Dietitian Seasonings and Therapist Reasonings

Dear Followers: This will be the last podcast of Dietitian Seasonings & Therapist Reasonings......we have served our community for two years and are ready to close this chapter of our work in the eating disorder community.  We hope this podcast was helpful in your journey in understanding eating disorders through the encouragement and process of supervision concepts (vs just education). You can still find us! Through A Collaborative Approach we will continue to offer dual sessions to clients that desire to have both a dietitian and therapist in session: www.acollaborativeapproach.com. Meredith Riddick is continuing to provide supervision and webinars (with even continuing education credits by 2021) at www.harmonytherapygroup.com Jill Sechi is continuing to provide supervision as well as offering a residency program at www.wcandnt.com or www.jsechinutritiontherapy.com  

Jill and Meredith review basics about digestive issues that one often sees when working with clients that are struggling with an eating disorder.  There are some great podcasts that cover more in depth- stomach issues- which often clients want to focus on food to change or eliminate. Do you have clients with "IBS" or "constipation, diarrhea, or vomiting" or perhaps struggle with sleep?  Today Jill and Meredith discuss how these digestive issues might come up in session and are more often than not due to handling emotions in effectively (ie, not actually dealing with them but attempting to numb or distract from emotions one feels challenging).  Meredith encourages looking at the client as a "whole" person and not just seeing their issues as "all in their head." Jill discusses the nutritional issues that impact digestive issues. Often digestive issues (up to 40% of IBS cases) are due to the "mishandling" of emotions through eating disorder behaviors and or malnutrition through elimination of foods, food groups over and under eating. Often this process and helping clients "connect the dots" can take up to a year or longer. 

We're back! Yes, right before Thanksgiving Day to boot! Today Jill and Meredith discuss countertransference. This information is from Lisa Ferentze. Check out her resources at the Ferentze Institute . Have you ever seen a movie or TV show that had a therapist role. Were they ethical? Would YOU do this in session? Lisa Ferentze discusses Wilson and Lindy's models of countertransference. Listen on as Meredith and Jill will highlight a few areas from this training.  What is countertransference? How can it be helpful and perhaps hurtful in sessions. KNOW YOURSELF and use SUPERVISION to process your countertransference when it comes up! Watch this clip from Good Will Hunting for a little background or go watch the movie.  We will cover these aspects of countertransference: 1-Empathic disequilibrium: Feel a little ineffective with clients? 2-Empathic withdrawl: Feeling distant from your client for your own safety?  3-Empathic enmeshment: Feeling highly related to a client's story leading to inappropriate boundaries?  4-Empathic repression: Feeling overwhelmed with a client's emotional experience by rationalizing or minimizing or not coming back with a follow up session? 

Jill takes the stage this week to discuss the importance of understanding macronutrients. The current "diet" trend is for clients to be "counting macronutrients." What are macronutrients? What do you mean by "counting them?" Jill discusses the very basics of macronutrients. What they are and how they are described in nutrition and dietetics. She also goes through basic functions of macronutrients.  Here are a few links/resources for your clients: Having difficulty getting your client to see a specialized dietitian (ED RD): https://www.jsechinutritiontherapy.com/post/why-is-it-important-to-see-a-dietitian-that-specializes-in-eating-disorders

Yep, we are a bit behind on recording but have several new episodes coming up! We decided to repost this important episode. Enjoy! Be tuned in to next Monday for a new episode.

Meredith and Jill discuss the words one uses in conversation with clients and also in conversations between colleagues and professionally.  What words are we talking about? For example saying "completed suicide" vs "committed suicide." Calories vs energy? How about "obesity" which is often referred to as the "O" word within the ED community.  Listen on as Meredith and Jill discuss the WORDs we use and how they can hold deep meaning. Do you want to be "right" or do you want to be "effective?" Know your audience and work on strong skills of communication and persuasion.       

