Workshop Summary

Educational Session 1: Concurrent Workshops & SIG Panels
Thursday, June 1, 3:00pm -  4:30pm

SIG Panel: Eating Disorder Symptoms, Body Image Concerns & Related Assessment Considerations among South Asians

Sponsored by the Assessment/Diagnosis SIG & Body Image/Prevention SIG

Neha Goel, Doctoral Candidate, Virginia Commonwealth University
Shruti Kinkel-Ram, Miami University
Dr. Helena Lewis-Smith, Senior Research Fellow, University of the West of England
Dr. Nadia Craddock, Senior Research Fellow, Centre for Appearance Research 
Dr. Jessica Saunders, Assistant Professor, Ramapo College of New Jersey

Abstract: Much of the research conducted within the eating disorder (ED) and body image fields have focused on White, affluent female populations from the Global North. Currently, our understanding of ED presentations and prevalence in marginalized groups is sorely limited, likely due to methodological and conceptual issues involving the definition and assessment of EDs and weight/shape concerns in non-Western groups. Thus, the Assessment/Diagnosis and Body Image/Prevention SIGs propose a panel that seeks to explore the challenges and strengths associated with the current assessment of EDs and body image concerns amongst a group that has been notoriously neglected from the literature: South Asians (SAs; referring to people descending from India, Bangladesh, Nepal, Pakistan, Sri Lanka, Bhutan, and the Maldives). The four panelists will provide an overview of challenges and improvements to the assessment of EDs and body image in SAs in the pursuit of increasing access to culturally-sensitive care and enhancing understanding of cultural variations in ED presentations. Dr. Lewis-Smith will present on assessment considerations and validation of ED and body image measures among SAs in India. Ms. Kinkel-Ram and Dr. Craddock will present their work on the assessment of “traditional” (i.e., interoceptive awareness) and culturally-influenced factors (i.e., colorism) among SAs in India and the United Kingdom. Dr. Saunders will present her longitudinal research on SA women over a 25-year timespan and discuss ways that her team is culturally-tailoring assessments. Ms. Goel will serve as chair and provide an overview of both “traditional” and culturally-influenced factors that affect weight/shape and eating concerns for SAs, notable methodological issues with extant assessment measures for this group (e.g., lack of relevant cut-off score; translational difficulties), and recommendations for culturally-adapting measures for SAs living in the United States to improve ED detection and treatment referrals. Discussion may stimulate insights, ideas, and methods for modifying ED and body image measures for other underserved groups. 

Learning Objectives:

1. Recognize how South Asians have thus far been neglected and under-studied in eating disorder and body image research.
2. Learn about the limitations of current assessments in identifying eating disorder symptoms among South Asians and the validation of culturally appropriate measures that can be used as an alternative.
3. Identify cultural factors (such as differing weight and shape ideals) that may result in unique eating disorder presentations for South Asian individuals.

 
SIG Panel: Facilitating a two way conversation between researchers and clinicians using family based treatment

Sponsored by the Early Career & FBT SIGs

Lindsey Bruett
Gina Dimitropoulos, Associate Professor, University of Calgary
Ayla Gioia
Dr. Andrea Goldschmidt, Assistant Professor,  University of Pittsburgh School of Medicine
Rachel Kramer PhD, Assistant Professor, University of California, San Francisco
Bridget Whitlow, LMFT

Abstract: Although several psychological treatments for eating disorders (EDs) have demonstrated consistent efficacy in randomized control trials, research in EDs, as well as in other areas of psychopathology, suggests that clinicians frequently “drift” away from evidence-based treatments as outlined in manuals. Therapist “drift” suggests that existing interventions may not be serving the full needs of clinical providers in real-life settings. Given that dissemination of research generally flows unidirectionally (i.e., from academics/research settings to clinical settings), incorporating bidirectional communication between researchers and clinicians may mitigate the research-practice gap and ultimately improve outcomes. For instance, such communication may identify reasons for departure from evidence-based techniques and inspire further research incorporating novel adaptations to treatment. Accordingly, the current panel discussion aims to provide a venue for a bidirectional conversation between researchers, clinicians, and attendees with experience in delivering Family Based Treatment (FBT). More specifically, we aim to 1) discuss pressing issues occurring in real-life application of FBT; 2) share common adaptations for implementing FBT in real-world settings, such as in community-based, publicly-funded clinics, with families with lower incomes, and those who identify as IBPOC and 2SLGBTQ+; and 3) discuss current efforts to improve access to training in FBT for providers in community-based settings. We will also facilitate breakout groups for panel attendees to facilitate exchange of their own relevant experiences. Panelists will include researchers and clinicians employed in a range of settings, including private practice, academic medical centers, and university settings. The panel will begin by discussing both barriers and facilitators to implementing FBT in research and clinical settings. Next, moderators will discuss adaptations to using FBT in real-world contexts with diverse populations. Ultimately, this panel will help our interdisciplinary field generate next steps toward an understanding of how to best research and implement FBT in a diverse range of geographic, cultural, and practice-based settings. Panel discussions will provide guidance on how to navigate barriers encountered using FBT and foster collaborations between researchers, clinicians and those affected by eating disorders.

