NZEDC are specialist clinicians working in the private setting trained in working with anorexia nervosa, bulimia nervosa and binge eating disorder (also known as compulsive overeating). This also includes any disordered eating or dieting/body image related issues and any combination of the above in both adults and adolescents.
NZEDC is proud to host for the first time in New Zealand:
Integrative Cognitive Affective Therapy (ICAT) for Bulimia Nervosawith Stephen Wonderlich Ph.D. and Carol Peterson Ph.D.
Integrative Cognitive Affective Therapy for Bulimia Nervosa (ICAT-BN) has been established as a new evidence based treatment of bulimia nervosa. ICAT-BN has been tested in pilot studies and also in a randomised control trial, in which it was compared to Cognitive Behavior Therapy-Enhanced (CBT-E) and did not differ from CBT-E in its effectiveness.
Presenters will review the model of bulimic psychopathology which underlies ICAT-BN, with a particular emphasis on the momentary emotional correlates of bulimic behavior and their role in precipitating eating disorder psychopathology. The overarching clinical aim of ICAT-BN is to assist patients to enhance their awareness of momentary emotional factors which contribute to their psychopathology and also to identify the processes in their lives which generate periods of emotion dysregulation. Also, ICAT-BN attempts to help patients develop a variety of behaviors to manage urges for bulimic behavior, including promoting normalised eating.
The workshop will be very clinical in content, with an emphasis on reviewing the phases of treatment in ICAT-BN, clinical targets for treatment, and techniques for modifying the target and associated bulimic behavior. The workshop is suitable for all clinicians providing eating disorder treatment.
Dates: Monday 21 and Tuesday 22 October 2019 Cost: $897 incl. GST ($780 + GST) Venue: Quality Hotal Parnell, 10-20 Gladstone Rd, Parnell, Auckland Registration FormICAT Training Flyer
To register and for more information, please contact the NZEDC clinic manager:
Carol B. Peterson, PhD, is an Associate Professor in the Department of Psychiatry at the University of Minnesota and the Chief Training Officer of The Emily Program (an eating disorders treatment program).
Stephen Wonderlich, Ph.D., is the Chester Fritz Distinguished Professor, University of North Dakota School of Medicine & Health Sciences. He is Co-Director of the Eating Disorder and Weight Management Center at Sanford Health. He serves as Vice President at Sanford Research.
New Zealand Eating Disorders Clinic (NZEDC) is offering an exciting opportunity for a New Zealand Registered Clinical Psychologist to join their team. NZEDC has been established out of dedication to helping people get the best eating disorder treatment possible in the private setting. NZEDC is committed to providing high quality personalised care to maximise chances of recovery.
You will join a multidisciplinary team of highly skilled and experienced clinicians. Clinicians operate their practice in a self employed capacity. NZEDC expects their clinicians to be committed to working at a high standard, providing evidence based treatment for anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder (ARFID). NZEDC also offers treatment for a range of comorbid psychological, emotional and relational problems. The role includes provision of assessment and treatment of adolescents (and adults) presenting with an eating disorder. The ideal candidate will be trained and experienced in Family Based Treatment (FBT) and Cognitive Behavioural Therapy (CBT-E) and will have work experience in the field of eating disorders and mental health. You will be supported and expected to engage in professional development opportunities and mentoring provided by NZEDC. Certification in FBT can also be negotiated.
This role is part-time, work hours are flexible and to be negotiated.
The clinic is located in central Auckland in a charming old villa with comfortable treatment facilities.
To apply, please email your CV and a covering letter to Kathrin:email@example.com
This workshop will provide an overview of the current understanding of the role of the neurobiological underpinnings in the development and maintenance of anorexia nervosa with their implications for prognosis and treatment. The workshop will include a brief introduction of the neurobiology of the brain and the application of general neuroscientific principles of learning to the facilitation of therapeutic change. It will explore the effects of eating disorder behaviour and malnutrition on the brain and will highlight the effects of illness duration on neuroprogression and habit formation and the resulting urgency for early and effective intervention. The workshop will explore in depth how these neuroscientific principles can be applied in a practical way to the provision of the current evidence best practice treatments like FBT, CBT-E and MANTRA. The workshop will have interactive components and will allow for ample time of discussion. The workshop is primarily suitable for clinicians familiar with the specialist eating disorder therapies. Some experience in clinical neuroscience will be helpful but is not essential.