Jill goes on a rant and Meredith goes in more detail about the importance of not crowd sourcing to get support with clients on social media. There are many issues about posting detailed information to seek consultation on difficult cases on social media platforms! What's available instead? Paid consultation with a supervisor (who you get to determine level of of experience and expertise). We encourage you to form a peer consultation group within your community of ED professionals. There are also many resources on iaedp that provide monthly supervision (have to be a member): peer consultation group and also one for a focused BIPOC perspective. Another resource more specifically for dietitians is EDRDPRO. And of course there are supervisors (like Meredith and Jill) and others that provide paid consultation groups throughout the United States. 

Meredith and Jill review higher level of care recommendations presented by the American Psychiatric Association guidelines.  There are basically 5 levels of care ranging from out patient to inpatient. The chart helps reflect on key points to consider.  As always, seek supervision or peer consultation when you need more support with the client or understanding the complexities of helping a client with this decision. 

We are reposting a past season episode as we are preparing for several new episodes coming down the pike!  Meredith and Jill discuss the challenge of treating clients with eating disorders. How do you hold support and understanding yet also provide accountability during the eating disorder recovery process? If you have not heard this episode, listen on or listen again as we discuss how to not align with the eating disorder which may bring about difficult discussions and uncomfortableness in the room.   

Jill takes the wheel this week with the focus of metabolism and how eating disorders effect the metabolism process of the body.  Jill goes through very basic concepts of metabolism, function and how eating disorders can lower or "rev up" the body's metabolism (during refeeding).  Is metabolism as simple as "calories in vs calories out?" Mmmmm, no. Listen on! As you listen to this episode, Jill hopes you understand the importance of using a dietitian. If you struggle getting a client to see a specialized dietitian, this article may help.  Dr. Guadiani also has some great articles on metabolism to share with clients or understand more details about our amazing machine: the human body. 

This is a bit of a somber episode. Meredith and Jill discuss their personal experiences losing a client or a client in their practice. How do you handle this as a clinician? As Meredith states "we build relationships with clients and we genuinely care about them." It makes sense they we will be affected by their passing or that may be worried that they might pass away.  Here are some resources that might be supportive to you if you have experienced the death of a client.  Article Coping with a Clients Suicide

Jill begins this episode with a client's letter to her ED. A letter of "goodbye."  How do you know when to discharge a client or decrease frequency of appointments. Do you use your gut feeling? What behaviors are you hoping to see?  Often in the ED field, clients are seen for a longer length of time. Now this may be more known from a therapist point of view. In particular to a dietitian, a dietitian may see a client for several years which is different for the "traditional" nutrition field.  Listen on as Meredith and Jill discuss timelines, what to look for and why some clients need support longer than others before it's time for discharge.  Haven't heard of Julie Dillon's podcast, Love, Food? Click here to enjoy those episodes!  

We've decided to repost and episode from season 1 on body image. Meredith and Jill discuss body image when working with clients, their own body image, and what the treatment provider roles are and how to address them. 

This is the second part of our series on Trauma and EDs. Meredith reviews the concept of fight, flight or freeze and gives descriptions of various characteristics of these behaviors.  Meredith emphasizes the importance of diagnosing accurately as there are may characteristics of trauma that seem to be other psychiatric diagnosis. For example some clinicians feel that Borderline Personality Disorder is actually the "result" of complex trauma. Also, there are many behaviors that result in eating disorder behaviors as well.  Our title is based off a very good book that we recommend you read: The Body Keeps the Score: Brain, Mind and Body In the Healing of Trauma by Bessel Van der Kolk, MD. Please note that this podcast episode does not replace the importance of more indepth understanding and training often required to effectively treat clients with trauma.

This session (and maybe the next) will be some Meredith time! She  reviews basic aspects of trauma. What is trauma? How does this occur? When we say someone has trauma, what does this mean? Meredith also discusses various interventions therapists may use.  Our title is based off a very good book that we recommend you read: The Body Keeps the Score: Brain, Mind and Body In the Healing of Trauma by Bessel Van der Kolk, MD. Please note this podcast episode does not replace the importance of more indepth understanding and training if this is an area you are interested in supporting clients through. 