Learning Objectives:

1. Identify barriers to implementing FBT in real-world settings.
2. Recognize potential limitations of using FBT as currently prescribed with underserved and/or diverse populations.
3. Describe adaptions used to implement FBT in real-world settings and identify future areas of research that could further explore how to incorporate novel adaptations into FBT manuals.

SIG Panel: Translating & Disseminating Neuropsychology Research to Laypersons and Caregivers of ED Individuals

Sponsored by the Neuropsychology and Child/Adolescent SIGs

Sophie Abber
Meghan Byrne, PhD, National Institute of Mental Health
Allison Chase, PhD, CEDS-S, Regional Clinical Director, Eating Recovery Center and Pathlight Mood and Anxiety Center
Kelsey Hagan, PhD, NIMH T32Postdoctoral Research Fellow, Columbia University
Anna Karam Jones PhD, Clinical Psychologist, UC San Diego Health Eating Disorders Center for Treatment and Research
Alix Timko

Abstract: There is a significant body of research on the neuropsychological correlates of eating disorder (ED) behaviors, including restrictive eating, binge eating, and engagement in compensatory behaviors. While there is high potential for this research to meaningfully impact ED treatment and recovery, translation and dissemination of these findings has been limited. Specifically, more work is needed to disseminate these research findings to laypersons and caregivers/families and to translate these findings to benefit individuals in ED treatment and recovery. Knowledge of neuropsychological correlates of EDs may be particularly useful for caregivers and families of children and adolescents with EDs, given the unique developmental considerations of individuals with EDs in these age groups. Additionally, improved translation of neuropsychological research findings into clinical practice may aid in improving suboptimal ED treatment outcomes. The proposed panel will assist researchers and clinicians in understanding and disseminating neuropsychological research findings in EDs, with an emphasis on neuropsychological research in children and adolescents. To stimulate a rich and constructive discussion on this topic, panelists will comprise researchers and clinicians across a range of career stages and areas of expertise (e.g., family-based treatment of EDs, developmental neuropsychology in EDs). Additionally, the panel will include a discussion of the importance of disseminating neuropsychological research to laypersons, families/caregivers, and individuals with EDs and effective strategies for doing so. Specifically, we will cultivate a discussion focusing on the following topics: 1) The neuropsychological impacts of eating disorders that are most important for laypersons and family/caregiver to understand when receiving psychoeducation (e.g., cognitive impacts of restrictive eating on a developing brain, implications for family vs. youth’s independent decision-making regarding treatment); 2) An overview of current strategies for incorporating neuropsychological research findings into patient psychoeducation and ED treatment across the developmental spectrum; 3) Existing gaps in dissemination and translation of neuropsychological research in EDs, particularly across ages and developmentally appropriate levels; and 4) Exploration of suggestions for more effective methods for disseminating neuropsychological research to caregivers and laypeople.

Learning Objectives:

1. Describe current strategies for incorporating neuropsychological research in ED treatment across ages and developmental levels.
2. Understand gaps in disseminating and translating neuropsychological research in EDs.
3. Explain the relevance of important neuropsychological research findings in EDs to caregivers, families, and laypeople.

