Adolescent Eating Disorders: Summary Overview, Common Causes, and Counseling Methods

Useful Counseling Methods

Family Therapy

When an individual is plagued with an eating disorder, it can affect the entire family unit in a way that is very new and perhaps frightening to them. Family therapy can be used in a systemic approach. The purpose of family therapy from a systemic approach is to examine the relationships and interactions among members of the family. This can help the therapist identify any habits that the family has developed over time. The systemic approach can be further broken down into different viewpoints. These viewpoints include Adlerian Family Therapy, Multigenerational Family Therapy, Human Validation Process Model, Experiential/Symbolic Family Therapy, Structural Family Therapy, and Strategic Family Therapy (Corey, 2009). Adlerian Family Therapy focuses on helping the parents become leaders and discover mistaken or misinterpreted goals. Multigenerational Family Therapy focuses on changing the individual while remaining in the family unit. The human validation processes model focuses on helping the family achieve communication and interaction. Experiential/Symbolic Family Therapy’s primary focus is to encourage spontaneous activity, creativity, and the ability to play. Structural family therapy places an emphasis on trying to restructure the organization of a family. Strategic Family Therapy focuses on working through problems and changing disruptive patterns. Family therapists try to identify ways in which the family can better operate. The whole purpose of family therapy is to create a change in the individual with an eating disorder. A change can be created only if there is a joint effort in planning, proper interventions that are meant to benefit the individual, and also hypothesizing and sharing information with the family. By performing these tasks in a family therapy session, this can help create dialogue in the session and it can help allow the family to provide additional help for the individual with the eating disorder. These minute appearing tasks can lead to the difference between a healthy individual who is no longer plagued by an eating disorder and an individual who has been hospitalized with multiple organs shutting down.

The way some therapists view an eating disorder is through a behavior, the eating disorder which is reinforced by a consequence that benefits the individual with the eating disorder. A behavior therapist would try and identify the situational antecedents, the behavior, and the consequences via the ABC model. In order for effective behavior therapy the behavior therapist would have to pay close attention to what the client is saying, contain sensitivity, and be willing to be directive for the client. The therapist could provide the client with goals or homework assignments. In the case of a client with an eating disorder, the goals might be to try and not take part in purging or binging and try to fill the time that could otherwise be used focusing on the eating disorder with something more productive that the client enjoys participating in. The client can then return to the therapy session in order to discuss the results of the homework assignment and anything else that is troubling the young client. Afterwards the therapist and the client can work together in order to make additional changes as needed and evaluating further plans. This method could be beneficial to the client because it could help them realize why they engage in the seemingly safe, but yet incredibly dangerous behavior of an eating disorder.

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Rational Emotive Behavior Therapy

Rational Emotive Behavior Therapy stems from the belief that disruptive behaviors are due to errors in thinking or incorrect inferences from invalid information. This method of thinking could lead an individual to believe that they are inadequate and that might allow them to try and perfect themselves through the development of an eating disorder. A rational emotive behavior therapist could discuss with the client the automatic thoughts he or she experienced before making the decision to try and lose weight and eventually lead to the development of an eating disorder. As the client is talking, the therapist could point out to the ways in which the client had displayed emotional disturbances. In order to combat the irrational beliefs that are associated with an eating disorder, the therapist can discuss the beliefs with the client. The therapist can explain to the client the worse possible situations that could happen, and then they could decide that it would be unfortunate but still bearable. By doing this, this can help the client realize that their self-defeating beliefs are not as helpful for them as they were once believed to be. By helping the client change their former irrational ways of thinking, this can allow the client to realize that their former beliefs were not helpful to them and can help them create new beliefs that are more beneficial to them. The clients can then take these new beliefs and try and apply the beliefs to their everyday lives.

Summary

The eating disorder plagued client is likely to have many needs when entering counseling. One of the major needs is to realize that what they are doing to their bodies is very dangerous. The client would put themselves at the risk of experiencing early bone degenerative disorder, more commonly known as osteoporosis, cardiac arrest, and eventually death. The client also needs to realize that by hurting themselves physically, they are hurting those who are close to them and care about them emotionally. The client also needs to realize what is more important in his or her life, fleeting looks or a healthy life. The client needs to learn about proper balance between a healthy lifestyle and a life obsessed with calories, grams of fat, and minutes spent on the treadmill. In order for a client to truly understand how important it is to eat healthily in order to maintain good health, the client should probably seek out a therapist who can collaborate well with the client on improving the client’s behavior with food and a registered dietitian in order to help the client learn about proper nutritional balance. The client also needs to learn that by focusing exclusively on their eating habits they can end up hurting people close to them and eventually themselves. By confronting their beliefs about themselves and their eating habits, can the client be able to maintain a healthy lifestyle. However, the client needs to be able to help themselves before it is too late. According to Judith E. Brown (2011) about ten to fifteen percent of people who suffer from an eating disorder will die due to physical complications from it. The young client must also decide what kind of treatment method would work best for his or her life. The young clients must decide whether they would be better situated in an outpatient therapy setting or would they be better situated if they were admitted to an eating disorder rehabilitation clinic. If a client did choose to undergo therapy the client must decide what kind of therapy would be best for the situation and lifestyle.

