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Thinking back to the first of the year, how many of us set a resolution with the intention of bettering ourselves? How many of us set goals that were focused on new exercise regimens, weight loss and/or the changing of dietary habits? A recent Nielsen survey stated that almost one-third of Americans declared their resolution was to lose a few pounds and sculpt their bodies.  What if we shifted this thinking – what if at the start of each new year we moved away from weight management goals and put an end to critical thoughts about ourselves and our bodies?

To approach this idea of eliminating our criticisms in an effort to improve our self-esteem and reduce eating disordered behavior, Florida State University Professor, Pamela Keel tested a novel approach to encouraging body acceptance. Keel suggested to her participants that they consider what would truly make them happier as the new year progresses. Would this mean losing a few pounds here and there, or shedding harmful attitudes and outlooks about their bodies?

Keel and her team worked to develop body-acceptance strategies that could help individuals feel better about themselves and avoid criticism. These ideas came from an intervention program called “The Body Project.” The Body Project was initially designed to reduce the risk of developing an eating disorder as the result of poor body image and self-talk. One specific intervention from The Body Project is called  “mirror-exposure.”  In mirror exposure, individuals are asked to stand in front of a mirror (in various stages of undress) and comment out loud about aspects of their bodies that they like.  In doing so, they’re encouraged to focus on the body part’s function or use.   For example, “I really like the shape of my shoulders” or “I really appreciate the way my legs take me wherever I need to go…  every day without fail, they get me out of bed, to the car, up the stairs and into the office. I don’t have to worry about walking,” Keel stated. As time passes, the individual will scan the body for higher risk body parts, like the gut and replace any automatic negative thoughts with an alternative phrase such as “I really like the shape of my legs.” The exercise encourages participants to appreciate positive aspects of the body rather than discounting the positive.  This process supports a transformation of sorts in terms of how individuals evaluate themselves. This practice employs a principle known in the field of psychology as cognitive dissonance theory: acting in opposition to a negative attitude.  Over time and with repetition, these more positive assertions become more natural and feel more accurate.  

Keel reports that this strategy and others targeting cognitive dissonance (e.g. experiencing that nothing bad will happen if they do the opposite of what they fear, such as eating in public, bathing in a public pool, etc) have proven effective and that the benefits of such practices go beyond the improvement of body image. Once comfortable with the practice of positive self-talk and practicing cognitive dissonance, the study noted increased self-esteem, improved mood, reduction in the risk of self-injury and reduced eating disordered behaviors. Luckily, these interventions do not take much time and can be done anywhere. An online version of this program is available via The Oregon Research Institute.

While we may be a month and a half into our New Year’s resolutions, it’s not too late to turn back the hands of time and select a more productive resolution. Try body-love instead of body-change and see what effects this may have on your everyday life. Interested in learning more about self-love, healthy goal setting and risk reduction? Contact Columbus Park.  

References:

https://www.sciencedaily.com/releases/2017/12/171221122541.htm

The post Resolutions or Revelations? Try Body Love in the New Year appeared first on Columbus Park | Eating Disorder Experts.

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Research from a recent study out of Macquaire University has demonstrated that visual comparisons of body image have the ability to physically adapt our brain’s visual perception. After such an adaptation, we are more likely to overestimate our own body size and perceive a thinner body type as ‘normal.’ The research has identified a psychological pathway that may put individuals at greater risk of developing conditions such as anorexia nervosa, bulimia nervosa, and muscle dysmorphia. “When presented with images of thin and fat bodies at the same time, our study found that people who are less satisfied with their bodies tend to look longer and more often at thin compared to fat bodies,” said Dr. Ian Stephen from Macquarie University, the lead author on the study.

Depending on the amount of time a person spends looking at a desired body type, brain mechanisms will normalize this body type as the ‘normal’ through a process called “visual adaptation.” To complete this experiment, individuals were exposed to both thin and heavy body types on an app. After the viewing segment was completed, the research participants were then asked to alter body types to represent ‘normal’ in a specially designed app. Those who paid more attention to the thinner bodies during the exposure period altered the bodies to a thinner frame than they did before their exposure period. Naturally, there are many dangers associated with viewing an average sized body and perceiving it as fat, especially in a society that has placed such a high value on media and media imagery. Senior author Kevin Brooks writes “gazing at thin bodies for as little as two minutes causes a recalibration of the mechanisms in our brain that encode body fatness. Then, when we see an average sized body, we perceive it as fat.”