We are working on some new episodes so please tune in next week! Remember to sign up for our newsletter to receive some extra bonus materials such as role plays. As we are busy behind the scenes, listen to one of our previous episodes where we talk about the importance of obtaining supervision.  Meredith and Jill discuss the supervision process for the certified eating disorders specialist designation (CEDS or CEDRD). Meredith describes supervision for the therapist which is required for one to obtain a LPC or LCSW. Jill discusses how the supervision process is new and unfamiliar for a dietitian as they are not required to go through supervision to obtain their RD status.  Jill and Meredith discuss the general current requirements to obtain the certified eating disorders specialist designation (as of Fall 2019 through iaedp).  We would love to support you in this process. Interested in supervision? Visit our website at www.acollaborativeapproach.com/supervision

We are so excited to get requests for topics! Today's podcast is covering compulsive exercise in relationship to eating disorder recovery. Meredith and Jill first review the difference between athletes and compulsive "exercisers." An excellent resource is Dr. Kate Bennett's website: Athlete Insight.  Meredith reviews aspects of exercise that a therapist and dietitians in the field of eating disorders can focus on in the assessment process. Athletes, compulsive exercise and "over" exercise aspects are reviewed. Think INTENT and MOTIVATION.  Other resources: Dr. Brian Cook Guidelines for the Use of Exercise in Eating Disorders Treatment 

Welcome Becky Henry to this weeks podcast. Read more about Becky Henry here. Becky discusses a bit of her own story about how she was first a parent of a child in the throws of an eating disorder. She discusses what was helpful for her as she was supporting her child in the recovery process. Becky also discusses the perspective of the parent and the process she went through in order to effectively support her child.  Becky currently has a successful parent coaching program and reviews some of the process she uses to support current parents that are going through similar situations. Parents and caregivers are a vital part of the treatment team. How do we get them on board when often the parent is overwhelmed or not understanding the treatment process?  Other resource: Recovery Roadmap Specialists  

This is an episode addressing a requested topic: "How to handle clients whose trauma involves a lot of foods (either specific types of foods or certain settings or preparing foods) as an RD (ie how to do your work while staying in your lane?)" Meredith and Jill discuss their thoughts and opinions on how to address when clients struggle with trauma specific to food concerns (such as abuse, food insecurity, etc).  Meredith discusses grounded skills and validation that can be helpful that dietitians absolutely need to know and can support a client with in session.  Also dietitians often have not been taught how to "handle emotions." Jill discussed the importance of holding space and learning the skills of validation.  Interested in supervision? Visit our website and sign up for our monthly newsletter! Follow us on our socials: Facebook and IG: @acollaborativeapproach

Meredith and Jill discuss the difficulties that can occur when working with clients that are 18 or older and their usually very concerned parents. There are of course laws and guidelines with age however with eating disorders, malnutrition can affect an individual's brain. Working with the most "nourished" brain in the room is often needed (the parent). Listen on as they explore what might be helpful in sessions, what Meredith and Jill often do in their sessions working with this transitional group of clients.  Interested in supervision? Visit our website. Follow us on social media: we are on Facebook and IG ! @acollaborativeapproach Links for Becky Henry and Beth Ayn

Meredith and Jill discuss their thoughts and opinions about Episode 25 with Dr. Ralph Carson: What's weight got to do with it? We hope you found his presentation thought provoking, powerful and informative. As Dr. Carson says, he's the messenger and all of what he presented was research as we currently know.  Meredith and Jill emphasized the importance of "openess" and importance of being able to hear what the current health care providers are supporting as way of promoting dialogue to "bridge the gap" between the the eating disorders field and the healthcare industry. As well with new clinicians in the field or to inform current clinicians about eating disorders, it is vital to have positive and open discussion between us all. Enjoy! If you are interested in supervision please visit us at www.acollaborativeapproach.com/supervision. 

