Using career development theories in the treatment of clients with eating disorders

Various types of psychotherapy have been used in treating clients with eating disorders - a debilitating and frustrating form of psychological illness which mainly occurs in females, especially female youth. However, little is known about the relevance of career counselling for this group of clients. This article attempts to incorporate theoretical concepts from vocational and career psychology into the helping process for clients with eating disorders. It illustrates the rationale and applicability of infusing career counselling concepts and strategies into the psychotherapy for individuals recovering from eating disorders. It also provides the implications for blending the career counselling and therapeutic interventions in the treatment process.     

The use of group therapy to help women with eating disorders differentiate and articulate affect

In this discussion of eating disorders, symptoms are viewed as responses to unprocessed and unprocessable affect—what Stolorow and Atwood, Krystal, and Sifneos have called alexithymia. The article explores ways in which a group experience can help to provide an arena for the articulation and exploration of this affect. The group can provide its members with the responsive milieu necessary for the development of an internal structure that eliminates the need for the eating behavior. The metaphor of a child learning to swim is used to suggest that the group process can be seen as a kind of group swimming lesson. Group members work together with the therapist to develop the necessary skills and muscles to negotiate the waves of their own feelings, making the eating behavior unnecessary.     

Sociological factors in the development of eating disorders.

In recent years, anorexia and bulimia nervosa, whether combined into a single clinical picture or considered as distinct syndromes, have reached epidemic proportions among adolescents. Professionals in the educational and physical and mental health care fields need to be aware of the influence of social pressures on teenagers' perceptions of body image and appearance. This article reviews the sociocultural, socioeconomic, and sex-related factors which contribute to the development of eating disorders. It is recommended that professionals help adolescents resist societal pressure to conform to unrealistic standards of appearance, and provide guidance on nutrition, realistic body ideals, and achievement of self-esteem, self-efficacy, interpersonal relations and coping skills.     

Self-reported parental abuse relates to autobiographical memory style in patients with eating disorders

Previous research has shown a relationship between levels of self-reported childhood abuse and overgeneral memory style. This relationship was further clarified in patients with an eating disorder (ED). Patients and healthy controls completed a task in which they had to generate specific autobiographical memories to emotional cue words. The results showed that first, the ED group, relative to the controls, produced more first memories that were "overgeneral" and fewer first memories that were specific. Second, in the ED group, the level of self-reported parental abuse was positively correlated with the tendency to produce overgeneral memories to negative cues. This effect remained significant even after levels of depressed mood were controlled for.     

Exercise commitment and proneness to eating disorders in a group of physical education teachers

The study examined the association of exercise commitment with proneness to eating disorders in 50 physical education teachers who had been practicing various aerobic sports at least three times a week for at least 5 years. Significant coefficients were found between Commitment to Exercise Scale scores, the number of weekly training sessions, and scores on the Eating Disorders Inventory-2 scales measuring Maturity Fears, Social Insecurity, Perfectionism, and Asceticism. However, no relationship was found between the Commitment to Exercise Scale and the Eating Disorders Inventory-2 variables measuring anorexic tendencies (such as Drive for Thinness, Body Dissatisfaction, and Bulimia). Findings suggest the presence of some psychological factors common to both anorexic tendencies and excessive exercising but not complete overlap, so a rather more complex pattern of relationships appears to be mediated by sex and personality characteristics.     

Significant events in a psychodynamic psychotherapy group for eating disorders

This qualitative pilot study was designed to identify and explain significant events for patients participating in a psychodynamic psychotherapy group for eating disorders. Specifically, seven members of a mixed (i.e., anorectic, bulimic, obese) eating disorders group recorded what they perceived as the three most significant events in group meetings for 14 weeks. In addition, group members were instructed to record why each event was significant. Manifest and latent content analyses of the data revealed that members found feedback and observing others the two most common types of significant events, and emotional experience, insight, and relationship the reasons these events had such impact. The implications of these results for working with the eating-disordered patient in group, as well as their implication for general group theory and practice, are discussed.An earlier vesion of this paper was presented at the 1991 meeting of the American Group Psychotherapy Association, New York. This paper was funded, in part, by a California State Faculty Support Grant and a Santa Barbara Cottage Hospital Research Grant awarded to the first author. The authors would like to thank Sean T. Casey, Sally Barton, Dr. Allison Wollitzer, Tom Knowlton, Craig Park, and Beth Buxton for their assistance in the preparation and execution of this study.     