Workshop: Medical Complications of Anorexia Nervosa, Bulimia, and ARFID and their Treatments

Philip S. Mehler, MD, FACP, FAED, CEDS, Founder & Chief Executive Office, ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health

Abstract: During this workshop there will be a comprehensive review of the medical complications and blood result abnormalities of eating disorders and their treatments for patients age 15 and older. This will also include medical issues which are unique for transgender eating disorder patients and those with constitutional thinness. Particular attention will be given to recent new findings in these topical areas, and defining which medical complications require more urgent attention, or hospitalization. Patient cases will be reviewed which will serve to introduce relevant body system medical complications and from which the PowerPoint presentation will flow. Attendees will receive a thorough and very current overview of this relevant topic, so that regardless of their respective disciplines (MD, RD, Therapist, CSW, RN), they will then feel more comfortable with the ongoing medical treatment challenges of patients with eating disorders. Further, there will be mention of some of the best papers to read and reference for each body system affected. Ample time for Q&A will be allotted.

Workshop: Eating Disorders in Orthodox and Ultra-Orthodox Jewish Communities

Catherine Drury, LCSW, PhD Candidate, Fairleigh Dickinson University
Sara Fruchter, Doctoral Candidate, Fairleigh Dickinson University
Devorah Levinson, Referral Specialist and Director Eating Disorders Division, Relief Resources
Katharine Loeb , PhD, Director of Research and Training, Chicago Center for Evidence Based Treatment

Abstract: In 2010, media outlets began to report a concerning increase in eating disorder (ED) pathology among Orthodox Jewish adolescent females. Within the more Orthodox denominations of Judaism, there can be a false assumption that the insularity of community members, their separation from secular society, and their level of religious observance confer protection from ED risk. When EDs are identified in such communities, stigma associated with mental illness, and distrust of secular institutions, make Orthodox Jewish individuals less likely to seek mental health treatment. As a result, the Jewish community, specifically the ultra-Orthodox (UO) Jewish community, remains an underserved population in need of specialized ED services. This workshop offers insights for increasing access to, and effectiveness of, care for UO Jewish patients. It will be divided into three parts. Part I will set the stage for the topic with a condensed review of the published literature on ED in Jewish communities, highlighting methodological limitations, plus a brief presentation of new data from the Eating Disorders Division of Relief Resources, a mental health organization that was founded specifically to increase knowledge of and access to treatment among UO Jewish individuals. Part II (45 minutes) will apply a diversity-based framework to clinical recommendations in the provision of mental health services for Orthodox Jewish patients, translating the research from Part I to practice. We will provide guidance on how to conduct culturally-informed assessment and intervention with this population and adapt prevention programs and treatments according to patients’ sociocultural context. We will present cautionary measures to avoid diluting any of the active mechanisms of interventions, or ignoring the paramount importance of individuality and intersectionality. Special topics include Kashrus, Shabbos and Jewish holidays, Shidduchim, role of the Rabbi, gender and sexuality and family size. In this segment, we will illustrate key issues with case examples and group-based roleplays with workshop participants. Part III will focus on challenges (clinical and service-based) in real-world implementation of evidence-based treatments with the UO community. These themes will be generated interactively from the audience and responses modeled by unscripted dialogue between culturally-competent providers among the presenters. The workshop will conclude with a question-and-answer segment.

Learning Objectives:

1. Following the training, participants will identify gaps and limitations in the existing literature on EDs in the Jewish community.
2. Following the training, participants will understand the cultural considerations relevant to the Jewish community that may complicate aspects of ED prevention and treatment, including barriers to care.
3. Following the training, participants will demonstrate a working knowledge of culturally aware clinical practice for ED in the UO Jewish community.

Workshop: Become an FBI Agent: Learning a novel approach to treating ARFID in young children

Ilana Pilato, Clinical Psychologist. Duke University Medical Center
Nancy Zucker

Abstract: Avoidant Restrictive Food Intake Disorder (ARFID) is a disorder characterized by an individual’s inability to eat an adequate amount or variety of food such that it results in impacted growth, development, and psychosocial functioning. In young children, there are currently no empirically-validated treatments for ARFID. Thus, we are evaluating an acceptance-based, interoceptive exposure treatment called the Feeling and Body Investigators – ARFID Division (FBI-ARFID) in a randomized control trial. We teach children and their parents to become “FBI Agents,” learning to view their sensory and somatic sensations as clues to understanding themselves through illustrative characters (e.g., Patricia the Poop Pain, Gassy Gus, Fiona the Flawed French Fry). We conduct body investigations that may provoke intense sensations and worksheets that map sensations to meanings and actions. The goal is to make somatic and sensory experiences playful – and to promote adaptive self-awareness and food approach. In this intervention the aim is not to necessarily extinguish uncomfortable situations or emotions that naturally arise from these experiences, but rather to accept them as a natural body function to be explored and understood. In this workshop, we aim to present preliminary data from our trial and train providers in the FBI-ARFID protocol. Providers will learn the principles of the treatment, practice various exposure techniques, conduct their own body and food investigations, and gain insights on how to work with this complex population. 

