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Eating Disorders Counselor Certificate Training Part 8


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Part of a 12 part series of courses resulting in the receipt of a certificate in eating disorders counseling. Addresses bulimia, binge eating, anorexia, obesity. Uses The Body Betrayed by Zerbe and Brief Therapy with Eating Disorders byMcDonald

Published in: Health & Medicine
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Eating Disorders Counselor Certificate Training Part 8

  1. 1. Dr. Dawn-Elise Snipes PhD, LPC, LMHC, CRC, NCC Clinical Director, Unlimited CEUs $99 per year. Copyright
  2. 2. <ul><li>Determines clients </li></ul><ul><ul><li>willingness to openly discuss and explore behavior patterns </li></ul></ul><ul><ul><li>Willingness to consider altering eating behavior </li></ul></ul><ul><ul><li>Willingness to disclose accurate information </li></ul></ul>Unlimited CEUs $99 per year. Copyright
  3. 3. <ul><li>Power </li></ul><ul><ul><li>Relinquish role of expert </li></ul></ul><ul><ul><li>Use client’s verbage </li></ul></ul><ul><li>Collaboration </li></ul><ul><ul><li>As necessary as understanding diagnosis is getting client buy-in </li></ul></ul><ul><li>Faith </li></ul><ul><ul><li>In the client </li></ul></ul><ul><ul><li>In the self-regulatory feedback loop </li></ul></ul>Unlimited CEUs $99 per year. Copyright
  4. 4. <ul><li>Develop curiosity regarding each client as an individual and her unique reality </li></ul><ul><li>Be sensitive to client’s language, idiosyncrasies and personal views of the world and her problems </li></ul><ul><li>Sensitive to clients goals without passing judgment </li></ul>Unlimited CEUs $99 per year. Copyright
  5. 5. <ul><li>Consumer/Determination </li></ul><ul><ul><li>Has identified the behaviors as a problem and is internally motivated </li></ul></ul><ul><li>Complainant/Contemplator </li></ul><ul><ul><li>Ambivalent about change. Still has lots of fear </li></ul></ul><ul><li>Visitor/precontemplator </li></ul><ul><ul><li>Not ready for change, do not identify a problem </li></ul></ul><ul><li>The major responsibility for determining the type of relationship rests with the counselor </li></ul>Unlimited CEUs $99 per year. Copyright
  6. 6. <ul><li>Solution focused therapy rejects the notions of resistance and inherent readiness for change. </li></ul><ul><li>Stages of Readiness are determined by the client’s motivation </li></ul>Unlimited CEUs $99 per year. Copyright
  7. 7. <ul><li>The clients sense of safety/alliance with the therapist </li></ul><ul><li>Client and therapist have similar goals for treatment </li></ul><ul><li>The cost/benefit of the current behaviors </li></ul><ul><ul><li>Fear of fat vs. desire to be healthy </li></ul></ul><ul><ul><li>Social pressures vs. desire to change </li></ul></ul><ul><ul><li>Sense of self-efficacy </li></ul></ul>Unlimited CEUs $99 per year. Copyright
  8. 8. <ul><li>Listen and sympathize with frustration and ask what it would take so they would not “have” to continue in counseling </li></ul><ul><li>Work with significant others who choose to participate </li></ul><ul><li>Reinforces positives and leaves the door open to retun </li></ul><ul><li>Provide basic education (increase awareness) </li></ul><ul><li>Determine if the “visitor” has another complaint that could be addressed </li></ul><ul><li>Support client in her desire to discontinue counseling </li></ul>Unlimited CEUs $99 per year. Copyright
  9. 9. <ul><li>Yes…but </li></ul><ul><li>Key activities </li></ul><ul><ul><li>Increasing dissonance (miracle question) and self-efficacy (Exceptions) to increase motivation and empowerment </li></ul></ul><ul><ul><li>Minimize discussion of the problem instead focusing on solutions </li></ul></ul><ul><ul><li>Not necessarily a time to assign “doing” tasks, but more reflection and observation </li></ul></ul>Unlimited CEUs $99 per year. Copyright
  10. 10. <ul><li>The customer has determined that she has a problem AND is ready to set aside the “yes, buts” </li></ul><ul><li>The therapist </li></ul><ul><ul><li>Agrees with the client’s goal </li></ul></ul><ul><ul><li>Believes she can assist the client in finding a solution </li></ul></ul><ul><ul><li>Uses therapeutic skills to guide client to a solution </li></ul></ul>Unlimited CEUs $99 per year. Copyright
  11. 11. <ul><li>Amplify </li></ul><ul><li>Reinforce </li></ul><ul><li>Highlight/Increase positive action behaviors </li></ul>Unlimited CEUs $99 per year. Copyright
  12. 12. <ul><li>Counselor must help client understand the difference between cognitive and behavioral relapse and the concept of relapse warning signs </li></ul><ul><li>Counselor must normalize potential “slips” and relapses </li></ul><ul><li>Counselor works with client to develop a relapse prevention plan </li></ul>Unlimited CEUs $99 per year. Copyright
  13. 13. Unlimited CEUs $99 per year. Copyright
  14. 14. <ul><li>What kind and type of therapy did you have in treating your eating disorder </li></ul><ul><li>What parts of your treatment were helpful, if any? </li></ul><ul><li>What interventions were helpful and under what circumstances </li></ul><ul><li>Do you believe you have any other issues such as depression or anxiety? </li></ul><ul><li>What interventions or strategies that were helpful in the past might be helpful now? </li></ul>Unlimited CEUs $99 per year. Copyright