These reports should compel us to evaluate the visuals we are exposing ourselves to, and why.  Let’s review what we know. We know that those who spend more time looking at certain body types will speed up their adaptation process and increase the likelihood that they will misperceive physical forms and develop a disorder. We know that on average, teens (and many adults) today spend 7-10 hours per day on social media platforms.. When we take into account recent news stories that have highlighted social media models and influencers who report having developed depression, anxiety or eating disorders as a result of intense pressure to maintain an unrealistic image of perfection for their viewers, it is easy to see how this becomes a dangerous cycle.

Model/Influencer Alexis Ren described the development of her eating disorder in a Cosmopolitan magazine feature.  She writes “I was my worst critic ever. The only sense of relief I had was to be able to monitor my eating and my workouts… Everyone around me was like, ‘Alexis, what are you doing?’” she says. “But I felt like my body was the only reason why people liked me.” As Alexis fell deeper into the throes of an eating disorder, viewers of her page were largely unaware that the “desirable” physique before them was one of an individual with an eating disorder. While visual adaptation is not a lone factor in the development of an eating disorder (we already know about the social, emotional and biological components to these diagnoses) we may now know more about the perceptual mechanisms that drive the development of an eating disorder. With this understanding, perhaps we can better educate our media-soaked youth about the dangers of screen time, comparison-making and identifying with an unrealistic ideal of beauty.

We must take the time to remind ourselves that the images we are viewing on our screens do not represent the whole truth.  Now that we are armed with this knowledge, we can choose to surround ourselves with positive, healthy imagery and better protect our sense of self. For more information about eating disorder treatment and recovery visit us at www.columbuspark.com.

References:

http://www.cosmopolitan.com/health-fitness/a9657755/alexis-ren-eating-disorder/

https://m.medicalxpress.com/news/2018-02-perceptual-pathway-linked-body-size.html

The post Visual Perception and Body Dysmorphia-Social Media & Brain Mechanisms appeared first on Columbus Park | Eating Disorder Experts.

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From infancy onward, mothers are under pressure to balance (as if!) their own self-care with the demands of a growing family.  Women so often set high standards for their ‘performance’ as mothers which adds on more stress and pressure during an already challenging time of life.  No doubt, managing the various tasks and expectations of motherhood can be overwhelming, both physically and emotionally. If you’re experiencing motherhood while also struggling with an eating disorder, these demands can feel even more burdensome.

Many mothers who may be struggling with eating concerns, avoid seeking treatment because of shame or guilt (“I should have it together”) or because they simply can’t rationalize taking time away from family.  So often, mothers are credited for this selflessness. We see it in quotes like “a mother’s love is a selfless sacrifice” that adorn the front of advertisements or greeting cards. But the truth is that sometimes you have to be selfish to be selfless. L.R. Knost, author and child development researcher, once said: “taking care of yourself doesn’t mean me first, it means me too.”

Having It “Together”

With the never-ending list of responsibilities and with a family depending on you, it’s not surprising if you work hard to hold it together – to appear strong, invincible – even when inside you may be overwhelmed.  Trying to maintain a strong exterior means internalizing your feelings and possibly going to great lengths to hide disordered behaviors. Mealtime, food shopping and preparing food for the family – seemingly mundane tasks – will be highly triggering and difficult for someone with an eating disorder.

A mother struggling with an eating disorder may fear the children will pick up on unusual dining habits or a poor relationship with food. Thoughts of restricting, binging or purging can overwhelm, creating a constant and nagging distraction from the present.  Mothers will report laboring to find opportunities to sneak away to binge or purge without being discovered.  The pressures and stress of mothering, only makes these moments of solitary release all the more appealing – but the aftermath that much more distressing.  

Bypassing Treatment

In Cosmopolitan Magazine article “I Developed an Eating Disorder as a Mom,” one mother writes “even though I was a mom in my 20s and I knew full well the importance of balanced meals, I began skipping them altogether. I started seeing how long I could go each day without eating anything…I was embarrassed to be an adult and a mother suffering from a disorder I thought was so common in teenagers. Looking back, I know I could have avoided anorexia if I had found other ways to cope with stress over the years.” So often, mothers will report that these stigmas (identifying with a “teenagers disorder”), in addition to scheduling conflicts, fear of being absent from the home during treatment hours, appearing as a failure to children, self or spouse etc., prevent them from seeking treatment.

