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Effective Clinical Practice in the Treatment of Eating Disorders:

The Heart of the Matter

Margo Maine, Ph.D. co-edited with Wiiliam Davis and Jane Shure)

2009 Hardback 251 pp.,
Print ISBN: 9780415964616
Print list price: $39.95 USD

New York: Routledge

This book is the first to address what really happens behind closed doors during eating disorders treatment, as most writing has only  addressed theoretical approaches and behavioral strategies. The field has long needed a book that describes the heart of the matter: the therapeutic interventions and interactions that comprise life-changing treatment for this life-threatening disorder. In response to this need, the authors have created a book that reflects the individual therapeutic skills and the collective wisdom of senior clinicians, all of whom have years of experience treating anorexia, bulimia, and binge eating disorder. Intended to be a deeply thoughtful and instructive volume,

Effective Clinical Practice in the Treatment of Eating Disorders: The Heart of the Matter demonstrates the depth, complexity, and impact of the therapeutic process. In particular, the book articulates and explores essential points of information, issues, insights and unresolved questions about eating disorders treatment. Effective Clinical Practice in the Treatment of Eating Disorders describes and explicates important treatment issues and themes in a nuanced, highly contextualized and qualitative manner. The book offers a significant reference for both novice and seasoned therapists, and it includes specific information that will serve to inform and mentor future generations of eating disorders clinicians.


Editorial Reviews

“...A thorough yet practical compilation of many years of collective wisdom in the psychotherapeutic management of eating disorders by a group of seasoned and highly respected colleagues. It is an outstanding tool for clinicians of all disciplines to develop a better understanding of the art of working with those affected by these challenging illnesses. It gives the reader a psychological and socio-cultural perspective that should be part of the approach for all those working with this patient population.”— Ovidio Bermudez, MD, Medical Director, Eating Disorders Program, Laureate Psychiatric Clinic and Hospital, Tulsa OK

"Margo Maine, William N. Davis, and Jane Shure, an experienced trio of eating disorders clinicians and theorists, have engaged a large number of highly qualified eating disorders therapists to contribute reflective essays, offering their perspectives on what transpires at the core of their therapeutic work. Most of the contributors practice individual psychotherapies with adult clients informed by various versions of psychodynamic, humanistic, existential, feminist, holistic, and spiritual perspectives. To give you a further sense of this collection, of the 16 contributors, only one is an MD, and none of the chapters deals with cognitive behavioral therapy.

What we have here is a thoughtful group of practiced clinicians offering insights into their extensive consulting room experiences, with accompanying vignettes, describing what they and their clients take to be key aspects of the genesis and psychological effects of and healing interventions for eating disorders.

Dr. Maine sets the stage in her opening chapter, "Beyond the Medical Model: A feminist frame for eating disorders." Subsequent chapters deal with many of these issues and extend the frames as well. A non-complete list of topics you will encounter includes psycho-spiritual perspectives, body trust, and a "body-positive" approach, holistic integrative psychiatry, sacred circles employing feminist group therapy, guided imagery, and body-mind treatment. Psychodynamic psychotherapy and family therapy receive good consideration. Particular attention is paid to issues of shame in the evolution and treatment of women with eating disorders, all manner of countertransference reactions in therapists, and the use of the self in therapy.

Readers who expect the word "effective" in the book's title to mean that treatments are backed up by research studies showing good outcomes will be disappointed and might feel misled. The evidence for effectiveness in these presentations is largely limited to anecdotal descriptions. What we're given here are, for the most part heartfelt, compassionate and personal beliefs and discussions based on the connections and practices that these therapists and their clients have found to be experientially and intuitively satisfying. These practices have worked well for these therapist-client dyads, groups and families in clinical settings and, evidently have contributed to good outcomes.

Unfortunately, at this point, evidence-based treatments only go so far, so in practice therapists require a wide array of clinical skills. Since huge differences in individual clinical characteristics and personal preferences will also guide patient-oriented treatments, clinicians require a large clinical toolbox from which to select what is likely to work best for and best fit each client. Think variations on a theme around evidence-based practices, or improvisations around evidence-based practices, or for good cause and judicious reasoning, in some instances clinical approaches that have not yet been tested in research settings in lieu of evidence-based practices. From that perspective, the approaches described in this book undoubtedly have much to offer.”—  Joel Yager 

Table of Contents

Effective Clinical Practice: Approaches

  1. Beyond the Medical Model: A Feminist Frame for Eating Disorders- Margo Maine

  2. Wholeness and Holiness: A Psychospiritual Perspective - Steven Emmett

  3. Individual Psychotherapy for Anorexia Nervosa and Bulimia: Making a Difference- William N. Davis

  4. Developing Body Trust: A Body Positive Approach to Treating Eating Disorders- Deb Burgard

Effective Clinical Practice: Methods

  1. Holistic Integrative Psychiatry and the Treatment of Eating Disorders- Barbara Wingate

  2. Countertransference in the psychotherapy of patients with eating disorders- Doug Bunnell

  3. Family Therapy with Eating Disorders: Creating an Alliance for Change- Anita Sinicrope- Maier

  4. Sacred Circles: Feminist Oriented Group Therapy for Adolescents with Eating Disorders-   Beth Hartman McGilley

  5. Treating Eating Disorders: The Healing Power of Guided Imagery- Judy Rabinor and Marion Bilich

  6. BodyMind Treatment: Connecting to Imprinted Emotions and Experiences - Adrienne Ressler  

Effective Clinical Practice: Special Themes

  1. Shame, Compassion, and the Journey Toward Health- Jane Shure and Beth Weinstock

  2. The Embodied Therapist: Perspectives on Treatment, Personal Growth, and Supervision Related to Body Image - Carolyn Costin

  3. Connecting Through Difference: Therapeutic Use of Self to Promote Eating Disorder Recovery- Cynthia Whitehead-LaBoo 

  4. Therapy Redux: The Evolution of a Treatment Relationship- Stephen Zimmer

  5. Working with People Who Live Dangerously: Perspectives on Managing Negative Countertransference During the Treatment of Eating Disorders- Andrea Bloomgarden

  6. Forgiveness:  The Final Frontier in Recovery from an Eating Disorder- Robin Sesan, Ph.D.

“Effective Clinical Practice in the Treatment of Eating Disorders; The Heart of the Matter is truly a major contribution to the field and to those who struggle with eating disorders. Bringing together these wonderfully talented and experienced experts in one carefully crafted book is a masterful stroke. Maine, Davis and Shure have led the way for increased collaboration that will contribute greatly to this field and we are grateful.” Lynn Grefe, MA, Chief Executive Officer, National Eating Disorders Association

"Effective Clinical Practice in the Treatment of Eating Disorders: The Heart of the Matter is an amazing new resource for anyone who is in the business of treating eating disorders. It is brilliant! Taking the collective wisdom and insight of the leaders in the field, asking them to discuss the treatment methods they find most effective and find the “heart” of their approach will prevent thousands of broken hearts each year.  Thank you on behalf of the millions of people who suffer from eating disorders, their families and friends." Kitty Westin, MA, LP, Founder of the Anna Westin Foundation and President of the Eating Disorders Coalition for Research, Policy & Action

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