Date: Friday 14 June 2019, 9:00am – 5:00pm
Venue: The Community of Saint Luke, Presbyterian Church 130 Remuera Rd, Auckland 1050
Garalynne Stiles is a Registered Dietitian who first entered the field of nutrition because she liked to cook and wanted to understand how people thought about food. That passion brought her from her home in Seattle all the way to New Zealand.
Garalynne has been working in mental health and eating disorders in New Zealand since 2009, including seven years at Tupu Ora Regional Eating Disorder Service. She is experienced in tailoring nutrition care to evidence based treatments, including Family-based Treatment (FBT) and Cognitive Behaviour Therapy (CBT) in tandem with your primary therapist. Garalynne provides dietetic nutrition care for children and their families, older adolescents and adults with both mild forms of disordered eating and severe eating disorders. Knowing that each individual is unique, Garalynne enjoys helping people figure out what normal eating means for them.
Garalynne is also provides primary treatment for patients with bulimia nervosa and binge eating disorder using Cognitive Behavioural Therapy - Enhanced (CBT-E).
Massey Dietetic Students
The Master of Nutrition and Dietetics programme at Massey University boasts a strong link between academia, clinical practice and research. It seeks to grow high calibre graduates who will enter the health workforce with competence and confidence. Providing real-life exposure and hands-on training to their students underpins this goal.
The collaboration between the Nutrition and Dietetic Centre and New Zealand Eating Disorders Clinic upholds the Massey philosophy
The dietetic students you will encounter are all qualified Nutritionists – they have already completed three years undergraduate study in Nutrition and some have also majored in Psychology or Sports & Exercise. The MSc Nutrition and Dietetics programme is a two year postgraduate degree and the students involved at Grafton specialists will either be in the first or second year of their Masters programme.
The students undertake internships in various organisations including District Health Boards. As a result they undergo police vetting, are reference checked and also screened in accordance with the Vulnerable Children Act 2014. In addition, they go through strict health screening in line with DHB policies. All the students also comply with professional conduct and confidentiality requirements in accordance with the Health Information Privacy Code 1994 and the Privacy Act 1993.
Students develop and deliver education with the support of experienced an Registered Dietitians who also fulfils a Clinical Educator role at Massey University.
We are pleased to announce two important workshops held by Kellie Lavender from NZEDC early 2019.
Family Based Treatment (FBT) is a behavioural treatment empowering parents to manage their child’s eating disorder through a firm, compassionate focus on renourishment efforts with gradual transition of control over eating back to the adolescent to enable a quick return to normal child or adolescent development, reflected in both eating behaviour and daily life.
Introduction to Family Based Treatment (FBT) for Adolescents with Anorexia Nervosa
The introductory workshop is suitable for clinicians interested in working with children and adolescents with eating disorders, including psychiatrists, psychologists, psychotherapists, social workers, occupational therapists and medical practitioners. It will provide a good understanding of the background and theory of FBT.
Advanced Practices in FBT - "Getting it right from the start and keeping on track"
Family Based Treatment is well established as the best evidence based treatment for adolescents presenting with anorexia nervosa. However, treatment fidelity remains an issue and many clinicians may be making fundamental mistakes that will have an impact on treatment success. This workshop provides an opportunity to discuss and practice different case scenarios that may occur in sessions one and two of FBT and the transition to phase two. There will also be the opportunity to have current cases supervised as part of the day.
On Tuesday night, FAT TALK was held at Lost and Led Astray (plus size fashion label) in Auckland. Emma Thomas (eating disorder therapist and Health At Every Size advocate, NZ Eating Disorder Clinic) and Meagan Kerr (plus size fashion blogger ThisisMeaganKerr.com) presented this evening, hosted by Sarah-Jane Duff, designer and founder of FAT YOGA NZ. This was an evening aimed at helping people deal with fears around eating over the holiday period, as well as dealing with the fat shaming messages that often surround this period. There were also some pretty big truth bombs dropped about the actual possibility of long term weight loss, the damaging nature of dieting and diet culture, and uncovering some myths around the actual relationship between weight and health.
