Characterized by severe disturbances in eating behavior and distressing thoughts and emotions, an eating disorder is considered a serious mental health condition. Some of the most common signs of an eating disorder include a preoccupation with calories, body shape, and weight, as well as a distorted body image. However, misconceptions about eating disorders—such as it being a lifestyle, a choice, or an illness that only affects women—may complicate the diagnosis for some people.
Professionals who treat eating disorders aim to address behavioral, psychological, as well as nutritional deficiencies and possible complications resulting from malnutrition. Resistance to treatment, however, is not uncommon in these clients since they live with a disorder that may involve sensitive, trauma-related issues. Treatment for eating disorders is generally provided by mental health professionals with specialized training.
There are many options for eating disorder training for therapists, which include courses that address trauma, webinars in emotional eating and binge eating, rapid eye movement desensitization (EMDR), and enhanced cognitive behavioral therapy (CBT-E), among other approaches that address the underlying causes of disordered eating and its signs and symptoms. Treatment for eating disorders may include various therapeutic interventions, including those based on self-compassion and mindfulness. Here, we’ll explore eating disorders in more depth and detail where you can access training to improve your ability to treat these conditions as a therapist.
What’s An Eating Disorder?
According to the American Psychiatric Association, an eating disorder is defined as “behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions.” Affecting one’s physical and psychological functioning, eating disorders include anorexia nervosa, binge eating disorder, bulimia nervosa, as well as other disorders such as pica, rumination disorder, and avoidant restrictive food intake disorder (ARFID).
Someone with an eating disorder may display an intense preoccupation with their body weight, shape, food intake, and calories. Other disorders may also be present, such as obsessive-compulsive disorder or substance use disorder.
While anorexia nervosa and bulimia nervosa may be more prevalent among women—which may be partly attributed to social pressures—a person of any gender or background can be affected by these conditions.
Along with trauma-related issues, a sense of deep shame and self-loathing may accompany an eating disorder, along with various types of addictions.
The type of treatment received for an eating disorder often depends on its diagnostic criteria, which can be found in the International Classification of Diseases (ICD-10) or the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
A diagnosis typically involves a patient assessment/interview, a medical exam, laboratory testing, and the Eating Disorder Examination (EDE) questionnaire, which is considered the gold standard in assessment by some experts. Other specialized screening may also be utilized. A diagnosis may be conducted by psychologists, psychiatrists, primary care physicians, social workers, and other clinicians.
CBT-E For Eating Disorders
Enhanced cognitive behavioral therapy (CBT-E) is one of the most recommended approaches for treating eating disorders, particularly bulimia nervosa and binge-eating disorder. Originally designed for adult outpatient treatment, it can be adapted into an intensive intervention for inpatients and day patients; it may also be used for younger people.
“CBT-E is conventionally administered over 40 sessions, focusing on regularizing eating patterns, eliminating exercise or other compensatory behaviors, and challenging cognitions supporting overvaluation of shape and weight.”
One CBT-E training program developed by the Center for Research on Eating Disorders at Oxford (CREDO) offers online training with modules, clinical workshops that complement the program, and clinical supervision. The National Center of Excellence for Eating Disorders (NCEED) calls it an individualized treatment program that places its focus on the underlying factors that “maintain the disorder.” Therapists are encouraged to adapt CBT-E to the specific eating concerns faced by the individual client. This program also offers a certificate of completion.
Certified Shame-Informed Treatment Specialist Qualification
PESI offers a course to become a Certified Shame-Informed Treatment Specialist (CSTS) in eating disorders, which has been pre-approved by Evergreen Certifications. This two-day, shame-informed treatment certification course is titled Eating Disorders, Addictive Eating, Body Shame, and More and addresses concerns such as self-loathing, complex trauma, and other co-addictions. Its aim is to aid clinicians in helping their clients develop a healthier relationship with food and their bodies.
