As a current practicum student and future licensed school counselor there are going to be many different situations that I am going encounter during my career. These possible situations span a wide array of issues including: educational, emotional, psychological, and physical. So far, during my limited experiences I’ve encountered a few of these situations. However, one of the situations that I have yet to encounter is that of an individual who is suffering from an eating disorder. The purpose of this paper is to examine this problem a bit further. In this paper I plan on discussing exactly what an eating disorder is, what causes an eating disorder, what are the possible theoretical approaches to treating an eating disorder, and finally my plan of action for treating an individual(s) who is suffering from an eating disorder.
I would like to begin my examination of eating disorders by explaining what exactly an eating disorder is. An eating disorder is a complex compulsion to eat, or not eat, in a way which disturbs physical and mental health. Often the symptoms can be seen as extreme, or as extensions of culturally acceptable behavior and preoccupations. The eating may be excessive (compulsive over-eating); too limited (restricting); may include normal eating punctuated with episodes of purging; may include cycles of binging and purging; or may encompass the ingesting of non-foods. The most commonly known eating disorders are Anorexia nervosa (starving yourself) and Bulimia nervosa (bingeing and purging). The most widely and rapidly spreading eating disorder is compulsive overeating or Binge eating disorder. These are also the three most common eating disorders. All three cause severe immediate and long-term health issues and can cause death.
Now that I have explained exactly what an eating disorder is, I would now like to discuss briefly what exactly causes an individual to have an eating disorder. There are many different reasons and factors that could possibly contribute to an individual having an eating disorder. These include: environmental factors (our society/media), family relationships, being depressed, failures in an individual’s development, and as an individual’s response to trauma.
Since I have now covered a bit on my general knowledge about eating disorders, I would now like to discuss a few of the many theoretical approaches in treating an individual who is suffering from an eating disorder. In my examination of these approaches I found the following two to be the most effective. The approaches I plan of focusing on are Dialectical Behavior Therapy and Cognitive Behavior Therapy.
According to Wiser and Telch (1999) Dialectical Behavior Therapy is a “comprehensive long-term treatment aimed at reducing life-threatening and quality-of-life-impairing behaviors. It conceptualizes characteristic behavior such as self-mutilation and anger outbursts as faulty attempts at affect regulation, and teaches clients new, more functional ways to modulate their emotions, thus its strategies and techniques are useful in treating eating disorders” (p. 757).
DBT is comprised of four overarching treatment components including: “mindfulness skills, distress tolerance, emotion regulation, and interpersonal effectiveness” (Wiser & Telch, 1999, p.758). Each of these components has central goals that are used to educate the client on how to combat their eating disorder. The central goals of mindfulness are to, “decrease judgment of self and others and to increase awareness and acceptance of experience” (Wiser & Telch, 1999, p.758). Here a counselor would work with the client to get them to realize that they are acceptable to not only society but to themselves as well. It also focuses on getting the client to understand that what they are doing is harmful to their overall well being.
Distress tolerance teaches how to “increase an individual’s tolerance of the painful affect and how to decrease the maladaptive behavioral responses to distress” (Wiser & Telch, 1999, p. 758). Here a counselor would work with a client to get them to increase their willpower and not “cave in” to the power that their eating disorder has over them. This also helps clients understand how to deal with the pain they are having that contributes to their eating disorder.
Emotional regulation teaches how to “reduce emotional vulnerability and how to enhance their ability to alter a current emotional state” (Wiser & Telch, 1999, p.758). Here the counselor would work with the client on how to change their emotional state about their eating disorder. Finally, interpersonal effectiveness is to teach, “clarification of interpersonal priorities and objectives, and increase appropriate assertiveness” (Wiser & Telch, 1999, p.758).
Through the use of these Dialectical Behavior Therapy strategies, a counselor can work with a client either individually or in a group setting. However, it is suggested that these strategies are most effective in a group setting because it allows the clients to see and understand that they are not the only ones going through such a difficult and painful experience.