The initiation and development of a group for relatives of patients with chronic emotional disorders

This paper describes the initiation and development of an educational discussion group for relatives of patients with chronic emotional problems and the process by which it became transformed into a group combining a self-help, modified therapy model with a primary focus on the members' interaction with their patientrelatives. The group offered the opportunity to ventilate pent up emotions in a supportive, reality-oriented context and provided information and education about the nature of emotional disorders. Generally this helped family members to effect positive changes in their interactions with their patient-relatives; to accept with greater understanding their relatives' illness; and to better evaluate the quality of treatment their relatives were receiving. The group chose this model over an educational model or traditional psychotherapy model or multifamily model, all of which were phases of this process. The positive results are supported by recent reports in the literature of similar groups.Formerly on the staff of The New Britain General Hospital Mental Health Clinic.     

Group therapy for eating disorders: A step-wise approach

Group therapy is emerging as a favored treatment for eating disorders. Open-ended psychodynamic group therapy is an effective treatment for the underlying conflicts in eating-disordered patients, yet these groups are difficult to form. The authors suggest a specific sequence using time-limited psychoeducational groups initially for symptom control, then offering an open-ended group for patients who are ready to address deeper issues in a group therapy setting.     

Comparison of group climate in an eating disorders partial hospital group and a psychiatric partial hospital group

Women in an eating disorders partial hospital program and a psychiatric partial hospital program were compared on a self-report measure of group climate following a psychodynamic-interpersonal therapy group. Those with eating disorders experienced their groups as more engaged and as more avoiding than those in the psychiatric partial hospital group. Therapists may be able to use initial heightened engagement in eating disorder groups to counteract the tendency to avoid content.     

Visual palatability of food in patients with eating disorders and dieting women

The effects of 19 meals of different caloric content on slides on palatability and hypothetical duration of consumption were investigated in 7 patients with anorexia nervosa, 17 patients with bulimia nervosa at the beginning and after 8 weeks of hospital treatment. Nine healthy females served as controls. At the beginning of treatment, palatability of low caloric food was significantly higher and hypothetical duration of consumption of high caloric food was significantly longer in patients when compared to controls. After 8 weeks, in the patients palatability of low caloric food had decreased. Dislike for high caloric food remained stable in anorexics.     

Assessment of emotional reactivity produced by exposure to virtual environments in patients with eating disorders.

The aim of this study was to assess the usefulness of virtual environments representing situations that are emotionally significant to subjects with eating disorders (ED). These environments may be applied with both evaluative and therapeutic aims and in simulation procedures to carry out a range of experimental studies. This paper is part of a wider research project analyzing the influence of the situation to which subjects are exposed on their performance on body image estimation tasks. Thirty female patients with eating disorders were exposed to six virtual environments: a living-room (neutral situation), a kitchen with high-calorie food, a kitchen with low-calorie food, a restaurant with high-calorie food, a restaurant with low-calorie food, and a swimming-pool. After exposure to each environment the STAI-S (a measurement of state anxiety) and the CDB (a measurement of depression) were administered to all subjects. The results show that virtual reality instruments are particularly useful for simulating everyday situations that may provoke emotional reactions such as anxiety and depression, in patients with ED. Virtual environments in which subjects are obliged to ingest high-calorie food provoke the highest levels of state anxiety and depression.     

Changes in alcohol intake in response to transdiagnostic cognitive behaviour therapy for eating disorders

Objective

The aim of this study was to examine how alcohol intake changes during and after transdiagnostic cognitive behaviour therapy for eating disorders (CBT-E). Additionally, the paper considers the relationship between alcohol consumption, eating disorder diagnosis and current major depressive episode at the time of first assessment.

Method

One hundred and forty nine outpatients with an eating disorder (body mass index over 17.5) were divided into high or low alcohol intake groups (HIG and LIG) according to their intake at pre-treatment assessment. Their alcohol intake and eating disorder psychopathology were examined over the course of treatment and follow-up.

Results

There was no difference between the groups on response of the eating disorder to treatment. The HIG significantly reduced their alcohol intake following treatment whilst the intake of the LIG remained stable over the course of treatment and follow-up. There were no group differences in major depression and overall severity of eating disorder at baseline.

Conclusions

The response to CBT-E was not influenced by baseline level of alcohol use. The mean alcohol intake of the heavy drinking subjects decreased without being specifically addressed by the treatment.