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Management & Psychological Treatment of Eating Disorders in Adults

Workshop Overview: This three-day workshop is aimed at mental health professionals who have completed their clinical degree and who are interested in providing treatment for adults with eating disorders. Assumed knowledge includes understanding how to assess and treat mental health conditions that commonly coexist with eating disorders. This workshop covers ANZAED’s Practice standards and is designed to give those clinicians the core skills to assess and plan treatment, establish a safe therapeutic framework to manage risks and comorbidities, and then conduct effective treatments. The focus is on adults with severe and complex eating disorders, especially anorexia nervosa and bulimia nervosa. The workshop commences with crucial information about the emotional, cognitive and behavioural features of the eating disorders and moves to cover the medical and psychiatric dangers associated with this condition. The training curriculum includes key elements from the ANZAED practice standards for the treatment of severe and complex eating disorders.

Participants will learn how to conduct a thorough assessment and establish a safe therapeutic modality to deal with the medical and other dangers that are associated with eating disorders. Whilst CBT-E constitutes many of the core treatment skills at the centre of the workshop, additional clinical skills which are also core principles of a good eating disorders treatment will be taught over the three days. These will be drawn from a range of evidenced based treatments such as Specialist Supportive Clinical Management (SSCM), Maudsley Model of Treatment for Adults with Anorexia Nervosa (MANTRA) and Focal Psychodynamic Therapy. This will include managing the therapeutic relationship, knowing how to identify level of readiness for change of each client, having capacity to respond to any stage of readiness for change and increase motivation. The workshop includes lecture-style content, group discussions, role-play exercises and video and in vivo demonstrations. Extensive handouts will be provided on assessment, formulations, management approaches, treatment techniques and the Medicare Guidelines introduced in November 2019.

Event Details

Thank you for your interest, we have reached maximum capacity for this workshop.

Dates: Thursday 26 November, Friday 27 November & Saturday 28 November 2020
Time: 9.00am – 5.00pm AEST (on all days)
Join in 15 minutes prior on Day 1 for orientation
3-day Registration Fee: $380 Members; $480 Non-Members

Presentation: The workshop will be delivered online with a combination of lecture format, small group exercises in online rooms and presentation of video material of therapy sessions.

WORKSHOP PRESENTERS

Speaker: Chris Thornton (B.Sc. Hons; M.Psychol)
Chris Thornton is a clinical psychologist, teacher and researcher who specialises in the eating disorders. He has established a number of highly effective day programs, has consulted to several eating disorder units throughout NSW and has published numerous chapters and research articles in this field. Chris now works primarily in his private practice seeing clients, teaching and conducting supervision.

Speaker: Chris Basten (B.A. Hons; M.Psychol; Ph.D.)
Chris Basten is a clinical psychologist who has previously worked in and managed a hospital eating disorders service. He has undertaken research in the field of eating disorders and has been active in training GPs and psychologists in the area for many years. Chris now works in private practice seeing clients and conducting supervision, and also consults to health services.