In this episode Meredith and I have the opportunity of speaking with Dr. Ralph Carson, RDN, CEDRD for a full hour and a half. Dr. Carson provides more of a presentation with question and answers towards the end. The focus of this podcast is bridging the gap between healthcare recommendations and focus of weight loss vs the recommendations by eating disorders professionals which is often "let go of weight loss" to repair your relationship with food and body. Dr. Carson feels that both are discussing "two sides of the same coin" and feels ED treatment and obesity medicine do not have opposing agendas. Dr. Carson also reviews perspectives of the Corona Virus and "weight" connection.  We encourage you to listen to the podcast more than once as this is pack full of information. Dr. Carson first starts with the perspective and "view point" of the medical community and then dives into the recommendations and focus of the eating disorders community. Finally Dr. Carson discusses how we might "bridge the gap." Meredith and Jill have a brief discussion after with various perspectives.  Please check out our website for references for the presentation. We encourage you to sign up for our monthly newsletter for our supervision times and upcoming podcasts. Enjoy!

In preparation for our upcoming episode to be released on July 6, 2020, with Dr. Ralph Carson, RD, CEDRD, LD we wanted to share a role play that we published (video version) in our June newsletter. You can sign up here to receive our newsletter and for the special bonuses we will be providing from Dr. Carson's discussion (powerpoint video version of the podcast for those visual learners!).  Jill and Meredith role play from a therapist and dietitian perspective how to work with a client with a strong desire to lose weight either through chronic dieting or in the throws of an eating disorder (such as binge eating). Enjoy!  

Hi all! In preparation for our July 6, 2020 podcast, Meredith and I wanted to re-post a previous podcast topic: The Role of the Dietitian in Eating Disorder Treatment. Listen on and be refreshed. Dietitians play an essential role in the treatment of eating disorders. They also have a deep understanding of health and wellness and can blend this knowledge and understanding as they work as a vital component on the treatment team. We are very excited about Episode 25 which will be released on July 6 along with additional special add ons. Please sign up for our newsletter to receive some special bonuses and additional resources to improve your skills as a well seasoned clinicians or a "newbie" in the field of eating disorders.  Stay tuned!

In this episode Meredith and Jill discuss their personal perspectives about Douglas Bunnell, PhD, FAED, CEDS-S's interview on Episode 23. Meredith reflects on the anxiety of clinicians that are new in the field and seasoned in the field and how this develops through personality types and also training in graduate school.  Jill discusses the difficulty dietitians carry having to develop "thick skin" and bring up difficult (avoid, avoiding) topics and behavioral challenges.  The function of education and supervision in the field of eating disorders is emphasized.   

In this episode, Meredith and Jill have the opportunity to interview Dr. Bunnell. Through his 30 years of experience in the ED field, he shares his clinical wisdom and generally describes the 14 qualities or characteristics of effective therapists/clinicians. There are more and more clinicians entering the ED field. However, there lacks adequate training and supervision. How do we nourish and grow new talent in the field of EDs and accelerate the process of learning and professional development? How do you teach "clinical wisdom?" 1-Interpersonal skills (you don't need to be "technically good") 2-capacity to create trust 3-build alliance with your client 4-provide a clear explanation for what you are doing 5-provide a plan that is consistent with your explanation (aka, "treatment planning") 6-influential, persuasive and convincing 7-monitor progress authentically 8-flexible and willing to adapt 9-AVOID avoidance 10-conveying hope and optimism 11- EMBRACE complexity (resisting the urge to be reductionistic of EDs on how they start and what maintains the ED itself in each client) 12- ability to factor in the clinician's emotional reactions and use these to guide your communication, reaction and conceptualization 13- greater self awareness and CONSTANTLY looking to improve your skills and understanding 14- ability to THINK "outside the box:" don't get locked into one treatment modality and READ and UNDERSTAND outside your scope of practice and the ED field (substance use for example) EDs are complex illness. Even clinicians can get in the trap of "knowing what is coming" and you must stay humble with each client you serve. Dr. Bunnell encourages those clinicians that feel they need a high level of clarity and confirmation in the  work they are doing is effective you might be in the wrong niche or area. Developing faith that the the clinician has set something in motion and develops the ability to tolerate ambiguity is a must in the ED field.   

