Academy for Eating Disorders
#ICED2015

Clinical Teaching Day

Wednesday, April 22, 2015
2:00 – 6:00 p.m.

Separate registration fee required.

Clinical Teaching Day Workshops are designed for the treatment provider. These sessions are smaller, “how-to” workshops that are designed to increase participants’ knowledge of accepted treatments and expand clinical skills.

A.
An Introduction to Radically Open DBT – Targeting Anorexia Nervosa

Thomas R. Lynch, PhD, United Kingdom
Self-control, the ability to inhibit competing urges, impulses, or behaviours is highly valued by most societies. However, excessive self-control has been linked to social isolation, poor interpersonal functioning, hyper perfectionism, rigidity, risk aversion, lack of emotional expression, and the development of severe and difficult-to-treat mental health problems, such as anorexia nervosa.
RO-DBT posits emotional loneliness as the core problem underlying maladaptive over control. Heightened threat sensitivity and diminished reward sensitivity are hypothesized to transact with early family experiences emphasizing “mistakes intolerable” and “self-control imperative” to produce over controlled coping. A novel thesis linking the communicative functions of emotional expression to the formation of close social bonds will be introduced, as well as new skills emphasizing receptivity, self-inquiry and flexible responding. New approaches to activate a neurobiologically based social-safety system, signal cooperation, enhance forgiveness, and change envy/bitterness will be introduced; using videos and role play.

Learning Objectives:

  • Recognize a new biosocial theory for OC and new RO DBT treatment strategies designed to enhance willingness for self-inquiry and flexible responding.
  • Identify new skills designed to enhance intimate relationships and vulnerable expression of emotion, learn from critical feedback, and enhance loving-kindness-forgiveness.
  • Identify a novel treatment mechanism positing open expression = trust = social connectedness and examples of strategies designed to improve pro-social cooperative signaling via activation of the parasympathetic nervous system’s social-safety system.

B.
Update on the Neuroscience and Genetics of Eating Disorders: Key Findings and Implications for Clinical Practice
Howard Steiger, PhD, FAED, Canada; Guido Frank, MD, FAED, USA

This workshop is intended to provide an overview on the ways in which neuroscience findings inform the understanding and treatment of the eating disorders anorexia and bulimia nervosa.  It is designed especially for people who may not have an in-depth background in neuroscience, including those who identify themselves primarily as clinicians, or as non-biological researchers.  The workshop will include a review of current neuroscience findings related to eating disorders, and a broad review of recent findings derived from neuroendocrinological, neurocognitive, neuroimaging, molecular-genetic and epigenetic studies. 

Learning Objectives: 

  • Better understand the role of neurotransmitter functions, gene pathways, epigenetic processes, and brain circuitry in the eating disorders, and be informed of investigational techniques used in current neuroscience research.
  • Discuss the importance of alterations in the functioning of key neurotransmitters, gene pathways, and brain circuits in the eating disorders and how this may relate to state of illness or recovery.
  • Appreciate the relevance of neurobiological brain research to clinical practice in the eating disorders field, and how this research can influence future classification systems, prevention efforts and treatments.

C.
Integrated Treatment Principles, Strategies and Therapies for Eating Disorder Patients with Comorbid Substance-Related Disorders and Addictions
Timothy Brewerton, MD, FAED, United States; Amy Baker Dennis, PhD, FAED, United States; Therese Killeen, PhD, APRN, United States

There is a high prevalence of substance-related disorders and addictions (SRDA) in patients with eating disorders (ED), especially those with bulimic symptoms. However, very few programs in either field have developed comprehensive, evidence-based, integrated programs for this comorbid group. Treatment is often provided sequentially (e.g., SRDA treated first and then the ED) or concurrently (by two different treatment providers or programs simultaneously). Unfortunately, this fragmented approach can lead to patient and family confusion and poor treatment outcomes. Research suggests that individuals with co-occurring disorders have a greater chance of recovering from both disorders when they receive integrated treatment from the same practitioner. This workshop will begin with a review of the guiding principles behind integrated treatment for individuals with ED/SRDA, a discussion of staff training and treatment team composition, and strategies for program implementation. Then evidence-based treatments that have been adapted for ED patients with co-occurring SRDA will be presented including: 1) Motivational interviewing; 2) Family therapy; 3) Cognitive behavioral therapy (CBT) and related approaches, and; 4) Dialectical Behavior Therapy (DBT) and other mindfulness-based treatments.  

Learning Objectives: 

  • Describe the guiding principles for the development of an integrated treatment approach for eating disorder patients with eating disorders (ED) and substance-related disorders and addictions (SRDA).
  • Increase their knowledge of the application of motivational interviewing techniques and cognitive behavioral therapy (CBT) for patient with both ED and SRDA.
  • Describe adapted family therapy for eating disordered adolescents with comorbid SRDA.


D.
Ethical and Legal Issues in the Treatment of Eating Disorders
Wayne Bowers, PhD, FAED, United States; Craig Johnson, PhD, FAED, United States; Patricia Westmoreland, MD, United States

This workshop will focus a range of ethical and legal issues clinicians can face in their treatment of this patient population. The primary topic will be the role of civil commitment in the treatment of eating disorders. We will review the current literature and case law regarding the use involuntary treatment with an emphasis the use of hospitalization, forced feeding and psychiatric medications. Ethical issues such as autonomy (allowing patients to make their own decisions), nonmaleficence (“do no harm”), beneficence (providing care that will benefit the patient) and paternalism (interfering with a person’s freedom for his or her own good) will be addressed as they pertain to civil commitment. The status of Medical Guardianships as a tool for families and Psychiatric Advanced Directives as a tool for patients and families will be reviewed with an emphasis on their use in the management of family members who have recurrent life threatening eating disorders.  The role of palliative care for patients who have failed multiple prior treatments will also be addressed. The goal of this workshop will be to engage the audience in a robust discussion of these issues. The workshop will meet criteria for 2 hours of CEU Ethics credits.

Learning Objectives: 

  • Describe current literature and case law regarding the use of involuntary treatment.
  • Explain the use of Medical Guardianships and Psychiatric Advance Directives as a tool for management of a family member with an eating disorder.
  • Discuss the role of palliative care for patients who have failed multiple treatments.


E.
Medical Complications and Treatment of Children and Adolescents with Feeding and Eating Disorders: What Every Clinician Needs to Know 
Debra K. Katzman, MD, FAED, Canada; Rollyn M. Ornstein, MD, United States

Medical complications are common among children and adolescents with feeding and eating disorders.  This workshop is designed to provide health professionals with the practical information they need to identify and treat medical complications in children and adolescents with feeding and eating disorders eating disorders.  We will review the medical complications of the most common feeding and eating disorders, focusing on the signs and symptoms and the medical assessment and management of the unique complications that arise in this population. Current clinical practices and controversies will be highlighted in a session that promises to be informative, stimulating and interactive. This workshop is intended for interdisciplinary clinicians who are involved in the care of children and adolescents with feeding and eating disorders.

Learning Objectives: 

  •  Recognize the main feeding and eating disorders in children and adolescents.
  •  Identify children and adolescents with feeding and eating disorders.
  •  Describe the unique medical complications of child and adolescent feeding and eating disorders.
  •  Explain the evidence-based treatments for children and adolescent with feeding and eating disorders.