The second approach that I found to be effective in combating and treating eating disorders is Cognitive-behavioral therapy. According to Parrott (1998) “cognitive-behavioural therapy (CBT) is based upon the premise that thoughts mediate and interact with emotions. This interaction is cyclical in nature: thoughts generate feelings that produce similar cognitions. When thoughts are negative in nature, the resulting effect is either depression and/or anxiety. In addition, behaviors and physical symptoms help to maintain the cyclical pattern appropriate to the thoughts and feelings. Cognitive formulation of a problem identifies core beliefs and dysfunctional assumptions (rules) that generate these distorted negative cognitions” (p.266).
Because of this, the cognitive-behavioral model of an eating disorder proposes that distorted and dysfunctional cognitions perpetuate a cycle of partaking in an eating disorder and a low self-image. In using this technique, a counselor would combat the negative thoughts and actions of an individual who partakes in an eating disorder and replace them with more positive ones. This technique is extremely effective because it forces the client to actively examine what causes them to do the things they do and, by working alongside a counselor can effectively change their habits and behaviors. This technique is also extremely beneficial because it can be used during individual counseling sessions as well as group sessions.
Now that I have briefly discussed the two theoretical approaches that I plan on using to treat individual(s) suffering from an eating disorder, I will now discuss my plan on how I would implement these techniques. For my plan for treating an individual who is suffering from an eating disorder I plan on running a small group that will allow individuals to discuss and work through their issues.
My eating disorder group is for anyone who is struggling with an eating disorder. Family and friends are invited to attend as well. The group will be lead by myself, is free, and no registration is required. The group will provide intense, comprehensive treatment for persons of all ages who have been diagnosed with an eating disorder. This eating disorders group will address the psychological, physiological, and sociocultural aspects of eating disorders. Dialectical Behavior Therapy as well as Cognitive Behavioral Therapy will be the two main strategies used throughout this group.
The goal of the group is to provide personalized, multidimensional treatment in a safe and supportive environment. Because each person is unique, all treatment is designed to meet the specific needs of the individual. Clients are provided group psychotherapy, family therapy, nutrition education and counseling, individual therapy, psychoeducational groups, and recreational and occupational therapy.
Operating with the philosophy that an eating disorder is an external symptom of an internal psychological cause, the groups focus addresses both the symptoms and the internal psychological dynamics. The groups focus is practical and solution focused with an emphasis on assisting patients on their journey toward health.
The following are a few of the possible specific eating disorder group topics: Body Image/Body Awareness, Relaxation/Stress Management, Communication Skills/Assertive Behavior, Eating Disorder Education, Nutrition Education, Meal Planning, Exercise Education, and partaking in a supported meal.
I decided to form an eating disorders group that focused on using the strategies suggested in Dialectical Behavior Therapy as well as Cognitive Behavioral Therapy because these two theoretical approaches are essentially perfect in focusing on why an individual partakes in a particular behavior. In addition, these approaches offer effective techniques to combat an individual’s disorder and assist them in becoming healthy again.
Overall, I feel that my eating disorders group would be an extremely effective method of treatment for someone who is suffering from an eating disorder. The theoretical techniques used in the group are effective and easy to implement into a treatment program. The only concerns that I have with my group is that not all individuals suffering from an eating disorder may benefit from participation in my group. This is because not all individuals are receptive to group therapy. A few individuals may need a more direct and rigorous individual counseling sessions. If that is the case, additional accommodations could be made for these individuals. Second, my group is open to anyone who is suffering from an eating disorder. This may pose a potential problem due to the fact that there may be a very diverse group that participates. For example, there may be more young people than older people or, there could be more females than males. Some individuals may have difficulty opening up initially within the group because of this. To combat this, I may plan on running separate eating disorder groups that have specific requirements regarding gender and age. However, if there are only a small number of individuals who are unable to participate within my group, I would suggest individual counseling.
In closing, I feel that my plan of implementing the two theoretical approaches of Dialectical Behavioral Therapy and Cognitive Behavioral therapy into my eating disorders group is a solid foundation for an individual’s treatment.

References
Hyde, J., Lindberg, S., & McKinley, N. (2006). A Measure of Objectified Body Consciousness for Preadolescent and Adolescent Youth. Psychology of Women Quarterly, 30, 65-76.
Parrott, C. (1998, September). Treating binge eating disorder. Counseling Psychology Quarterly, 11(3), 265-279.
Wiser, S., & Telch, C. (1999). Dialectical Behavior Therapy for Binge-Eating Disorder. Psychotherapy in Practice, 55(6), 755-768.