All of these twos! This was not planned. In this session Jill and Meredith discuss the education component in dietitian sessions. Dietitians have a huge role in eating disorder support by providing education to clients. Often most client "know" a lot however they "know" a lot of misinformation. A dietitian helps dispel these food and nutrition myths, helps a client unlearn and then learn evidence based information.  Meredith and Jill also discuss the concept of education or psychoeducation being a "clinician block." If you do not know about clinician blocks, check out Dr. Adele LaFrance's work around Emotion Coaching Family Therapy or EFFT. Meredith discusses the concept, "Knowbody cares about what you know unless they know that you care!" Meredith and Jill provide reduced rate informal consultation or formal supervision from a dietitian and therapist perspective. If interested, check out our website and to learn more. Sign up for our newsletter for monthly "freebies!"      

Do you provide education in your sessions? Most clients that struggle with eating disorders need to "unlearn" misinformation that they have heard from youtubers, the internet or Netflix "shockumentaries." Often those newer in the field provide much more nutrition and psychoeducation in sessions than those that are more seasoned. But for those that are seasoned, are you providing "enough" education now that your clinical skills are more fine tuned? In part 1, Meredith discusses her experience providing the delicate balance of therapy and psychoeducation as a therapist. Watch for part 2 next week!  

In this episode Meredith and Jill discuss the "Stay At Home" (due to the Covid 19 Pandemic) challenges that have demanded many clinicians in the eating disorders field to see clients via video or phone. During this pandemic, have clients been able to transition smoothly from in person to "virtual?" Do you you prefer or do you struggle with the virtual platform? For some clinicians this may be the first time that you are seeing clients "not in person." For others, this may be the only platform one uses. Meredith and Jill discuss the pros and cons they have experienced providing telehealth as their only platform. Listen on for validation, empathy and encouragement!

In part 2 of our interview with Robyn Goldberg, RDN, CEDRD-S, Robyn discusses some content in her book regarding supporting and helping caregivers in supporting their loved one during eating disorder recovery. She discusses the importance of emphasizing not "envying" their loved one's eating disorder. Robyn encourages the awareness of their loved one's body language and their body language in addition to what is asked or stated.  How does a clinician redirect a physician's recommendation who is not specialized in eating disorders while supporting the caregivers worries and concerns? As a dietitian, Robyn discusses the edge she has as a seasoned dietitian with experience in general clinical nutrition as well as eating disorders. Meredith emphasizes the importance of new therapists receive experience in a higher level of care first or learning more depth of common occurring mental health issues associated with eating disorders.  Robyn also explores how she has been an advocate for those with eating disorders, how she markets herself to be known as an eating disorders specialist.  Resources discussed in this podcast: Medical Care Standards Guide - The Purple Book https://www.aedweb.org/resources/online-library/publications/medical-care-standards Learn more about Robyn Goldberg, RDN, CEDRD-S: www.askaboutfood.com Learn more about Robyn Goldberg's new book: The Eating Disorder Trap at www.theeatingdisordertrap.com Interested in supervision? Visit www.acollaborativeapproach.com/supervision Meredith and Jill would love to work with you to build your skills and knowledge in the eating disorders field through both the dietitian and therapist lens!