Children of Mothers with Eating Disorders

As stated by Eating Disorder Hope, Statistics show that first-degree family members of individuals with anorexia are eleven times more likely to have anorexia themselves and six times more likely to have some disordered eating behaviors. This is likely due to both genes and the modeling of eating disordered behaviors.  We know that mothers who frequently comment on weight are statistically more likely to have daughters who use weight control behaviors and/or binge eat.  It is for these reasons among many others that appropriate care and support are essential for both the individual sufferer and the family unit.  


Getting Help

There is a reason we inflate our own lifejacket before inflating the life jackets of those around us. While it may be challenging to face some of these stressors or stigmas, one cannot simply “stop” an eating disorder in its tracks without the support of an educated treatment team. Once informed on the risks of eating disorders on the family structure, we can foster a family environment of trust, non-blaming, understanding, and health.

Columbus Park is launching a new group specifically for mothers working toward recovery.  The group will create space to talk about body image concerns, parenting struggles, feeding children, managing self-care and more.  The group will be facilitated by Columbus Park’s Clinical Director (and mother of two!), Melissa Gerson, LCSW.  There will be a monthly nutrition-focused session facilitated by Registered Dietician, Justine Violante-Roth. Please contact info@columbuspark.com for more information.

References:

https://www.eatingdisorderhope.com/treatment-for-eating-disorders/family-role/mothers-daughters-and-eating-disorders

https://www.eatingdisorderhope.com/information/bulimia/bulimia-and-mothers-taking-care-of-others-but-not-themselves

http://www.cosmopolitan.com/health-fitness/a53338/mother-with-an-eating-disorder/

The post Mothers Working Toward Recovery appeared first on Columbus Park | Eating Disorder Experts.

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To date, significant neurological imaging and research has been conducted to better understand the underlying mechanisms driving anorexia nervosa. For those suffering from atypical anorexia nervosa, questions still remain regarding the existence of a brain-basis and what the identification of brain alterations may mean for the treatment and diagnosis of this disorder. The evaluation of 22 adolescents under the care of head researcher Dr. Gaia Olivo determined there was no difference in the detectable grey matter (GM) regional volume between the atypical anorexic population and the control group. Historically, atypical AN patients and AN patients were thought to be part of the same spectrum of restrictive-ED although as there was no detectable difference in grey matter in the atypical AN group (as typically seen in the AN brain), more work will need to be done to determine how to further differentiate atypical AN from AN. To learn more about the implications of these findings head to the International Journal of Eating Disorders.

Read More:

https://www.ncbi.nlm.nih.gov/pubmed/29215777

The post CP RESEARCH CORNER: Atypical Anorexia Nervosa & Brain Structural Changes appeared first on Columbus Park | Eating Disorder Experts.

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Author of New York Times article “When Anorexics Grow Up”, Lisa Fogarty, vividly recalls her first experience with anorexia on screen. A number of made-for-TV movies hit televisions in the late 80’s and 90’s that provided her and many others with their first visual depictions of adolescent anorexia. Movies such as For The Love of Nancy and Dying To Be Perfect served as moving images that “wrapped up anorexia into tidy boxes where therapy, feeding tubes, weight gain, finding release from a controlling mother’s grip and discovering the joys of food led to a happy ending. ” While such movies may bring awareness to the experience of an eating disorder, Lisa reports that they send the wrong impression to the public. She writes “My heart hurts thinking about a teen anorexic sitting in her suburban bedroom… She may believe that eating dessert one day means she’s saved. That she can then bid farewell to therapy and go enjoy a banquet of delicious foods for the rest of her life. I hope that’s her fate, but for an anorexic, it isn’t always the resolution.” Some individuals with anorexia are never fully cured and eating disorders are often not wrapped up in little boxes easily pushed aside once one leaves adolescence. Lisa fears that the public’s association with anorexia and adolescence may leave many adults feeling isolated if and when their struggles continue into or develop during adulthood.