  15. 15. <ul><li>Focus on tomorrow, not way in the future. </li></ul><ul><ul><li>“ If your problem was solved magically overnight, what would be the first thing you noticed different when you woke up in the morning?” Take me through the rest of your day and describe what else is different. </li></ul></ul><ul><li>The response is fleshed out to help the client identify specifically what she wants to be different </li></ul>Unlimited CEUs $99 per year. Copyright
  16. 16. <ul><li>When has what worked and why? </li></ul><ul><li>Under what conditions has each activity produced an exception and failed to produce an exception </li></ul><ul><ul><li>Why is it important to understand when activities fail? </li></ul></ul><ul><li>Spontaneous Exceptions vs. Deliberate Exceptions </li></ul>Unlimited CEUs $99 per year. Copyright
  17. 17. <ul><li>Use scaling questions to help the client stop viewing things in terms of dichotomies </li></ul><ul><li>Have the client rate on a scale of 1-5 (It is helpful to give verbal anchors) and then explain why she chose her number. </li></ul><ul><li>Scaling can help therapists highlight ignored exceptions and positives </li></ul>Unlimited CEUs $99 per year. Copyright
  18. 18. <ul><li>Highlight positive actions or events </li></ul><ul><li>Agreement with and restatement of the client’s goal </li></ul><ul><li>Provision of homework assignment and rationale if appropriate </li></ul>Unlimited CEUs $99 per year. Copyright
  19. 19. <ul><li>Keep a quarter by your bed. Toss it each morning. </li></ul><ul><ul><li>Heads= pretend it is your miracle day. </li></ul></ul><ul><ul><li>Tails= Regular Day. </li></ul></ul><ul><li>What “resistance” might you anticipate? </li></ul><ul><li>How can you help the client overcome this? (Schedule homework assignment) </li></ul><ul><li>Pay attention to how you feel different and what others notice as different on your Miracel days </li></ul>Unlimited CEUs $99 per year. Copyright
  20. 20. <ul><li>Attend to present and future with little attention paid to the past </li></ul><ul><li>Explore a problem free future </li></ul><ul><li>Enhancing exceptions and previous solution patterns </li></ul><ul><li>Provide feedback and therapeutic compliments </li></ul><ul><li>Assign homework </li></ul>Unlimited CEUs $99 per year. Copyright
  21. 21. <ul><li>Separate the person from the problem </li></ul><ul><li>Stay focused on client strengths and resources </li></ul><ul><li>Don’t take a position regarding the client’s situation </li></ul><ul><li>Constantly check in to see if the client’s specific goals have changed. (i.e. I want to be happy, but have realized that losing weight won’t make me happy it is…) </li></ul><ul><li>Continually evaluate the client's stage of change…watch for yes buts which indicate… </li></ul>Unlimited CEUs $99 per year. Copyright
  22. 22. <ul><li>Explain the necessity to focus on small goals one at a time </li></ul><ul><li>Highlight the necessity of setting realistic goals </li></ul><ul><li>The necessity to tolerate behavioral and attitudinal slips or relapses </li></ul>Unlimited CEUs $99 per year. Copyright
  23. 23. <ul><li>Must be concrete and practical </li></ul><ul><li>Must be presented as a way to create an “exception” related to a client’s identified goal </li></ul><ul><li>How many calories </li></ul><ul><ul><li>What about this compromise rewarded/reinforced the client’s willingness to increase calories? </li></ul></ul><ul><ul><li>Calorie Counting---good or bad??? </li></ul></ul><ul><li>What foods </li></ul><ul><li>How often: every 3-4 hours </li></ul><ul><li>The food plan template 50-25-25 ish 1500-2500cals </li></ul>Unlimited CEUs $99 per year. Copyright
  24. 24. <ul><li>Create a table asking… </li></ul><ul><ul><li>Time </li></ul></ul><ul><ul><li>What did you eat </li></ul></ul><ul><ul><li>Were you hungry </li></ul></ul><ul><ul><li>Were you craving sweet/salty/spicy or a specific food? </li></ul></ul><ul><ul><li>Did you purge? </li></ul></ul><ul><ul><ul><li>If yes, how did you feel afterwards and what could you do differently next time? </li></ul></ul></ul><ul><ul><ul><li>If no, how did you feel afterwards and what did you do to prevent the purge? </li></ul></ul></ul><ul><li>What information/exceptions can you derive from this type of </li></ul><ul><li>table? </li></ul><ul><li>How might this table be helpful? </li></ul>Unlimited CEUs $99 per year. Copyright
  25. 25. <ul><li>Addressing seemingly unrelated concerns can have a positive (or negative) effect on eating behaviors. </li></ul><ul><li>Why? </li></ul><ul><li>Part of brief therapy means meeting the client where they are at, and developing mutually agreeable goals. </li></ul>Unlimited CEUs $99 per year. Copyright
  26. 26. <ul><li>Conduct a clinical assessment to identify </li></ul><ul><ul><li>Medical reasons for cravings or mood issues </li></ul></ul><ul><ul><li>Co-Morbid mood issues </li></ul></ul><ul><ul><li>Client’s understanding of her eating disorder </li></ul></ul><ul><ul><li>Client’s readiness for change </li></ul></ul><ul><ul><li>What has and has not worked for the client </li></ul></ul><ul><li>Develop mutually agreeable goals focusing on what the client hopes to achieve </li></ul>Unlimited CEUs $99 per year. Copyright