Eating disorders (EDs) affect at least 11 million people in the United States each year and spread across age, race, ethnicity and socio-economic class. While professional literature on the subject has grown a great deal in the past 30 years, it tends to be exclusively research-based and lacking expert clinical commentary on treatment. This volume focuses on just such commentary, with chapters authored by both expert clinicians and researchers. Core issues such as assessment and diagnosis, the correlation between EDs and weight and nutrition, and medical/psychiatric management are discussed, as are the underrepresented issues of treatment differences based on gender and culture, the applications of neuroscience, EDNOS, co-morbid psychiatric disorders and the impact of psychiatric medications. This book uniquely bridges the gap between theoretical findings and actual practice, borrowing a bench-to-bedside approach from medical research.
• Includes real-world clinical findings that will improve the level of care readers can provide, consolidated in one place
• Covers underrepresented issues such as gender, culture, EDNOS and co-morbidity • Represents outstanding scholarship, with each chapter written by experts.
While the professional literature related to eating disorders has grown considerably, the gap between research paradigms and clinical realities remains. For example while half of clinical cases are diagnosed with Eating Disorder Not Otherwise Specified and many eating disordered patients suffer from comorbid conditions, research tends to overlook such issues. This schism compromises critical prevention and treatment advances and patient care, but this volume bridges such gaps, assuring that research better informs clinical work, and clinical work better informs the research agenda and process. Content areas include: the biopsychosocial nature of eating disorders; diagnosis and treatment; special populations; family issues; clinical interventions to address mind, body, and spirit; and future directions. This unique integration of outstanding scholarship, with chapters written by expert clinicians and researchers, borrows a bench-to-bedside approach from medical research, enhancing both domains.
* Real-world clinical findings that will improve clinical care consolidated in one place
* Underrepresented issues such as gender, culture, EDNOS and comorbidity covered in full
“Treatment of Eating Disorders: Bridging the Research-Practice Gap”
Edited by Margo Maine, PhD, FAED, Beth Hartman McGilley, PhD, FAED and Douglas W. Bunnell, PhD, FAED
(Academic Press, 2010, 499 pages)
Bridging the research-practice gap has been a central theme within the Academy for Eating Disorders, particularly in recent years. Clinicians often do not utilize evidence-based treatments, and researchers often do not incorporate clinical realities into their research designs or find ways to disseminate evidence-based treatments. This division within the field of eating disorders is the basis for “Treatment of Eating Disorders: Bridging the Research-Practice Gap,” which represents a collaboration of over 40 eating disorders experts from both research and practice disciplines.“Treatment of Eating Disorders:
Bridging the Research-Practice Gap” is comprised of 28 chapters broken down into six broad headings: Overview; Diagnosis and Treatment; Special Populations; Family Issues; Mind, Body and Spirit; and Future Directions. Each of these sections presents topics that are timely and relevant to the kinds of debate and discussion that are frequently a part of AED conferences and listserv debates. For instance, Deborah Burgard’s chapter entitled, “What’s Weight Got to Do with It? Weight Neutrality in the Health at Every Size Paradigm and Its Implications for Clinical Practice” outlines the importance of a weight-neutral stance in treatment.
Similarly, Drew Anderson’s chapter on “The Assessment Process: Refining the Clinical Evaluation of Patients with Eating Disorders” emphasizes the evaluation of key symptoms rather than how to make particular diagnoses. This approach is timely given the impending publication of DSM-5 with possible changes to the diagnostic criteria for eating disorders, as well research supporting Fairburn’s transdiagnostic theory of eating disorders.
The section on Special Populations is particularly useful for those interested in working with clients with borderline personality disorder (Randy and Lori Sansone), comorbid substance use (Amy Baker Dennis and Bethany Helfman), trauma (Diann Ackard and Timothy Brewerton), self-harm behaviors in adolescents (Kim Dennis and Jancey Wickstrom), older adult women (Margo Maine), and men (Douglas Bunnell). The authors present current research findings, as well as clinical experience that may provide additional insight into a best-practice approach to treatment. Likewise, a poignant chapter on the family’s perspective by Robbie Munn, Doris and Tom Smeltzer and Kitty Westin provides invaluable insights into the devastating consequences of eating disorders and includes 13 messages that the authors suggest are important to convey to parents involved in treatment.
“Treatment of Eating Disorders: Bridging the Research-Practice Gap” does not include descriptions of evidence-based treatments for eating disorders, such as Cognitive Behavioral Therapy, Interpersonal Psychotherapy, and Family-Based Treatment. Instead, constructive criticisms are presented for why these approaches do not work for everyone. The clinical contributions to these chapters are very stimulating and should be viewed as a starting point for continued discussion rather than a definitive conclusion as to how the current approaches should be adapted or improved.