Lisa suggests that the underrepresentation of this adult demographic in the media is due to the fact that “the aging anorexic doesn’t make for a compelling movie. Adults with the disorder aren’t represented in pop culture and news outlets…so I assumed we were either supposed to outgrow our eating disorders or die.” It was not until the shocking death of beloved Karen Carpenter at age 32 that Lisa recalls recognizing that, unlike the girls in the movies, she may not ‘age out’ of her disease. While for Lisa, her struggle with anorexia began at age 13, puberty and its associated factors are not the only time frame in which one may be triggered into the development of an eating disorder. Many other life stages (e.g. leaving home, getting pregnant, watching children age) bring enormous change and pose risks for the development of an eating disorder.

Despite the underrepresentation of adults with eating disorders on the big screen one-third of inpatient admissions to a specialized eating disorders treatment center were for people over age 30, according to the National Eating Disorders Association. According to the Times article, “In an online survey published in the International Journal of Eating Disorders, 13 percent of women over age 50 were found to have eating disorder symptoms. Many older sufferers of eating disorders (some of whom have been battling the disorder since they were young) report feeling a sense of shame as they may ‘have a teenager’s problem.'” This unfortunate experience can often prevent individuals from seeking the quality treatment that they deserve.

Regardless of where you are in your process of discovery or recovery, Columbus Park Eating Disorder center in New York City is here to provide help. If you or a loved one are struggling with symptoms of an eating disorder, do not hesitate to seek out help. Contact us Here for more information about the services provided to individuals of all ages.

References:

https://www.nytimes.com/2018/01/11/well/live/anorexia-eating-disorders-adults-anorexic-aging.html

The post Aging Anorexia & The Media appeared first on Columbus Park | Eating Disorder Experts.

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Researcher Walter Kaye and his team at the UC San Diego Eating Disorder Center believe that brain imaging may play a key role in shaping the way we understand disordered eating behaviors. The team identified specific reward mechanisms within the brain that may be altered in those struggling with eating disorders and that may contribute to the maintenance of the eating pathology. These findings could lead to the development of new and modern therapies, reverse stigmas associated with eating disorders and usher us into a new era of understanding and sensitivity.

Kaye and his team first aimed to understand how brain structures/responses in those struggling with bulimia and anorexia physically differed from those of their peers.  “The brains of individuals with anorexia nervosa and bulimia nervosa process reward, food and hunger/satiety differently than healthy peers. Women recovered from anorexia nervosa tend to show decreased brain response to both food and money in brain reward regions, whereas women recovered from bulimia nervosa tend to show increased brain reward response.”

How would this function serve to maintain either disorder? For those struggling with AN, the reward response region was more inactive in response to both money and food explaining why women with anorexia are not motivated to eat and maintain the ability to starve themselves. Simply put, the brain associates less reward with the experience of eating and like anything/anyone else that is driven by reward, if the reward is not satisfying, one would not be compelled to engage in that target behavior.

The opposite experience was observed to be true for those with bulimia nervosa. In BN the amplified brain reward response will not diminish once the individual becomes “full.” Imaging suggests that the brain does not appear to have the ability to devalue food after enough has been consumed to sustain the individual, contributing to the propensity to binge eat.

Where do we go from here? While there is a general understanding of the various environmental, social and genetic factors that contribute to the heritability and development of an eating disorder, very little work has been done that helps definitely prove a brain basis to eating disorders. An article from UCSD explains “The history of medicine is that a better understanding of the causes of an illness often leads to more effective treatment. We really know very little about the causes and factors that maintain eating disorders, which has hampered our ability to effectively treat these disorders.”  It is one hope of researchers that with a greater understanding of the biological basis for eating disorders, stigmas (e.g. that it is a disease for the vain, manipulative, willful) will be reduced and individuals will receive better quality treatment within the community.

How may this enhance existing therapies? With a greater understanding of neuro-imaging, clinicians in the field can incorporate biological psychoeducation into the treatment plan in an attempt to improve patients’ understanding of the disorder and validate their experiences. Further, if our clients can have a better understanding of the factors driving their struggles, they will be better able to cope with or manage them effectively.  

References:

https://health.ucsd.edu/news/features/Pages/2017-12-20-brain-imaging-findings-could-lead-to-new-eating-disorder-treatments.aspx

The post Reward Circuitry in The Anorexic & Bulimic Brain appeared first on Columbus Park | Eating Disorder Experts.