Learning Objectives:

1. Learn about unique challenges and characteristics of young children and their families with ARFID.
2. Learn the basics of a novel acceptance-based interoceptive exposure intervention for children with ARFID.
3. Practice using creative interoceptive exposures and explorations with children.

Workshop: Adapting CBT-E for adolescents and for different levels of care: efficacy and cost-effectiveness

Bernou Melisse
Dr. Elske Van den Berg, Novarum

Abstract: The purpose of this workshop is enabling participants to understand CBT-E adaptations to suit severely underweight inpatients up to eHealth adaptations, both for adolescents and adults. Cognitive Behavior Therapy-Enhanced (CBT-E), a recommended treatment, is originally developed and tested as an individually based, outpatient treatment for adults with a BMI >15. By various research groups around the world, CBT-E has been adapted to suit different age groups, all levels of care, to suit multidisciplinary teams and to be suitable for different ways of delivering treatment. CBT Multi-Step, developed in Italy, is designed for different care levels, for all diagnostic categories, ages, and BMI and is examined in several cohort studies. CBT-MS is the adaptation for a multidisciplinary but non-eclectic team and includes a family module for patients < 18. CBT-MS has two main advantages; (1) patients are treated with a uniform treatment instead of the common eclectic approach, and (2) it minimizes problems associated with transition from out- to inpatient care. In Holland, a 12-week eHealth CBT-E program for binge eating disorder is developed. It has been examined in a randomized controlled trial in which patients were assigned to either eHealth or to a waiting list condition. Of 180 participants, 79% completed treatment, 40% showed full recovery (absence of objective binges and EDE score <1.77) and binges reduced from 19 to 3 during the last month. Cost reduction of one binge was €17, gain of one additional QALY was € 32112 total costs. In a second RCT, eHealth is compared with regular 20-weeks CBT-E delivered screen-to-screen; in which eHealth appears as effective as in-person CBT-E. After adapting and implementing CBT-E in a Dutch treatment center across out- and inpatient settings for adults with BMI > 12.5, differential cost-effectiveness was examined between one cohort receiving TAU (N=304), the other CBT-E (N=408). For normal weight patients, no differences in clinical outcome were found with results comparable to original CBT-E studies, treatment costs and duration were lower during CBT-E. For anorexia, CBT-E was more effective at higher costs. Subject sample and simple statement of methods: The presented adaptations have been examined in either efficacy or effectiveness studies run in real-world settings, including adult and / or adolescent patients with anorexia nervosa, bulimia, and / or binge eating disorder. Economic evaluations were taken along.

Learning Objectives:

1. Following the training, participants will be able to understand the CBT- Multi-Step method and have learned about its effectiveness.
2. Following the training, participants will be able to understand clinical benefits and learn about economic evaluation of implementing CBT-E throughout inpatient and outpatient settings.
3. Following the training, participants will be able to adapt CBT-E to online treatments such as an eHealth and screen-to-screen treatment, and learn about their efficacy and cost-effectiveness.
   
   

Workshop: Emotional Escape Artists: Treating Eating Disorders and Co-Occurring Trauma

Erica Antonucci, Primary Therapist, Skyway Behavioral Health
Emily Hartranft

Abstract: Many eating disorder treatment centers take a trauma informed approach to client care, but few offer simultaneous eating disorder and trauma treatment at a higher level of care. A majority of clients with eating disorders have experienced trauma, the effects of which often keep clients stuck in a cycle of recovery and relapse. Identifying when a client is ready for trauma treatment can be a challenging task, especially while the client is in a higher level of care. We propose adapted criteria to Dialectical Behavior Therapy Prolonged Exposure (DBT PE) readiness, such as including both trauma and ED as "highest priority quality of life target” and adding in the ability to control eating disorder behavior when in the presence of triggering stimuli, in eating disorder treatment at partial hospitalization and intensive outpatient levels of care. We also focus on how clients, specifically those who identify as overcontrolled, use emotional escaping as a means of avoidance and continue to stay stuck. During this workshop, participants will learn to identify readiness for DBT PE and gain a greater understanding of traumatic invalidation and how its effects are reinforced by the client’s eating disorder. Participants will experientially engage with the material presented and have the opportunity to workshop a client case. 

