Eating Disorders: A Practitioner's Guide to Psychological Care
Dr Vivienne Lewis
Eating disorders involve complex psychological processes linked to self-worth that may challenge many mental health and allied practitioners, no matter how experienced. It is a topic little taught in clinical practice, and much of the information on the subject can seem contradictory or even inaccurate. Yet it is vital when working with such a client to have a solid understanding of what helps people improve their relationship with food and feel good about their bodies and themselves.
Based on extensive clinical experience and the latest evidence base, this new work from noted eating disorder specialist Dr Vivienne Lewis supports mental health practitioners who may be unsure how best to deal with the issue in their daily practice. Throughout the book, clients' voices shine through in numerous brief real-life stories, illustrating the personal and practical impacts of eating disorders and successful recovery. It is relevant for psychologists, counsellors, nurses, youth workers, psychiatrists, doctors, dieticians and trainees and includes sections on:
- Understanding complex client presentations.
- Challenging common myths about eating disorders.
- Structuring therapeutic sessions.
- Motivating clients to change.
- The importance of supervision.
Clinical psychologist Dr Vivienne Lewis has spent more than 20 years in private practice and academia, specialising in treating people with eating disorders and training other health professionals. Her knowledge, skills and compassion have helped children, young people, and adults face and defeat the destructive mental and physical effects of eating disorders and improve body image. Vivienne knows the professional challenges of working with these clients well but also understands the reward for practitioners is seeing someone who is very unwell go on to live a healthy and fulfilling life.
About the Author
About the AuthorDr Vivienne Lewis is a Clinical Psychologist at the University of Canberra specialising in the area of body image, disordered eating, and eating disorders. Her research focuses on the influence of appearance perceptions on wellbeing and mental health in males and females. Dr Lewis also has a private practice where she sees clients of all ages dealing with body dissatisfaction, eating disorders, stress, depression and anxiety. She is part of the University of Canberra experts guide and regularly features in the media. (https://researchprofiles.canberra.edu.au/ en/persons/vivienne-lewis) Dr Lewis is a member of the professional body, the Australian Psychological Society College of Clinical Psychologists. She is a Board Approved Supervisor and supervises clinical students, registrars and full qualified psychologists. She also offers workshops and supervision to a range of professionals working with people with disordered eating and body image issues and is a strong advocate for body respect and celebrating body diversity. She has previously written a self-help book for people battling body image issues called Positive Bodies: Loving The Skin You're In and one for adults including parents and teachers, helping children and young people with body image issues, eating disorders and mental health called No Body's Perfect: A helper's guide to promoting positive body image in children and young people.
Table of Contents
Introduction
Chapter 1: What is an Eating Disorder
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Other Specified Feeding and Eating Disorders
Orthorexia
Body Dysmorphic Disorder
Comorbidity
Rumination Syndrome
What is disordered eating?
Chapter Summary
Chapter 2: Helping People With Eating Disorders
Why don’t professionals want to work with people with eating disorders?
Why I love working within the area of eating disorders
How do I become competent in treating people with eating disorders?
The Importance of Supervision
What if I have an eating disorder myself?
Does being underweight or overweight make me unsuitable to work with people with eating disorders?
Chapter Summary
Chapter 3: The Dangers of Eating Disorders
Impact on the Heart
Impact on the Gut
Neurological Effects
Endocrine System Effects
Effects on the Liver
Bulimia is Dangerous
Overexercising
Treatment for Overexercising
Talking about the Benefits of not Engaging in Eating-disordered Behaviour
Chapter Summary
Chapter 4: Who develops eating and body image issues and why?
What causes someone to develop an eating disorder?
Being Teased for Appearance
The Role of the Family
The Media
Sports
As a health provider, what do I do about these risk factors?
The Impact of Covid-19 and Social Isolation on Eating
Risk Factors for the LGBTQIA (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual) Community
Eating Disorders and Indigenous Australians
Treatment and Your Own Experience
Chapter Summary
Chapter 5: Professionals Issues of Awareness and Treatment
Signs
The Role of the Dentist
The Role of Teachers
Suicidal Adolescents and Working with Parents
Private Treatment Centres
Inpatient Treatment
Chapter Summary
Chapter 6: Eating Disorder Assessment
What do clients and patients talk about that might indicate they have an eating disorder?
Taking a History and Case Formulation
An Example of a Case Formulation
Males with Eating Disorders
Chapter Summary
Chapter 7: Guiding Parents Through Their Child’s Eating Disorder
Anger and Eating Disorders
Parents Need Respite — What’s it really like as a carer?
Mealtime Tips for Parents and Carers
Siblings Need Respite
The Importance of School
Chapter Summary
Chapter 8: Therapeutic Treatment Session Breakdown
Enhanced Cognitive Behavioural Therapy (CBT-E)
Stage One: The First Session and Initial Interview
Stage 2: Beginning Sessions Two to Six (or a few more)
Stage Three: Behaviour and Thinking Change
Stage Four: Keeping Progress Going and Planning for Relapses
Stage Five: Spacing Out Sessions and Ending Therapy
Some General Points to Consider About Treatment
Chapter Summary
Chapter 9: Cognitive Behavioural Strategies for Increasing Body Satisfaction
Changing Behaviour to Change Feelings
Dealing With Body Distress and Anxiety
Changing Thinking
Chapter Summary
Chapter 10: Feeding and Sleeping
Why do we need calories and food?
Re-feeding Dangers
You’ve got to Have a Team
The Importance of Sleep in Recovery
Chapter Summary
Chapter 11: Raving About RAVES
Step 1: Regularity
Step 2: Adequacy
Step 3: Variety
Stage 4. Eating Socially
Step 5: Spontaneity
Chapter Summary
Chapter 12: Helping Clients Socially
Sex Avoidance and Hormones
The use of language
Chapter Summary
Chapter 12: Recovery
Stages of Change
Ready for Action
Chapter Summary
Chapter 14: Your Language and the Client’s Language
‘You look healthy.’
Feeling Fat
‘You don’t look like you have an eating disorder.’
Feeling Worthy of Treatment
‘I look ugly in that photo.’
‘Everyone diets.’
‘You’ve got a big appetite.’
‘I’m body positive.’
Dealing with Compliments
What you Should Never say to Someone with an Eating Disorder
A Word About Health Professional’s Session Notes
Chapter Summary
Chapter 15: Special Topics
Weddings
Having a Baby
Working with Couples
Food is not a Moral Issue
Chapter Summary
Chapter 16: Binging and Distress Tolerance
Strategies for Dealing with Binge Eating and Emotions
Learning about Hunger
Helping Clients Cope with Distress
Chapter Summary
Some Helpful Resources
Bibliography
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