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Here at Columbus Park, we respect the mindful practice of self-reflection. As individual clinicians and as a comprehensive team of dedicated professionals, we take time around the new year to honor that practice at our center and practice what we preach! As you may have learned in last week’s blog about Outcomes-Informed Care, Columbus Park is committed to ongoing treatment reviews with each client to ensure goals are being met in treatment, and that strong therapeutic alliances lead to consistently high success rates in our clients. We utilize this and other collected data to evaluate our effect size (magnitude of change) both ongoing and at the end of each calendar year. We are pleased to report that this year, our data has demonstrated continued improvement in our outcomes, further solidifying our position among the best outpatient centers in the country.

In 2016, we identified our effect size (magnitude of change) at .87 which is considered “highly effective” and was a figure we were extremely proud of; a figure that is only achievable through the delivery of world-class, gold-standard eating disorder treatments. In 2017 , our effect size was measured at a whopping .92!

                        Effect sizes of 0.8 or larger= large or “highly effective”

                        Effect sizes of .5 to .8=moderately large or “effective”

                        Effect size of .3 or less=are small; likely equivalent to no treatment at all

This past year, we continued working diligently, expanding on our current skills, and integrating more professional development and training in advanced practices. We are proud to report that our practice has achieved an effect size of 1.03. The below patient distribution graphic demonstrates that this effect size is off the charts, literally and figuratively!

We have placed a dotted line to denote the region that is considered “moderately large to highly effective”

What do these graphics demonstrate? What these numbers show is that in real time, 67% of our practice patients had measurable improvement with the majority “significantly improved” and demonstrating magnitudes of change that are exceptional.

What does this mean for prospective clients? Recovery from an eating disorder is achievable in time, though often, due to the persistence of these disorders, many sufferers enter and exit treatments multiple times during their lifetimes. Through the use of outcomes-informed care, continuing education and via our highly skilled clinicians, our clients and families continue to report that the road to recovery, while bumpy, is supportive and effective. Our high-quality interventions and ongoing reviews lead to improved treatment adherence, lower drop-out rates and better outcomes. These results should feel highly encouraging and motivating to those in our care, and those considering seeking treatment.

What methods do we use to track our clients’ progress? At Columbus Park eating disorder center in New York, NY, we utilize a survey questionnaire from ACORN (A Collaborative Outcomes Resource Network) designed specifically for eating disorder patients. Learn more about our weekly tracking and review process here!

Do you plan to identify any goals for your treatment in 2018? At Columbus Park, we’ve assembled a team of experts to treat eating disorders and their co-occurring conditions like depression and anxiety. We offer treatment to clients of all ages-adults, adolescents and children and continue to demonstrate our dedication to the field by providing the best in gold-standard treatments.

As always, when it comes to choosing a provider, do not hesitate to inform yourself and ask questions about their eating disorder outcomes. The best providers will be eager to share their methods and their results. We proudly present you with our 2017-2018 effect size in an effort to remain transparent.

References:

*Goodman, JD, McKay, JR, DePhilippis, D, Progress Monitoring in Mental Health and Addiction Treatment: A Means of Improving Care, Professional Psychology: Research and Practice 2013, Vol. 44, No. 4, 231–246.

The post 2017-2018 Outcomes in Review appeared first on Columbus Park | Eating Disorder Experts.

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Columbus Park | Eating Disorder Experts by Melissa Gerson Lcsw, Founder - 1M ago

There is no doubt that all patients deserve the very best care.  So whether a psychotherapeutic treatment is actually working or not working is highly relevant.  Therefore, outcomes – how patients are responding to treatment – absolutely must be monitored.  And not just at the end of treatment; progress should be monitored closely right from the very start.  Further, adjustments to the treatment should be made promptly if the current intervention is not leading to the desired change.  

What is Outcomes-Informed Care?

Outcomes-Informed Care (also called Feedback-Informed Treatment) is an ongoing process of treatment review between client and clinician, typically achieved via a patient self-report questionnaire completed at regular intervals (i.e. weekly) throughout the treatment. When clinicians use the practice of informed care, they are soliciting consistent feedback from the patient regarding the patient’s overall distress, the frequency of certain behaviors (like eating symptoms) and the patient’s feelings about the therapy itself (i.e. is it meeting the patient’s needs and expectations).