Learning Objectives:

1. Following the training, participants will be able to identify when eating disorder clients are ready to start trauma work.
2. Participants will be able to identify and label traumatic invalidation.
3. Participants will be able to use mindfulness of current emotion with clients to help identify escape behaviors.
   
   

Workshop: Off the Beaten Path: Changing the Landscape for Eating Disorders in Rural Communities

Dr. Jenny Copeland, The Ozark Center
Jacob Hefner

Abstract: Eating disorders (EDs) are a significant public health concern in the United States, such that approximately 28.8 million Americans will suffer from an ED in their lifetime. Yet many healthcare providers are unable to adequately care for these individuals due to insufficient resources and training. As a result, access to potentially lifesaving care is limited particularly for rural Americans, who may be uniquely at risk to develop EDs given the elevated presence of risk factors known to drive EDs nationally – such as food insecurity and traumatic experiences. Importantly, stereotypes about EDs are so pervasive for rural areas that little research has been conducted to better understand the prevalence of EDs in those communities or their unique experiences of the illnesses themselves. Recent studies have indicated EDs may not only be more prevalent in rural communities, but also that the symptoms may be more severe. One study concluded EDs are “common” among rural adolescents. Yet multiple barriers exist in rural communities between those who are struggling and the help they need. Rural areas are widely known to be underserved for both medical and mental healthcare. This disparity worsens when seeking specialized treatment for a variety of conditions, including EDs. Despite their likely elevated ED risk, rural individuals continue to experience significant barriers such as physical access to specialized treatment as well as the ability to financially afford it. Low resource settings such as Certified Community Behavioral Health Organizations (CCBHOs) and Community Mental Health Centers (CMHCs) serve as the safety net for these communities and are uniquely equipped to provide evidence-based, multidisciplinary ED care. The Reconnect Eating Disorders program at Ozark Center is the first documented ED program to develop in a CCBHO. Using a combination of didactic teaching, case examples, and clinical experiences, we will tell the story of how the Reconnect program came to be, including successes and learning opportunities. We will illustrate the need for specialty ED treatment and the capacity of CCBHOs and CMHCs to do so. Finally, we will discuss how trauma informed care principles can be applied to better serve individuals with EDs. The primary aim of this presentation is to give voice to an underserved population of individuals with EDs, and to empower clinicians in these areas or other non-traditional ED treatment settings to meet this need.

Learning Objectives:

1. Describe how food insecurity and trauma may function as eating disorder risk factors for people residing in rural areas of the United States.
2. Discuss at least one unique role or staff member in a CCBHO and what they may offer in the treatment of those with eating disorders in rural communities.
3. Explain the role CCBHOs could play in improving access to effective specialized treatment in rural communities

Workshop: Best Practices in Working with Primary Care Clinicians: A How-To Guide to Stakeholder Engagement

Judy Krasna, Executive Director, F.E.A.S.T.
Jocelyn Lebow, Mayo Clinic
Christine Peat, PhD, FAED, LP, Associate Professor of Psychiatry, University of North Carolina at Chapel Hill

Abstract: Primary care providers or general practitioners (PCPs) are crucial allies in the treatment of eating disorders; however, many of these providers lack the knowledge and skills needed to detect and manage these conditions in their practice. Conversely, other members of a multidisciplinary eating disorder team (e.g., therapists, dieticians, psychiatrists) despite having specialty training in eating disorders, often lack an understanding of the scope of care a PCP can offer. At best, this leads to missed opportunities for leveraging the unique skillset of the PCP, at worst, this can create challenges in communication which may result in mixed messages for patients/families and impediments to optimal care.

1. Describe common experiences of PCPs and specialists in eating disorder managemen. 
2. Identify opportunities and challenges involved in working across primary care and specialty settings.
3. Employ best practices in providing collaborative care with PCPs.

