Site Visit Report
Theresa Hill
BSHS/312 Models of Effective Helping
August 20, 2012
Elizabeth Jorgensen

Site Visit Report
The Eating and Weight Disorder Center of Seattle (EWDC) is one out of a group of treatment centers in Seattle called Evidence-Based Treatment Centers (EBTC). EWDC offers treatment for different eating and weight disorders. The program does not single out one type of population, as they serve a variety of populations. The disorders that EWDC help their clients with do not stand-alone as they usually lead to medical complications and mental health issues. These concerns were instrumental in determining the opening of the EWDC. It is important that individuals seek help, as it is the first step to recovery.
Staff
The staff at EWDC includes five licensed psychologists. Angela Doyle and Peter Doyle are both co-directors and licensed psychologists. Co-authoring many articles and book chapters, Dr. Angela Doyle also presents her work at national and international conferences. Dr. Peter Doyle authored and pre-authored numerous articles and book chapters in peer-reviewed journals and delivers invited speaks of eating disorders at notional and international conferences. Angela Davis earned a Ph.D. in clinical psychology worked at Harborview Medical Center on a study evaluating cognitive behavior therapy for over-weight and obese adults with binge eating disorders. She has also received extensive training in the latest version of cognitive-behavior therapy for eating disorder. Dr. Davis has authored and co-authored book chapters and research articles and journals. She has presented her work at national and international conferences. She is also an active member of the Academy for eating disorder, and the Association for Behavioral and cognitive therapies. Alison Leary received her Ph.D. in Child Clinical Psychology and has extensive experience providing evidence-based therapeutic interventions. She provides individual cognitive behavioral therapy for teens and adults. Alexia has completed her pre-doctoral internship, and she provides extensive group therapy. Kristy Ludwig earned a Master’s Degree at Harvard University, and she earned a Master’s Degree at Boston University. She received her Ph.D. in clinical psychology at Brigham Young University. Jeffery Kaiser. M.D.is a child, adolescent, and a board certified adult psychiatrist. Although a strong believer in behavioral and psychotherapeutic interventions, working with other across disciplines as a collaborating team member is something he enjoys.
Disorders
EWDC treats 12 different disorders. Anorexia nervosa, bulimia nervosa, binge eating disorder, body Dysmorphic disorder, night eating syndrome, emotional eating, compulsive eating, body image dissatisfaction, eating disorder, and anxiety, compulsive exercise, eating disorders in children and adolescents, and subthreshold eating disorders. Characteristic of anorexia nervosa is a feeling of isolation and a fear of getting fat. Some individuals engage in binge eating and purging. Bulimia nervosa includes behaviors, such as patterns of binge eating followed by the use of laxatives, self-induced vomiting, or over-exercising. These individuals report dissatisfaction with their bodies and often experience depression, anxiety, or indulgence in substance abuse. Characteristic of binge eating disorders are feelings of shame or self -disgust, or loss of control after eating a large amount of food. Characteristics of body Dysmorphic disorders are a preoccupation with minor physical abnormalities or the imagining of defects with appearance. Night Eating Syndrome occurs when an individual gets up in the middle of the night to eat and cannot go back to sleep unless he or she has eaten.
Treatments for Eating Disorders The medical and psychiatric communities are far more realistic in their perspective of eating disorders than they were in the past. According to Silverman (1997), some were of the mind in 1967 that “Anorexia nervosa results from oral ambivalence and abandonment at the genital stage of development,” and 27 years prior to that people thought that, “Anorexia is the result of symbolic or unconscious fantasies stemming from fears of oral impregnation.” Scientific research takes the fiction out of problematic disorders and creates a sound platform for professional guidance.
Treatment plans involve a network of physicians, psychiatrists, and dieticians. Therapies applied for eating disorders are cognitive behavioral therapy, dialectical behavioral skill, interpersonal psychotherapy, adolescent focused therapy, specialist supportive clinical management, family based therapy, and medication.