Why do we practice Outcomes-Informed Care?

“Research strongly suggests that therapists who incorporate outcomes-informed care in their own practice are likely to achieve better treatment outcomes that those who do not.”

Reason 1) Feedback-informed treatment leads to a stronger therapeutic alliance.  As part of a regular questionnaire, the client can safely share his/her ever-evolving feelings about the therapy relationship:

  • Are the discussions in therapy feeling relevant and in line with the client’s needs and interests?
  • Does the client feel comfortable with the overall treatment plan?
  • Is the client feeling understood by the therapist?

Not surprisingly, if the client is encouraged to share when the therapy is not feeling quite right, it gives the therapist the opportunity to address the concerns promptly and do what it takes to help the relationship back into positive territory.  You can see how this would lead to improved treatment adherence, lower drop-out rates and ultimately, a better outcome.    

Reason 2) As I mentioned in the blog opening, receiving consistent feedback regarding the client’s improvement – as in, is the client actually getting better? – makes it possible for the therapist to promptly tweak or change the treatment to be most effective.  

Reason 3) By tracking client outcomes, clinicians can demonstrate effective treatment protocols clearly and concretely to both policymakers and insurance providers. This results in increased funding, better coverage and reimbursement rates for the delivery of gold-standard treatments.

The Bottom Line

“The combination of measuring progress (i.e. monitoring) and providing feedback consistently yields clinically significant change.  Rates of deterioration are cut in half, as is drop out.  Include feedback about the client’s formal assessment of the relationship and the client is less likely to deteriorate, more likely to stay longer and twice as likely to achieve clinically significant change.”

With this knowledge of Outcomes Informed Care you are now more capable than ever to make an informed choice (pun intended!) when selecting your next treatment provider. Be sure to check back in with us next week when we launch our “2017 Columbus Park Year In Review” and proudly reveal details of our 2017 outcomes.  

References:

1 Brown, Jeb, Minami, Takuya.  Outcomes Informed Care.  Retrieved January 6, 2018 from https://psychoutcomes.org/COMMONS/OutcomesInformedCare

2 Duncan, Miller, Wampold & Hubble (2009); From Introduction in Heart & Soul of Change; p. 39; 2016 American Psychological Association.

The post Outcomes-Informed Care appeared first on Columbus Park | Eating Disorder Experts.

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A recent study conducted by lead researcher Kristen Anderson, LCSW aimed to test the feasibility of family-based treatment (FBT) delivered to adolescents and their families via Teleheath. All participants (N=10) were diagnosed with anorexia nervosa (AN) based on DSM5 criteria. Results were to be based on the outcome measure of weight gain or %mBMI increase. Results demonstrated preliminary evidence that it is, in fact, feasible to deliver quality FBT via Telehealth. Clinical outcomes were determined to be “satisfactory” as participant weight (%mBMI) increased significantly from baseline to EOT and from baseline to the 6-month follow-up. These results suggest that this method of delivering FBT could be effective for those residing in areas of the country where treatment resources are limited.

Read more: http://onlinelibrary.wiley.com/doi/10.1002/eat.22759/abstract

The post CP Research Corner: Utilizing Telehealth to deliver family-based treatment appeared first on Columbus Park | Eating Disorder Experts.

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Over the past 10 years, various universities, researchers, and clinical teams have worked to evaluate the efficacy and efficiency of eating disorder treatments delivered via technology. In this time, a wide range of technologies (e.g., televideo, e-mail, CD-ROM, Internet, text message) have been utilized with the intention of either delivering a treatment modality entirely or serving as a compliment to a specific level of care (e.g., therapy, guided self-help, treatment adjunct). These studies were typically based off cognitive-behavioral principles and interventions (CBT) and utilized a sample size of at least 10. While the studies demonstrated an overall positive result, caveats remain and are worth evaluating prior to implementing such services in any practice. The predominant concern that was shared between researchers and clients was a desire for more personal and face-to-face interaction. Despite this desire, technology continues to grow at an extremely fast rate and it is necessary to evaluate this rich area for growth and development within the field of mental health. Let’s review a few of the identified ‘major players’ within this pool of research.