Workshop: Channeling Youth Empowerment and Civic Engagement to Advance Research-to-Policy for ED Prevention

Ryan Ahmed, Trainee, Harvard STRIPED
Dr. S. Bryn Austin, Professor, Boston Children's Hospital/Harvard Chan School of Public Health
Amanda Raffoul, PhD, Instructor of Pediatrics, Boston Children's Hospital/Harvard Medical School

Abstract: Increasingly, mental health advocates are recognizing that youth are experts in their own lives and experiences and are putting the voices of affected youth at the forefront of health research and policy change. Eating disorders prevention and translating research evidence to inform policies can be enhanced by the effective integration of youth as partners. Impactful research-to-policy translation initiatives require eating disorders researchers and professionals not only to gain basic knowledge and skills in policy translation, but also to cultivate partnerships with the youth who may be affected by policy in ways that support their mastery of skills in civic engagement, communicating science to policymakers, and constituent organizing. For this workshop, a team including faculty and youth from the Strategic Training Initiative for the Prevention of Eating Disorders: A Public Health Incubator (STRIPED, www.hsph.harvard.edu/striped), a research and training program with special expertise in policy-relevant research and policy translation, will guide participants through the key steps involved in planning effective youth engagement and collaboration. Workshop leaders will begin with an overview of principles and practices from the fields of research-to-policy translation and youth empowerment, informed by practices from relevant health fields. Next, workshop leaders will introduce techniques for integrating youth as essential partners in effective research-to-policy translation activities for eating disorders prevention, including guiding principles from youth advocates themselves. Finally, leaders will guide learners through youth-designed activities to aid identification of practical approaches tailored for learner’s own work setting to implement techniques for integrating youth in research-to-policy translation for eating disorders prevention. Workshop activities will draw from the STRIPED Advocacy Playbook (tinyurl.com/STRIPEDPlaybook), a freely available, step-by-step guide for research-to-policy translation that centers youth and constituent civic engagement through all phases of the work. Through a combination of lightning talks and evidence-based active-learning techniques, this workshop will help learners develop the insights and skills needed to integrate youth effectively into research-to-policy initiatives to advance eating disorders prevention.

Learning Objectives:

1. Describe principles and practices of youth empowerment and research-to-policy translation.
2. Explain techniques for integrating youth as essential partners in effective research-to-policy translation activities for eating disorders prevention.
3. Identify practical techniques for integrating youth in research-to-policy translation for eating disorders prevention across a range of learners’ settings.

Workshop: From siloes to synergy: An interprofessional adaptation of Enhanced Cognitive Behaviour Therapy

Megan Bray
Dr. Susan Byrne
Gabriella Heruc

Abstract: Interprofessional Collaborative Practice (ICP) is endorsed by the World Health Organisation as the benchmark for collaborative healthcare, and is associated with improved health outcomes, reduced treatment dropout, increased patient satisfaction with services and improved work-related satisfaction among clinicians. ICP is characterised by shared treatment planning and goals, clear roles and responsibilities, interprofessional communication and principles of teamwork. Due to the complex presentation of anorexia nervosa, clinical practice guidelines recommend collaborative team-based treatment involving mental health professionals and dietitians. However, there are limited frameworks to guide ICP in eating disorder treatment. We have developed an interprofessional framework around Enhanced Cognitive Behavioural Therapy, otherwise known as Interprofessional Enhanced Cognitive Behavioural Therapy (CBT-IE), to facilitate ICP between mental health professionals and dietitians using this evidence-based outpatient eating disorder treatment.

Learning Objectives:

1. Participants will be able to describe Interprofessional Collaborative Practice and its application to outpatient eating disorder treatmen. 
2. Participants will be able to describe Interprofessional Enhanced Cognitive Behaviour Therapy. 
3. Participants will gain experience in conducting core elements of Interprofessional Enhanced Cognitive Behaviour Therapy.

Workshop: The Great Weight Debate: If And When to Weigh Patients in Evidence-Based Treatments

Carolyn Becker
Rachel Millner
Lauren Muhlheim, Psy.D., FAED, CEDS-S, Eating Disorder Therapy LA