It was a powerful evening and a safe space for those living in larger bodies or who generally feel uncomfortable in their bodies to have open and honest conversations about weight. Everyone left with a renewed sense of hope that the only path to happiness is not, in fact, by changing our bodies, but by changing attitude to our bodies and getting skeptical about the fat phobic messages we receive from multiple sources on a daily basis.
NZEDC is proud to host, for the second year running, ‘Hope Night’ for people and their families who are struggling with eating disorders.
HOPE night is an opportunity for people who are in the midst of an eating disorder to experience directly that becoming free from an eating disorder is possible. The night is also to encourage parents to not give up and keep fighting for their loved one.
There will be a panel with a range of different individuals and parents, who have recovered from an eating disorder or assisted a loved one, sharing their journey and providing practical tips.
We also have a screening of the brave New Zealand documentary “Disorder”, directed by Miryam Jacobi and Olivia Mahood.
Another special guest will be Millie Thomas who will share her personal story with an eating disorder and tell us about her advocacy work in the field as a recovery coach.
Date: Tuesday 30 October Time: 7:00pm – 8:30pm Where: Mercury Theatre (upper theatre) 9 Mercury Lane, AKL Cost: Free Parking: There is a Wilson car-park opposite the theatre Contact: Kathrin on firstname.lastname@example.org
The Neuroscience of Bulimia Nervosa and Binge Eating Disorder: Implications for Treatment Strategies15 November 2018
A variety of treatment options exist today for Bulimia Nervosa and Binge Eating Disorder which target different key factors of the conditions.
This work shop addresses the increasing need to develop treatment strategies which better understand and target the underpinning neurobiological factors of Bulimia Nervosa and Binge Eating Disorder. We will explore these factors and their implications for treatment interventions in more detail, and discuss the current main treatment models in light of neuroscientific findings.
Comments by Kellie Lavender and Dr Roger Mysliwiec from NZEDC regarding the recent Meta-analysis paper: Treatment outcomes for anorexia nervosa: A systematic review and meta-analysis of randomised controlled trials (2018). Murray, S., Quintana.D., Loeb, K., Griffiths, S., Le Grange, D.
NZEDC holds some concerns about the message of the paper, which has arrived at the conclusion that current specialised treatments have no advantages over comparator treatments as usual in terms of psychological symptoms and no advantage in terms of weight recovery at follow up.
We are concerned that the message this paper inadvertently sends could do significant harm to patients and their families and to clinicians and we believe that the message to this paper needs to be refined.
The conclusion that as a whole many interventions in the treatment of anorexia are not effective is already well established and not new and especially applicable to the treatment of adult anorexia. It is also not surprising that the paper reached that conclusion given that the metaanalysis included studies of interventions that we already know do not work effectively, including pharmocological interventions, hospitalisations and many adult treatment interventions.
The paper appears to have some fundamental methodological problems, which are worth noting.
In order for a meta-analysis to come to reliable conclusions it is essential to include enough well designed and comparable studies. In this review a lot of studies are included comparing different interventions and outcomes, in different contexts and for different populations.
By including studies with interventions that we already know do not work with studies that have shown interventions to work (like the FBT vs. AFT trial in 2010), the potency of a specific intervention gets diminished and watered down.
There are also a number of more specific issues with the methodology of the meta- analysis worth noting. Some studies included were only feasibility studies, many studies were very small, outcome measures and timelines for EOT were too varied, some studies (especially the larger ones) were comparing two specialist treatments and most significantly only a very small number of studies even had follow-up data included. Some of these issues the authors have acknowledged themselves.
What this means is that the conclusions of this paper are not based on reliable data and sound methodology. Apples are not being compared with apples. An illustrative metaphor would be if one was taking a cookbook, include all the ingredients in the book in one recipe – with the outcome that the prepared food was not tasty and then arriving at the conclusion that every recipe in the cookbook was terrible.
As an aside to the general issues of the meta-analysis itself, we would also like to comment on the paper’s reference to describing family interventions as focusing on weight recovery only. When manualised Family Based Treatment is done with fidelity there is a sustained expectation of weight recovery, as well as a focus on systematic extinction of Eating Disorder behaviours, and helping parents manage the inevitable distress that the young person will experience. Most importantly, Family Based Treatment studies do show full recovery of weight and psychological symptoms at EOT and follow-up at rates between 30 to 45%.