However if one were to be a part of any kind of therapy one must be able to:

• Be truthful about one’s goals and intentions in therapy in order to avoid setting goals at a level that is unattainable.
• Listen carefully to the insight of the therapist in order to help gain further understanding.
• Complete assigned homework assignments in order to continue the progress that is being made outside of the therapy sessions.
• Commit to open and honest communication between the therapist and family members, if they are present at the therapy sessions, in order to help further progress.
• Pay attention to how one is feeling during moments of anxiety or weakness around food or eating in order to speak about during the next therapy session in order to further progress and receive insight from the therapist.

The young client needs to be able to recognize that eating disorders do not differentiate between victims, and the client needs to recognize that help can be available to them as long as they are willing to seek it out.

References

Abraham, Suzanne, Boyd, Catherine, Lal, Maala, Luscombe, Georgina, &Taylor, Alan. (2009). Time since menarche, weight gain and body image awareness, among adolescent girls: onset of eating disorders? Journal of Psychosomatic Obstetrics & Gerontology. 30, 89-94. doi: 10.1080/01674820902950553.

American Psychological Association. (2009). Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. Washington D.C.: American Psychological Association.

American Psychological Association. (2000). Diagnostic Statistical Manual of Mental Disorders: DSM-IV-TR. Washington D.C: American Psychological Association.

Berg, Frances M. (1997). Afraid to Eat: Children and Teens in Weight Crisis. New York, New York: Understanding Weight Publishing Network.

Bratman, Steven. (1998). Confessions of a health food junkie. Utne Reader, 85,76-80.

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Brown, Judith E. (Ed.). (2011). Nutrition Through the Life Cycle. Belmont, CA: Wadsworth Cengage Learning.

Chen, Eunice Y., Matthews, Lauren, Allen, Charese, Kuo, Janice R., & Linehan, Marsha Marie. (2008). Dialectical behavior therapy for clients with binge-eating disorder or bulimia nervosa and borderline personality disorder. International Journal of Eating Disorders, 41, 505-512. doi: 10.1002/eat.20522.

Corey, Gerald. (Ed.). (2009). Theory and Practice of Counseling and Psychotherapy. Belmont, CA: Brooks/Cole Cengage Learning.

Dallos, Rudi. (2004). Attachment narrative therapy: integrating ideas from narrative and attachment theory in systemic family therapy with eating disorders. The Journal of Family Therapy. 26, 40-65. doi: 10.1111/j.1467-6427.2004.00266.x

Hayaki, Jumi. (2009). Negative reinforcement eating expectancies, emotion dysregulation, and symptoms of bulimia nervosa. International Journal of Eating Disorders. 42, 552-556.

Herrin, Marcia, & Matsumoto, Nancy, (Ed.). (2007). The Parent’s Guide to Eating Disorders. Carlsbad, CA: Gurze Books.

Leyse-Wallace, Ruth. (2008). Linking Nutrition to Mental Health. Lincoln, NE: iUniverse.

McNicholas, Fiona, Lydon, Alma, Lennon, Ruth, & Dooley, Barbara. (2009). Eating concerns and media influences in an Irish adolescent context. European Eating Disorder Review.17, 208-213. doi: 10.1002/erv.916.

Petrie, Trent A., Greenleaf, Christy, Reel, Justine, & Carter, Jennifer. (2009). Personality and psychological factors as predictors for disordered eating among female collegiate athletes. Eating Disorder. 17, 302-321. doi: 10.1080/10640260902991160

Scoffier, Stephanie, Maiano, Christophe, & d’Arripe-Longueville, Fabienne. (2010). The effects of the social relationships and acceptance on disturbed eating attitudes in elite adolescent female athletes: The mediating role of physical self-perceptions. International Journal of Eating Disorders. 43, 65-71. doi: 10.1002/eat.20597