Abstract:  Weekly weighing where weight is viewed and discussed openly (i.e., open weighing) is considered an essential element of the two leading evidence-based treatments for eating disorders—cognitive behavioral therapy (CBT) and family-based treatment (FBT). Proponents of this approach argue that weighing patients provides exposure to a fear-evoking scenario that is often avoided, teaches patients to tolerate their anxiety around weighing, disconfirms beliefs for many that they will gain an exorbitant amount of weight, and/or helps patients to view weight as more neutral biological data despite cultural pressures to imbue it with greater significance. In attempting to facilitate this disconfirmation, clinicians may inadvertently reinforce the idea that gaining weight is inherently bad. Research on the unique benefits of open weighing is not conclusive, and open weighing of patients in larger bodies has not been explicitly studied. Being openly weighed may never be a neutral stimulus for some individuals in larger bodies, and it may even be traumatic for some, given the weight stigma people in larger bodies face. In this workshop, a researcher/practitioner who has studied and encouraged implementation of exposure for eating disorders, a therapist trained in evidence-based treatments but has adapted them to reduce weighing, and a therapist who practices entirely from a trauma-informed Health at Every Size ® lens will discuss the history of and research on weighing in evidence-based treatments for eating disorders. They will discuss concerns that routine weighing of patients may be particularly harmful for certain populations of people with eating disorders and may reinforce weight stigma across populations of people with eating disorders. They will lead a discussion about whether therapists should continue to practice according to the manuals without adaptation and how protocols around weighing might be modified in a way that minimizes potential harm. They will also provide guidance around how to navigate this sensitive topic when planning treatment with patients, including special considerations for individuals in larger bodies. 

Learning Objectives:

1. Participants will be able to describe the history and rationale behind open weighing in evidence-based treatments.
2. Participants will be able to facilitate an open discussion with both patients and colleagues about the potential benefits and risks of open weighing.
3. Participants will be able to plan treatment collaboratively with patients in all body types, making careful considerations about the potential benefits and drawbacks of open weighing.
   
   
   
   

Educational Session 2: Concurrent Workshops & SIG Panels
Friday, June 2, 1:00pm -  2:30pm

SIG Panel: Beyond Telehealth: Innovative Applications of Tech to Improve Outcomes and Reach of Treatments for ED

Sponsored by the Technology & Innovations SIG

Laura D'Adamo
Dr. Ellen Fitzsimmons-Craft
Dr. Kelsie Forbush, Professor, University of Kansas
Dr. Adrienne Juarascio
Emily Presseller

Abstract: Despite many decades of research aimed to develop and establish evidence-based treatments for eating disorders (EDs), treatment response and access to care remain inadequate. Given the increased demand for high-quality ED care since the COVID pandemic, development of novel technologies is critical for improving treatment response and treatment reach. Expanding beyond the use of telehealth to deliver traditional therapy, the recent development and proliferation of novel technologies has offered new opportunities to improve treatment outcome and reach larger populations of individuals in need of care with tools such as smartphone apps and wearable sensors. Such applications for the treatment of EDs have demonstrated preliminary acceptability and effectiveness for improving symptoms. However, successful design and real-world implementation of these technologies requires innovative thinking, partnerships with providers and industry, and user-centered design that incorporates the needs of individuals with lived experience. The proposed panel will involve a discussion of cutting-edge research harnessing technology to improve outcomes and reach of ED interventions, including: 1) A mHealth intervention harnessing machine learning to predict relapse of anorexia nervosa; 2) A sensor-integrated smartphone application for intervening on dietary restraint, intended to be implemented alongside in-person or telehealth CBT for binge eating; 3) A coached mobile app for post-acute treatment and relapse prevention of anorexia nervosa; and 4) Chatbots for ED prevention and treatment-seeking. Panelists include Drs. Ellen Fitzsimmons-Craft, Adrienne Juarascio, and Kelsie Forbush, who are utilizing technology in new and inventive ways to improve treatment outcomes and ultimately increase access to evidence-based care for EDs. The discussion will also involve challenges inherent in designing and disseminating technology-based interventions, clinical implications, and avenues for future innovation.

Learning Objectives:

1. Understand the development and evaluation of mHealth tools to deliver interventions for EDs, including a discussion of challenges encountered while developing tools and lessons learned
2. Discuss preliminary findings supporting efficacy, clinical implications for utility, and ongoing efforts to broadly implement tools.
3. Identify next steps for enhancing the efficacy and reach existing intervention tools and future directions to address critical gaps in technology-based care.