A particularly valuable chapter in the discussion of the research-practice divide is presented at the end of the book. In “The Research-Practice Gap: Challenges and Opportunities for the Eating Disorder Treatment Professional,” Judith Banker and Kelly Klump describe data gathered from AED’s Research-Practice Initiative that shed light on why the research-practice divide has occurred and how it is sustained. The Initiative’s findings segue into strategies for bridging the gap that should be required reading for every professional working in the eating disorders field.
Unlike many other texts available, this volume should not be regarded as a comprehensive guide to the treatment of eating disorders, but rather as a starting point for or a continuation of an important and captivating debate. The editors, Maine, McGilley, and Bunnell, caution, “It is no longer acceptable to rely on research that does not reflect clinical realities…Nor is it acceptable for therapists to base their treatment approaches solely on their own clinical intuition” (p. xxv). “Treatment of Eating Disorders: Bridging the Research-Practice Gap” serves as an excellent resource for learning more from our colleagues “across the aisle” and as part of the shared mission of improving treatments for eating disorders.
Copyright 2010 Academy for Eating Disorders. All Rights Reserved
Table of Contents
Introduction- Eating Disorders as Biopsychosocial Illnesses- Maine, Bunnell & McGilley
Bridging the Gap: The Overview
1. A Perfect Biopsychosocial Storm: Gender, Culture, and Eating Disorders Margo Maine & Douglas Bunnell
2. What's Weight Got to Do with It? Using the Weight Neutrality of the HAES Model and its Implications for Clinical Practice - Deborah Burgard
3. Neuroscience: Contributions to the Understanding andTreatment of Eating Disorders – Francine Lapides
4. Are Media an Important Medium for Clinicians? Mass Media, Eating Disorders, and the Bolder Model of Treatment, Prevention, and Advocacy- Michael Levine & Margo Maine
Bridging the Gap: Diagnosis and Treatment
5. The Assessment Process; Refining the Clinical Evaluation of Patients with Eating Disorders - Drew Anderson, Jason M. Lavender, & Kyle P. De Young
6. Medical Assessment of Eating Disorders-Ed Tyson
7. Psychiatric Medications: Management, Myths and Mistakes- Martha Peaslee Levine & Richard Levine
8. Nutritional Impact on the Recovery Process-Jillian Croll
9. Science or Art? Integrating Symptom Management into Psychodynamic Treatment of Eating Disorders- Nancy Cloak & Pauline Powers
10 New Pathways: Applying Acceptance and Commitment Therapy (ACT) to the Treatment of Eating Disorders-Kathy Kater
11. Outpatient Treatment of Anorexia Nervosa after Weight Restoration: Practicaland Conceptual Issues - Richard Gordon
12. Recipe for Recovery: Necessary Ingredients for the Client and the Clinician's Success. Beth Hartman McGilley & Jacqueline Szablewski
Bridging the Gap: Special Populations
13. Borderline Personality and Eating Disorders: A Chaotic Crossroads- Randy A. Sansone & Lori A. Sansone
14. Managing the Eating Disorder Patient with Co-morbid Substance Use Disorders. Amy Baker-Dennis & Bethany Helfman
15. Co-morbid Trauma and Eating Disorders: Treatment Considerations and Recommendations for a Vulnerable Population - Diann Ackard & Tim Brewerton
16. Healing Self- Inflicted Violence in Adolescents with Eating Disorders: A Unified Treatment Approach- Kimberly Dennis & Jancey Wickstrom
17. The Weight-Bearing Years: Eating Disorders and Body Image Despair in Adult Women – Margo Maine
18. Psychotherapy with Men with Eating Disorders: The Art and Science of Treatmant Engagement - Douglas Bunnell
Bridging the Gap: Family Issues
19. Mutuality and Motivation in the Treatment of Eating Disorders: Connecting with Patients and Families for Change - Mary Tantillo, & Jennifer Sanftner.
20. When Helping Hurts: The Role of the Family and Significant Others in the Treatment of Eating Disorders-Judith Brisman
21. The Most Painful Gaps: Family Perspectives on the Treatment of Eating Disorders- Robbie Munn, Doris and Tom Smeltzer, Kitty Westin.
Bridging the Gap: Mind, Body, and Spirit
22. The Role of Spirituality in Eating Disorder Treatment and Recovery- Michael E. Berrett, Randy K. Hardman, & P. Scott Richards
23. The Case for Integrating Mindfulness in the Treatment of Eating Disorders- Kimberli McCallum
24. The Use of Holistic Methods to Integrate the Shattered Self- Adrienne Ressler, Susan Kleinman, & Elisa Mott
25. - Incorporating Exercise into Eating Disorders Treatment and Recovery:Cultivating a Mindful Approach-Rachel M. Calogero & Kelly N. Pedrotty-Stump.
26. Body Talk: The Use of Metaphor and Storytelling in Body Image Treatment- Anita Johnston
Bridging the Gap: Future Directions
27. The Research-Practice Gap: Challenges and Opportunities for the Eating Disorder Treatment Professional- Judith Banker & Kelly Klump
28. Call to Action- Authors.