Those seeking to attain the highest degree of integration between psychotherapy practice and technology would utilize devices such as the telephone, e-mail, and video conferencing. These devices are the most direct, meaning they administer actual psychotherapy. Studies surrounding these devices posed questions that would evaluate the acceptability of these formats for both the administrator and the recipient. A number of factors must be considered when utilizing an email or internet based format such as access to a computer and internet-based education.  

Email Format:

The first technology-based innovation in a large-scale trial was to contact a large number of potential patients by email through mass mailings. The therapists used e-mail to elicit history, encourage food monitoring, and identify and change maladaptive ED cognitions and behaviors.

The e-mail treatment lasted three months and averaged two e-mails per week. Researchers stated, “At the end of treatment, significantly fewer individuals met criteria for an ED in the e-mail condition (~22%) compared with the wait-list control group, of which all members were still diagnosed with an ED at follow-up.”

The email format demonstrated a new means to reach a large group of people who may not otherwise seek treatment or have access to an ED clinic in their geographic region.

Internet Format:

A second Internet-based format utilized an internet-based therapy called “Set Your Body Free,” (Gollings & Paxton, 2006). Regardless of designated format, each participant received the treatment manual that provided focused psychoeducation, change-based strategies and a treatment topic guide. Participants in the  Internet-based condition involved synchronous (scheduled, real-time, two-person) communication was paired with a therapist in an online chat-room with discussion board (“chats” included a  patient’s motivation to change, self-monitoring skills, degree of body dissatisfaction and more). At the end of the study, subjects in both conditions reported reduced ED symptoms (e.g., self-reported body image concerns, dietary restraint, and bulimic symptoms). While there were stronger initial effects in the face-to-face condition, participants in the Internet group continued to make gains, reaching similar levels of symptom reduction at 6 months follow-up.

It is important that researchers fully explored limitations of this study, and factors that may have impacted patient experience and results. These were identified as “participants’ keyboard skills, which may have reduced some individuals’ participation, difficulties in relaying the same amount of information as in traditional talk therapy, and computer problems that resulted in four participants’ premature termination.”

Video-conferencing (Telehealth):

A fourth study evaluated face-to-face intervention as compared to the use of video-conferencing. This technology-supported therapy condition attempted to replicate the experience of traditional psychotherapy more closely. Results indicated similar levels of ED symptom reduction in the two groups and equivalent therapist alliance in both conditions. Interestingly, therapists reported a subjective preference for the FTF format. Reasons cited included that therapists valued the experience of sharing a room with a client as the communication results in greater feelings of closeness between individuals and traditionally, psychiatrists and psychologists consider face-to-face contact necessary to fully assess the general mental (and physical) state of the patient’s health. Additional barriers included a difficulty scheduling sessions at distal sites and technical difficulties.

Guided Self Help:

In a research study that utilized internet-based guided self-help sites/manuals/CD-Roms, “more than one-third of the BED sample reported abstaining from binge eating post-intervention and showed significant improvements in related ED symptoms such as shape concerns and body dissatisfaction.” While outcomes suggest that Internet-based guided self-help holds promise to benefit patients who have difficulty accessing face-to-face psychotherapy, issues with treatment completion and with suboptimal response require additional attention. To remedy this, a set of research studies investigating guided self-help programs have also included additional contact between counselors and participants, with the aim of boosting the therapeutic alliance, promoting retention, and increasing the effect.

While generally, technology-delivered therapies have yielded positive results, interventions with the greatest level of therapist interaction resulted in higher abstinence rates. These findings suggest that there may be an ‘optimal level’ of therapist-client interaction that results in the highest rate of long-term symptom reduction. Researchers will continue to dive further into this field to identify what that necessary level of support is, and how to promote substantial and permanent behavioral change via the promise of technology.

Here at Columbus Park, our yearly reviews indicate that due to the quality of our face-to-face treatments, 69% of our practice patients reported having measurable improvement with 51% “significantly improved.”

Learn More about outpatient treatment in New York and do not hesitate to reach out. At Columbus Park, we’ve assembled a team of experts to treat eating disorders and their co-occurring conditions like depression and anxiety. We offer treatment to clients of all ages-adults, adolescents and children.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735837/

The post Technology for Eating Disorders: The Major Players appeared first on Columbus Park | Eating Disorder Experts.

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