Reducing Parental Accommodation of Eating Disorder & High-Risk Behaviors
Reducing Parental Accommodation of Eating Disorder & High-Risk Behaviors: Integrating DBT and "SPACE" in Work with Parents & Caregivers
By Amy Kalasunas, LPCC-S, CCMHC, DBT-LBC™ Certified Clinician
Eating disorders frequently co-occur with severe emotion dysregulation and other high-risk clinical presentations, including suicidal communications or behaviors, non-suicidal self-injury, and medical instability related to disordered eating. In these contexts, parents and caregivers by default provide crisis management and oversee daily functioning, yet their well-intentioned responses can unintentionally reinforce avoidance, maintain symptom acuity, and fuel treatment-interfering patterns over time.
This one-hour presentation introduces a clinical framework for understanding the intersection of eating disorders, multi-diagnostic emotion dysregulation, and parental accommodation of eating-disorder and other high-risk behaviors, including suicidality, self-injury, and medical risk. It reviews how accommodation functions behaviorally, why it becomes more complex in higher-risk contexts, and how clinicians can help parents make informed, effective decisions about when and how to change accommodations. The session provides an overview of a program integrating Dialectical Behavior Therapy (DBT) with an adaptation of Supportive Parenting for Anxious Childhood Emotions (SPACE) to help parents identify accommodations, tolerate distress, and change accommodations selectively. Informed by DBT and SPACE tenets, including a non-judgmental and collaborative stance , dialectical functions, deliberately paced steps towards change, forms of validation, and effective contingency management, this intervention offers instruction on coaching parents on simultaneously supportive responses and a gradual reduction of accommodations that maintains symptoms or interfere with recovery over time.
Learning Objectives
By the end of this presentation, participants will be able to:
• Describe the clinical relationship among eating disorders, emotion dysregulation, and parental accommodation in multi-diagnostic presentations.
• Identify common forms of parental accommodation around eating-disorder symptoms and other high-risk or treatment-interfering behaviors.
• Explain how DBT and SPACE concepts, (including contingencies, treatment hierarchy, validation, and distress tolerance) can help parents recognize, tolerate, and selectively reduce accommodations while maintaining a supportive stance in the context of eating disorders and elevated risk.
Amy Kalasunas, LPCC-S, CCMHC, DBT-LBC™ Certified Clinician
Chief Clinical Officer, Center for Evidence Based Treatment
Amy Kalasunas (she/her), LPCC-S, CCMHC, is a behaviorist with over 25 years of experience working within evidence-based treatment models. A DBT-Linehan Board of Certification™ Certified Clinician, she has extensive training in Dialectical Behavior Therapy (DBT) and its sub-specialty area of DBT for Multi-diagnostic Eating Disorders ( MED-DBT), DBT- Prolonged Exposure for Borderline Personality Disorder, and DBT supervision and consultation team
Adherence Practices
In addition to her DBT-LBC™ Certification, Amy co-chairs the DBT LBC™ Communications Committee. A sought-after instructor, she consistently achieves the highest evaluation scores when presenting two- and three-day workshops on the topics of comprehensive Dialectical
Behavior Therapy (DBT), DBT and Multi-diagnostic Eating Disorders, and DBT-Prolonged
Exposure and Eating Disorders. Amy has also developed, piloted, and researches interventions
for parents of multi-diagnostic adult children using an adaptation of the Supportive Parenting
for Anxious Childhood Emotions (SPACE)
Registration
Registration not available.