This course focuses on interventions like internal family systems (IFS), cognitive behavioral therapy (CBT), mindfulness, meditation, polyvagal-informed therapy, movement, and somatic psychotherapy. Its course outline includes modules on using somatic interventions as well as those based on principles of self-compassion and mindfulness to treat disordered eating. It also provides several clinical interventions to treat underlying trauma and body shame in binge eating disorder and teaches practitioners how shame-informed treatment can empower clients. The course offers up to 26.5 continuing education hours.
Other courses completed by a licensed professional (either state or national) need to be submitted for approval to Evergreen Certifications. In order to qualify for CSTS certification, the applicant has to complete a minimum of 12 hours of continuing education in the following areas:
- Self-evaluative emotions, such as shame and guilt
Attachment in connection with the formation of shame-based identity - Polyvagal theory
- Assessment of clients who are prone to shame
- Multicultural considerations
- Identifying signs of shame (verbal and non-verbal)
- The neurobiological aspect of shame and trauma
- Defenses against shame
- The roles of attunement and connection
- Therapeutic empathy
- Interventions for treating core shame
To maintain certification and receive a one-year renewal, a practitioner will need to apply by submitting 6 CE credits for approval. For a two- and three-year certification renewal, 12 and 18 CE credits are required, respectively.
Certified Clinical Trauma Professional Training Course
PESI features a course titled “Treat Disordered Eating & Trauma with CBT, ACT & More,” which seeks to target and heal the underlying trauma that may have led to disordered eating. It aims to address the intersection between trauma and eating disorders by training professionals to deliver “trauma-sensitive disordered eating therapy.”
The modules contained in this course include topics such as:
- Strategies from thought field therapy, CBT, EMDR, and bilateral stimulation
- Assessment of traumatic stress disorders
- Evidence-based techniques including journaling, transitional objects, and relaxation
The Emily Program
The Emily Program faculty of the University of Minnesota provides eating disorders treatment and advanced training opportunities. They are associated with both the Academy of Eating Disorders and the International Association of Eating Disorder Professions.
The Emily Program offers continuing education, recorded presentations, postdoc fellowships, and internships, all of which emphasize evidence-based practice and involve a multidisciplinary team. Further, their continuing education (CE) program features two webinars and in-person events. The webinars are titled “Inviting the Body Back: When and How to Re-introduce Intuitive Eating in Eating Disorder Treatment” and “Comorbid Psychiatric Conditions: An Evidence-Based Guide to Treatment.”
Offering Online Therapy To Clients With Eating Disorders
Because many eating disorders develop from exposure to trauma, clients may have difficulty opening up to a therapist about what they’re going through. In these cases, online therapy may be preferable as it allows clients to meet with a provider from the comfort and safety of their homes. If you’re interested in offering support to individuals with eating disorders, consider signing up with an online therapy platform like BetterHelp. Here, you can connect with users through video chats, phone calls, or in-app messaging. You can set your own schedule and decide when and where to meet with clients, giving you more control over your career and allowing you to enjoy greater flexibility and convenience.
The Efficacy Of Online Therapy For Treating Disordered Eating Habits
Research shows that those who are finding it challenging to overcome an unhealthy relationship with food or individuals who are living with an eating disorder could benefit from online therapy. In one study published in the International Journal of Eating Disorders, researchers discovered that online therapy was more effective than face-to-face therapy in treating the symptoms of moderate eating disorders. Researchers also found that participants in the virtual therapy group were more likely to adhere to the study guidelines than those in the in-person treatment group.
Takeaway
There are many options for eating disorder training, which include online programs, courses that address trauma, webinars on emotional eating and binge eating, rapid eye movement desensitization (EMDR), CBT-E, certification courses, and more. These approaches and programs seek to address the underlying causes of disordered eating and help clinicians identify its signs and symptoms. Specific programs and courses include The Emily Program, Certified Shame-Informed Treatment Specialist training, CBT-E offered by the Center for Research on Eating Disorders at Oxford (CREDO), and the Certified Clinical Trauma Professional Training Course. If you’re seeking to connect with individuals struggling with eating disorders, consider becoming a certified online counselor through BetterHelp to gain access to a wide pool of clients.
