeable
and educative, caring and forthcoming,
imparting knowledge, offering a sense
of where you and your child are in the
disease and recovery processes, and of
what needs to happen next, laying out
alternatives for care provision. Questions to Guide Your Inquiry:
- Ask about the benefits of outpatient
therapy versus treatment in a hospitalor day program.
Inquire about the
therapist’s treatment
style or
philosophy and
then listen for such
words as eclectic,
cognitive-behavioral,
psychodynamic, relationship-
oriented,
and family-systems
based. Does this
person have a philosophy
of eating
disorder treatment
that focuses on
both the dysfunctional
behaviors
and the emotions
driving them?
Does this person
offer pointers
about what to
say to your child,
and how to say it
to express your
concerns and
convince your
child to accept professional care?
Does this person recognize medical
issues that may be serious and require
immediate attention or hospitalization?
Does this person suggest that
your child be seen by a medical doctor
for an evaluation as a first priority of
care?
Does this person collaborate with
skilled professionals as part of a treatment
team? If not, the task of creating
such a team may fall to you as the
parent. Do you get the impression
that you can count on this person for
cooperation and guidance?
Does this person request that you procure
the services of a nutritionist for
your child, and possibly a psychopharmacologist
where needed, as part of a
multi-disciplinary approach to care?
Will you and your spouse be invited
to join your child in family therapy,
becoming mentors and advocates of
the recovery process?
Does this person work with insurance
companies? Does he/she offer pointers
about how to secure optimized insurance
coverage and is he/she willing tointervene in your favor with insurance companies? Does this
person offer a sliding pay scale if needed?
- Does this person reassure you that eating disorders are highly
curable diseases if treated in a timely and effective fashion?
Your Child Needs You Now More Than Ever
Depending on your child’s age and the severity of her eating
disorder, she is likely to be too ill and/or too young to make responsible
decisions about self-care on her own. Despite age or life
stage, your child needs your assistance now more than ever. Don’t
fall victim to the commonly held misconception that a parent’s
appropriate intervention is synonymous with interference, or
that your participation in family treatment violates your child’s
independence, compromising confidentiality or privacy rights.
If a therapist implies that generic therapy techniques are sufficient
to heal an eating disorder, or that parents are to blame for
their child’s disease or should “butt out” of the recovery process,
seek help elsewhere. An eating disorder can easily send you and
your child off track as it speaks in her voice, threatens, intimidates,
and resists your efforts. Make sure you choose an expert
caregiver who can guide you in the right direction. Your educated
response and sound judgment will make the difference.
Abigail Natenshon, MA LCSW, GCFP, is a psychotherapist who
specializes in the treatment of eating disorders. Her first book, When
Your Child Has an Eating Disorder, is an excellent resource for parents.
Portions of this article are drawn from her second book, Doing What
Works; Strategies for the Successful Treatment of Eating Disorders, which
she is currently writing. Visit www.empoweredparents.com.
click
here to order
Eating Disorders Today!
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Read
More Articles From Eating Disorders Today
Additional Resources:
National Conference Aims to Increase Awareness of Eating Disorders
Night Eating Syndrome: A Unique Eating Disorder
Nourishing Connections: Controlling Your Biology versus Honoring Your Hunger
Nutrition Care for Clients with Diabetes and An Eating Disorder
Nutrition Hotline - Determining a 'Healthy Weight'
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