Adults with bulimia nervosa, adults with anorexia nervosa, adults with binge eating disorder, and early studies of adolescents with bulimia nervosa benefit from cognitive behavioral therapy (CBT). This therapy corrects inaccurate thinking such as self-worth, body weight, and shape, and eating. The goals of this therapy are to eliminate binge eating and purging and to normalize eating habits by reducing the fear of eating certain foods. This treatment plan generally runs for 20 sessions over a four to six month period. Dialectical behavioral therapy (DBT) applies to adults with bulimia nervosa, and binge eating disorder. This therapy helps individuals to develop new skills for mindfulness, interpersonal effectiveness, emotional regulation, distress tolerance, and to find alternatives for binge eating and purging. The course of these treatments are weekly for six to 12 months.
Evidence-Based Treatment Center Evidence-Based Treatment Center of Seattle is a limited liability company that operates four different programs within the same company. These programs are as follows: Anxiety and Stress Reduction Center of Seattle (ASRC), Dialectical Behavior Therapy Center of Seattle (DBTCS), Child, and Adolescent Treatment Center of Seattle (CATS), and Eating, and Weight Disorders Center of Seattle (EWDC).
In the ASRC, online http://asrcseattle.com/asrc.html the center has stress reduction worksheets and relaxation downloads for everyone with Internet access. The DBTCS online resources contain a strong list of resources for crisis (suicide), professional organizations, DBT referrals, and self-help referrals. DBT treatment originated from the treatment of interpersonal chaos, intense emotional swings, impulsiveness, confusion about self-identity and suicidal behavior. The Child and Adolescent Treatment Center concentrates on the use of evidence-based treatment and treats many problematic childhood and parenting issues.
Conversation with Staff Member In an attempt to clarify theories and differentiate methods of treatment, one stands the chance of becoming quite confused. The only recourse one may have is recalling course text, which suggested behavioral therapy as that of any therapy that attempts to change the behavior of an individual or group of individuals. The beginning of this week did not start well because of what may have been the team member’s perceptions regarding the content of communication. A personal confession will have to suffice; There is question as to the correctness of this paper (Parrott, 2003) Besides the upheaval that the team was in, it became clear that rather than direction, the syllabus offered complete confusion. Often times when people become confused it is easier to avoid the problem than it is to deal with it. This was the case. No question is a dumb question but at times, it seems that regardless of what the answer is, there is not a guarantee of comprehending it. The business week was lost and Saturday crept in. No site visit as of yet. The biggest delay was that it did not think it was right asking about therapies when they most likely were not employing any set method. An intensive outpatient treatment center perhaps or a counselor at a school maybe. A psychiatric clinic most definitely. With most everything closed, the only option was the Internet. Representing answers to questions, such as what the syllabus asked proved more difficult than anticipated because again, no comprende! If an employee is new, even there for years, he or she is not going to know how the need for the program came about. When asked who presents the program or intervention, by presenting do they mean presenting at a conference or in the office? Asking about the population of participants in a program feels biased. Expecting results from a phone call to the EBTC Monday morning proved more futile and embarrassing than anything did. The woman on the other end of the phone was just short of rude. She was not interested in answering any questions and apparently thought she may be talking to a police or spy. Regardless of the fatal phone conversation, the woman did include in the minuscule amount of information she offered that the business chosen from the Internet was only one part of the business. It was too late to change even though the business had behavioral treatment programs within the same enclosure. She also offered that they had no way of measuring the effectiveness of their programs. She must have been a receptionist. At-any-rate, I hope this is understandable.

References
Parrott, L., III. (2003). Counseling and psychotherapy (2nd ed.). Pacific Grove, CA: Thomson/Brooks/Cole.
Silverman, J., A. (1997). Anorexia nervosa: historical perspective on treatment. Handbook of treatment for eating disorders. Retrieved from: http://books.google.com.ezproxy.apollolibrary.com/books?hl=en&lr=&id=3gmogQshI_MC&oi=fnd&pg=PA3&dq=Behavioral+therapies+for+eating+disorders&ots=WIhYF64sy2&sig=Xu-UXH2EANOpe9L3xB-f5MrWJjI#v=onepage&q=Behavioral%20therapies%20for%20eating%20disorders&f=false