Robyn Goldberg joins Dietitian Seasonings & Therapists Reasonings with the release of her new book The Eating Disorders Trap for a two part series.  Part begins with Robyn discussing a case with a clinician who referred a very sick client to her. The clinician has minimal knowledge about eating disorders. Robyn's role became one of educating the clinician about eating disorders with the attempt of having the clinicians help and not harm the client.   Robyn, Jill and Meredith explore the process, experience and education clinicians need in order to be effective in the field of eating disorders. Robyn discusses through her 23 years of practice that most of what she has learned about the field has been through experience, mistakes and learning from them and strong mentoring relationships. How do you develop your confidence in speaking to others that may have more experience than you but you have more experience in the eating disorders field? 

Meredith and Jill talk about when and how to incorporate nutrition topics and concerns when a client has heart disease, diabetes, or abnormal lab values, etc. when they are in the throws of eating disorder recovery.  They review when a client is in the the "early stages of recovery" as well as when they have had a year or two of recovery "under their belt." How do you respond to your client's concerns yet keep their recovery a priority?

In this podcast Meredith and Jill provide a role playing scene that is often common in the dietitian's and therapist's sessions. Often times parents want to try to bargain and negotiate their child's weight goal that usually the dietitian sets through a full assessment and review of weight history.  We also have this on video as well on A Collaborative Approaches YouTube channel. Please sign up for our free monthly newsletter to also see the role play as a video version.

Kari Anderson joins us for another podcast on the subject of desire for weight loss or for clients who call themselves compulsive "overeaters" and "addicted to food." These clients often do not realized they may even be struggling with an eating disorder. How do we allow clients to talk about a strong desire to lose weight. As clinicians in the field of eating disorders, we learn more about our own bias and how to approach treatment in HAES and "weight neutral movement." Are we beginning to become close minded?  Kari discusses that she find supervising clinicians, clinicians begin to feel afraid to discuss the topic of weight loss and often times the clinician may "shut down the client."  Kari emphasizes the importance of learning to "speak your clients language" first and foremost.  Perhaps what we say needs to shift as we "sit" in our clients discomfort. Most are not content and at peace with their bodies when they enter treatment. 

Welcome Kari Anderson to our podcast! You can learn all about her at www.myeatingdoctor.com. She has also written a book and has a new one coming this year. Kari, Jill and Meredith discuss new interventions that continue to emerge that can be used in the treatment of eating disorders as well as established interventions.  What reason do new interventions and modalities perhaps not interest newer practioners in the field of eating disorders? What reason are "older" interventions and modalities not encouraged or used anymore (they are but actually often "repackaged"  as often in the field? How can we incorporate all of them, even as one practioner? CBT, DBT, ACT, IFS, RO-DBT, etc. There are so many amazing tools to place in a clinicians tool box. Listen on, on how to take risks to support clients in their recovery. 

Have you heard about Dr. Adele LaFrance and her work with Emotion Focused Family Therapy (EFFT)? If not, Meredith and Jill encourage you to seek training in this very helpful intervention for those with eating disorders (and other mental health disorders as well). Meredith and Jill attended to 3 day training in Virginia. In this episode we review very basic concepts of EFFT and how both therapists and dietitians can use this intervention to support those in eating disorder recovery.

Jill has a story to tell. We'll let you listen to hear. Meredith and Jill discuss the HAES (Health At Every Size) Movement and how our clients can advocate for themselves during physician appointments. Often clients have weight "issues" brought up in a medical appointments without their consent. Their weight is brought up out of context to why they are seeking medical support. How can we support our clients through these experiences? How do we allow space on our appointments so they can feel heard, understood and validated? How can you grow and learn from ALL perspectives?

What are some leading causes that may contribute to clinician burnout in the field of eating disorders? Those that treat eating disorders experience the highest burnout of other clinicians. What we do is hard work!  What are helpful interventions to prevent or reduce burnout? Owning burnout and actually attempting to curve burnout can be a difficult decision for a clinician. Burnout can cause lack of energy in the clinician, affect your clinical work with a client or affect the clinician's own mental health.  Listen on as Meredith and Jill review strategies to reduce burnout and discuss contributing factors. 