DAY ONE – Thursday 26 November
08:45am Log-in and orientation to the meeting room
09:00am – 10:45am Core Knowledge about the Psychopathology of Eating Disorders. For safe and effective treatment of eating disorders, the clinician needs to have a strong familiarity with the key causal and maintenance models of anorexia and bulimia, an understanding of how these conditions manifest, and knowledge of common comorbid psychological conditions. Diagnostic criteria and diagnostic uncertainty are discussed. The psychological and emotional consequences of low weight are discussed as they represent risks to the client and possible maintaining factors for the disorder.
10:45am – 11:15am Tea Break
11:15am – 12:45pm Core Knowledge about Medical and Nutritional Issues in the Management of Eating Disorders in Adults. Participants are provided with a summary of the biological changes that occur with dietary restriction, weight loss, vomiting, laxative use, excessive exercise and other symptoms of disordered eating. You will be taught how and when to share this with clients as psychoeducation. We then present how mental health professionals can contain medical risk through establishing non-negotiable rules for safe therapy and engaging a network of other health professionals. In addition to specific therapeutic interventions, ‘management’ of the treatment process is required and methods for doing this are discussed such that the clinician operates safely and effectively. Establishing a clinician’s readiness to treat severe & complex eating disorders is also discussed here. Tips for managing comorbidity are introduced.
12:45pm – 1:30pm Lunch Break
1:30pm – 3:00pm Addressing low motivation and building the relationship. This section is embedded in a broader tutorial on engaging the person with an eating disorder in therapy. Skills and strategies to enhance the therapeutic relationship are presented. The principles and practices of motivational interviewing are expanded on and demonstrated, as described in Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) and advocated by others.
3:00pm – 3:30pm Tea Break
3:30pm – 5:00pm The Core Therapy Process. We continue from the last section on building and maintaining a therapeutic alliance, whilst also responding skilfully to whatever motivational status the client is in at any point in time. An analysis of video vignettes of therapy is used as a teaching stimulus before practicing in role-plays.
DAY TWO – Friday 27 November
09:00am – 10:45am Individual Case Formulation (ICF). A case formulation is one of the more powerful therapeutic tools. It helps build and protect the therapeutic relationship. A good ICF delivers a rationale for treatment interventions, giving the client hope and direction. We present commonalities and difference between various theoretical approaches in formulations (CBT-E, Psychodynamic and MANTRA. Learning opportunities are provided to practice developing an ICF sketch for some common case examples and those with complexity and comorbidity.
10:45am – 11:15am Tea Break
11:15am – 12:45pm The Assessment for Treatment. Successful treatment requires a comprehensive assessment so that the clinician is confident that they know the person as well as ways that the eating disorder is manifesting and being maintained. A checklist and methods for assessment will be provided. Assessing motivational balance and stage of readiness for change is taken up here again, as is the therapeutic alliance, which starts at the assessment phase.
12:45pm – 1:30pm Lunch Break
1:30pm – 3:00pm Essential behavioural and cognitive therapy skills. Eating disorders are driven by unhelpful and faulty cognition at many levels (core self-loathing, heightened self-discrepancies, perfectionistic rules, all-or-nothing thinking, overvaluing weight and shape in self-evaluation, fears about weight gain, fears of calories, rigid rules about exercise and food and the like). Cognitive therapeutic strategies and discussed and demonstrated. Acceptance, mindfulness and compassion-focused versions of cognitive therapy and explained and explored.
3:00pm – 3:30pm Tea Break
3:30pm – 5:00pm CBT-E for Bulimia and related conditions. The core elements of Fairburn’s (2008) treatment plan are illustrated through cases examples. Exercises allow participants to practice developing a formulation, establishing normal eating, stopping unhealthy ‘compensatory’ behaviours after eating and rolling with resistance.
DAY THREE – Saturday 28 November
09:00am – 10:45am Advanced treatments for restrictive and low weight eating disorders. This section is devoted to collating knowledge and skills from Days and One and Two and then employing those techniques in role-plays. We develop advanced problem solving when a client is struggling to make changes. The CBT-E text (Fairburn, 2008) provides the scaffolding to learn techniques to treat anorexia nervosa. The elements include setting an appropriate weight goal, when and how to weigh your client, identifying and managing maintaining factors, having a range of cognitive therapy strategies, knowing which of these to use at a certain time, employing behavioural experiments, linking this treatment to the client as a whole person (through their values and pre-existing comorbid psychological difficulties). Other treatment approaches are also discussed as helpful adjuvant or alternative approaches to CBT.
10:45am – 11:15am Tea Break
11:15am – 12:45pm Further Practice at motivational enhancement. Learning opportunities are provided to practice the skills that have been discussed thus far. We use case examples of clients who are struggling with some aspects of treatment, those who rely on their symptoms to cope and those who resist engaging in treatment at all. This section is devoted to role-playing responses to a young adult client who is fiercely against any treatment at all.
12:45pm – 1:30pm Lunch Break
1:30pm – 3:00pm Interventions for common comorbidity, including trauma, low self-worth, perfectionism and body-distress. We start with techniques described in CBT-E and add to this repertoire in this section. Negative self-regard and a dysfunctional self-evaluation and renown aspects of anorexia and bulimia nervosa. A few key interventions are shared and some practice opportunities provided. Perfectionism is equally important to address and some strategies specific to this and other obsessional traits are included. Emotional distress is very common in people with an eating disorder and so having some strategies that clients can learn to contain their distress is important.
3:00pm – 3:30pm Tea Break
3:30pm – 5:00pm Clinical problem-solving and case examples
The final afternoon is devoted to further role-plays and demonstrations of therapy with clients who may be struggling with some aspect of therapy (such as eating a feared food or gaining another 2kg) or who are unwilling to engage in treatment at all. The presenters will present cases to work with and may also demonstrate the use of certain skills.