We think that the message of this paper is problematic as patients and affected families might conclude that there is no point (and no hope) in engaging in specialist treatments and therapists and service providers might use this as a rationale that it does not matter whether clinicians have training in specialist treatment nor that it is important to ensure treatment fidelity.
The conclusion that we need to keep finding new effective treatment is of course very true. However, we do have strong evidence for the effectiveness of Family Based Treatment (FBT) to treat anorexia in the adolescent population and this should be highlighted. To send a message that nothing works is not only unhelpful but also incorrect. We feel it is important that families, who are fighting for the recovery of their child, know that there is evidence for effective specialist treatment and that by intervening promptly and effectively there is a realistic hope for full recovery.
The New Zealand Eating Disorder Clinic is a private specialist outpatient clinic in Auckland, New Zealand, providing evidence based specialist treatment for eating disorders. Kellie Lavender is a specialist in Family Based Treatment and a faculty member of the Training Institute for Child and Adolescent Eating Disorders. Dr Roger Mysliwiec is a medical doctor, specialist in Psychosomatic Medicine and Psychotherapy (Germany). Roger has over 30 years of experience working with eating disorders and is considered one of New Zealand's leading experts in the field of eating disorder treatment.
sharing with you the story of Catherine. We feel deeply inspired by Catherine’s honest, open and brave sharing. Get inspired and connect to hope. Thank you Catherine.
It’s so hard to know where to start. I’m 34 years old and I’ve had an eating disorder for 20 years. I was an overweight, shy, scared, emotional kid. I never learnt how to talk about my feelings or express myself... only with anger. At the age of 14 I went on a trip to Aussie and stayed with my Mum and her sister. Because I was so shy and uncomfortable with myself I didn’t eat much... fat kids shouldn’t be seen to eat, right? When I came home, people at school including those who had been so cruel to me commented on how I’d lost weight. So, at that point was when my eating disorder started. This was the way to be accepted, to lose weight. How do I lose weight... by not eating. It progressed from skipping meals, to restricting types of food and then barely eating at all. I then learnt there was a way that I could eat but not get fat... I made myself throw up. It was a downward spiral from there. I struggled over the years with depression, suicide (one attempt) cutting, unhealthy relationships and so many broken promises to others and myself. “I will try harder tomorrow. “ - “Just one more time.” - “No, I didn’t eat the cake. “ - “Yes, of course I’ve had lunch. “ - “No, I didn’t take that money.” I lost friends, missed out on wonderful opportunities and above all I wasn’t really there for the first 9 years of my beautiful daughter’s life. I was so caught up in this abusive relationship... my disorder. Don’t get me wrong, I tried to recover. Self-help books, therapy. I entered a treatment plan at the public service and it worked, (for a while) I thrived, I wanted to please, I wanted to get those gold stars and I did. I was binge/purge-free but it didn’t last. It always felt forced and temporary, I reverted after some months and if anything, things got worse than ever. I got so lost, scared and beaten that I started working out how I would tell my daughter that I was taking my own life, that she deserved a real Mum not some weak pathetic excuse. In a final attempt for help I went to the HOPE night held by NZ Eating Disorders Clinic. What I got from that night was a glimmer of hope, hearing peoples’ stories, how far they had come. I booked myself in for treatment. I have been free for 5 months now, I know it’s not a long time but it’s different this time, it’s real. I eat cheesecake with my daughter, I go out for dinner and pick what I feel like and I enjoy it. I don’t sneak off to the bathroom afterwards. It’s not been easy, it still isn’t but I have hope, I have recovered. You are probably wondering why did it work? I’ve thought about this a lot; being accountable to somebody I viewed as safe, who to start with I saw twice a week kept me on track with the regular eating and made the goals achievable. Finally I had to stop lying to myself, telling myself tomorrow would be different and look at things as they truly were. Roger has given me life, given my daughter a mother and a chance for me to learn who I really am. I feel like I’m doing more than surviving, I’m actually living. For anybody thinking they are a lost cause I promise you that you are not. Catherine x