In our part 2 interview with Amanda Holben (which is a very different subject matter!), Meredith and Jill hear from Amanda what her experience has been like with starting a family after a very fulfilling 20 year career in the field of eating disorders and a huge choice she made to stay at home with her daughter.  This can often be a challenge for practitioner: stay home? Continue to work and balance being a parent and continuing in the field of eating disorders. Amanda discusses her experience and decisions she made. 

Meredith and Jill have the opportunity of interviewing Amanda Holben, RDN in part one of two interviews.  Amanda spent a good part of her career at the once Remuda Ranch in residential programming and then several years in outpatient nutrition counseling in Houston Texas before she decided to devote the majority of her time raising her child.   Amanda discusses aspects of being new in the field, looking back as a newer clinician compared to her skill level and knowledge base now. She reflects on areas of training and understanding of eating disorders she would recommend newer dietitians in the field understand and know to support them in the field of eating disorders. Have you ever had an abnormal psychology class? How about learning from your clients? Listen on and soak up Amanda's words of wisdom. 

Wondering what a hackle is? Listen on! If you are coming into the field as a "first career" you might be in your mid 20s or younger. This can bring up questions from parents or clients such as "how old are you?" And this can bring up a clinician's own counter transference (either positive or negative) which is your own internal  reaction in the session. This may bring up feelings of incompetence (understanding that we are all continuing to learn) for example. Meredith and Jill explore typical questions that might be asked, what this means and how you might respond. 

Meredith and Jill review the diagnosis of OSFED. Often times clients actually have AN or BN even though based on the DSM-V criteria, the client falls in the OSFED diagnosis based on BMI for example. Jill reviews looking at BMI vs the client's "normal" weight for the individual client. Jill also reviews the medical complications that may arise as well even though the client is at a "normal BMI."  Meredith also encourages looking at the length of time with the disorder and traits the client.  What about clients that might fall into BED but actually have BN as the binge eat and then follow a 1200-1500 calorie diet. What if they need HLOC? What facilities would be a good fit? 

Meredith and Jill discuss their experiences working in higher level of care (HLOC) and also now as out patient (OP) providers. They discuss what their clients may experience going from one level of care to the other. What might your client experience? What should they expect? How about the clinician? What is the clinician's experience in a HLOC vs OP setting? What might be helpful transitions for the client and the clinician and the client moves from one level of care to the other?  Interested in general consultation or supervision to obtain your CEDS or CEDRD? Contact us at www.acollaborativeapproach.com/supervision for group, individual and dyad supervision opportunities. 

What is the function of a therapist in the treatment of eating disorders? Don’t they just give good advice? In this episode Meredith and Jill explore the role of a therapist and how they are trained to help and support individuals through the process of therapy. Therapist employ strategic questions and pull on evidenced based theories while providing counseling to clients. During a therapist’s internship, a therapist is learning what theory they are more drawn to. Questions and answers that the therapist provides to a client is based on a particular theoretical orientation. Clients want black and white answers. Therapy allows clients to learn to live and work in the grey. Increasing confidence of the client and building self-efficacy of a client is a huge reason why therapist do not “just give advice.”

Often times individuals might think all dietitians do in a session is provide a meal plans: a beautifully laid out breakfast, lunch, dinner and snack option meal plan and "poof" the client magically decides to follow it. All in one magical session! Right?  Mmmmm, not so much. Meal planning is a small portion of the activities and responsibilities of a Registered Dietitian Nutritionist on an eating disorder treatment team. Jill reviews the various interventions, questions and nutrition therapy practices dietitians must be trained in to effectively support a client on their journey to developing a healthy relationship with food.  

How do you handle, work through or stay on the same page with a clinician (whether it be a dietitian, therapist, doctor or psychiatrist) who might have a different style or approach than you? Meredith and Jill explore the complexities of staying on the same page with your treatment team when the client may experience a different approach or style from different clinicians. They discuss the importance of frequent communication and collaboration. Meredith and Jill also explore how to provide feedback to another clinician if that individual’s style may collide with yours. Be careful though! At times a client will say that a clinician is not a "good fit" due to more avoidance. Make sure you "dig a little deeper" when you hear a client wants to switch treatment team members. Also be careful not to just refer to "your friend" and make sure the clinician you are referring to has the approach or style you feel the client needs. 

When do you know your client is ready for intuitive eating when they have been in the throws of an eating disorder? Please welcome our first guest on our podcast Ms. Evelyn Tribole, the registered dietitian who co-authored THE book Intuitive Eating A Revolutionary Program that Works! Meredith and Jill had the opportunity of interviewing Evelyn for this part 2 of a 2 part interview. Evelyn discusses how working as a team in the eating disorders field and emphasizes the important of consistent communication, allows each team member the freedom and latitude of discussing IE while staying in their scope of practice. What about groups? Should IE groups only be led by the therapist. Emotions and self care concepts are discussed. What about dietitians? Should this profession only lead groups on IE? Food and eating are discussed.  What about higher level of care? Should IE be discussed in RTC, PHP or IOP when a client is in the throws of an eating disorder? If YES, then HOW? Evelyn describes what her program would look like if she were to design a program.  Please visit www.acollaborativeapproach.com to find other resources and information on where to learn more about and implement IE as a clinician. 

When do you know your client ready for intuitive eating when they have been in the throws of an eating disorder? Please welcome our first guest on our podcast Ms. Evelyn Tribole, the registered dietitian who co-authored THE book Intuitive Eating A Revolutionary Program that Works! Meredith and Jill had the opportunity of interviewing Evelyn for this part 1 of a 2 part interview. In this episode Evelyn discuses  the importance of supervision for clinicians when providing guidance to their clients on the concepts and implementation of the intuitive eating process. What Evelyn describes as important to the client knowing they have something to “recover to.” Supervision is imperative as knowing how to provide guidance to your client goes well beyond any intellectual knowledge that you have (many have read her book); supervision provides guidance around the experience of supporting your clients during this process. Intuitive Eating has a few very small studies around the implementation with eating disorders. Much more studies need to be performed! So where do you start? Questions to ask your clients: “What are they capable of doing?” Can the client know and “listen” to their own body? Can they adequately respond to their body? Those in the throws of their eating disorder need a nutrition rehabilitation meal plan. BUT you can provide some insight into concepts of intuitive eating when they are on more structure. Questions you might ask your client” “How does this food feel in your body?” Generally a client needs structure. Evelyn described this as the body being ravaged by the eating disorder and they need a CAST first to stabilize their eating behaviors. Read more in our show notes at www.acollaborativeapproach.com/podcast

In preparation for some upcoming topics for 2020, Jill and Meredith have reposted a topic of importance: the function of meal plans in the treatment of those struggling with eating disorders. Listen on and be refreshed! We are excited about season 2 coming up! Stay tuned.

Meredith and Jill explore what it might be like working with an client that shares the same field you do. We focus more on treatment of those clients with eating disorders, but regardless working with someone in your field can feel intimidating, a sense of pressure to "say the right thing" or even feelings of being judged for not being a "good therapist or dietitian."  We also explore working in the field of eating disorders and how going to therapy yourself can be helpful as a form of self-care and/or for struggling with mental illness as a clinician. They hope this podcasts helps with normalizing this often common occurrence. 

Control is one small aspect that those with eating disorders struggle with on a day to day basis.  Often those newer to the field or those who do not treat eating disorders on a regular basis can feel "control" is the underlying issue an individual with an eating disorder is struggling with. Control however is just the surface of deeper concerns that have to do with malnutrition and emotion dysregulation. Eating disorders go way beyond the need "to control." Meredith and Jill explore what "deeper" issues could be lurking beneath.