 
SIG Panel: Co-Occurring Eating Disorders and OCD: Clinical Presentation and Implications for Treatment

Sponsored by the CBT SIG

Carolyn Becker PhD
Jenna DiLossi, Psy.D., ABPP, CoFounder & Clinical Director, Center for Hope & Health, LLC
Melissa Harrison, M,A., LPC, Director of Operations, Center for Hope and Health 
Dr. Cheri Levinson, Associate Professor, University of Louisville
Paulina Syracuse, Student, Center for Hope and Health

Abstract: The clinical presentations and treatment models for obsessive-compulsive disorder (OCD) and eating disorders (ED’s) continue to be widely examined and documented in the psychological literature. The literature suggests a phenomenological overlap between the pathology in these two disorders, and epidemiological research indicates that one in four individuals with an ED also meets diagnostic criteria for OCD. Despite such findings, the clinical presentation and treatment procedures of comorbid OCD and ED’s are far less understood by both researchers and clinicians. Thus, the pathway to implementing effective treatment for a comorbid, and often interrelated, OCD and ED presentation is not always clear. It is also not uncommon for clinicians to be highly proficient in one of these diagnoses while having limited training in the other. This panel will be comprised of providers and researchers with expertise in both OCD and ED’s who will discuss the best practices for treating individuals with a comorbid presentation of OCD and an ED(s) to achieve three main learning objectives. First, the panelists will discuss diagnostic and phenomenological overlap between OCD and ED’s (i.e., obsessional thinking, anxiety and fear responses, compulsive and ritualized behavior, rigidity, perfectionism, and avoidance), as these factors relate to symptom maintenance across pathologies. A portion of this discussion will include a review of specific obsessions and compulsions surrounding food, eating, bodily sensations, and feared consequences related to the body that are common to a comorbid OCD and ED presentation. Second, panelists will address the challenge of deciding which disorder takes precedence in the treatment plan. Panelists will also discuss the best practices for implementing interventions that are effective in treating the symptoms of one diagnosis but may serve as a maintenance variable to the other diagnosis. Third, using case examples from clinical practice, the panelists will highlight potential complications and barriers that, if not approximately addressed, may impede adequate implementation of assessment and treatment procedures. This discussion will also highlight the importance of prioritizing behavior change in treatment as the mechanism to achieve symptom reduction in both disorders.

Learning Objectives:

1. Understand the diagnostic and phenomenological overlap between OCD and ED’s.
2. Identify suitable assessment and treatment procedures for best practice of this comorbid presentation.
3. Identify potential treatment barriers and best practices for mitigation.

SIG Panel: Disordered Eating in the Military Family: Service Members, Veterans, and Dependent Youth

Sponsored by the Males and Eating Disorders SIG

David Klein
Dr. Jason Lavender, PhD, Uniformed Services University of the Health Sciences & The Metis Foundation
Dr. Karen Mitchell, Clinical Research Psychologist and Associate Professor, VA Boston Healthcare System and Boston University School of Medicine
Natasha Schvey
Marian Tanofsky-Kraff

Abstract: Current and former military service members (more than 4 out of 5 of whom are men) and their child dependents are at heightened risk for disordered eating symptoms. Unfortunately, eating disorders are often underrecognized in these groups, and there is a need to expand the reach of the eating disorders field to improve identification and enhance treatment access for these vulnerable populations. Service in the military is characterized by unique factors that may promote body weight concerns/overvaluation and patterns of both disinhibited and/or restrictive eating. Among these unique factors are: emphasis on, and career requirements related to, weight, fitness, and appearance; occupational weight stigma; intermittent and often limited access to food and constrained eating times; exposure to combat trauma and other service-related stressors. The impact of these factors also may persist or even worsen after military separation (i.e., among veterans). Moreover, the vast majority of service members are male. As men have historically been underserved in the broader field, current and former service members may be both at greater risk for disordered eating and particularly vulnerable to underdiagnosis and undertreatment. Notably, certain unhealthy eating- and weight-related attitudes and behaviors among current and former service members also may be communicated and/or modelled to the spouses and children of service members, leading to heightened risk for the entire “military family”, which includes current and former service members, as well as their partners and child dependents. This panel presentation, sponsored by the Males & Eating Disorders SIG, will focus on addressing important considerations for the nature, prevention/treatment, and co-occurring psychosocial concerns of disordered eating in the military family. Each panelist will provide a brief overview of their expertise and a summary of key takeaways relevant to their topic area, after which the chair (Dr. Lavender) will moderate an interactive panel discussion that will include questions from audience members. Dr. Tanofsky-Kraff will focus on disordered eating among child dependents of service members; Dr. Schvey will focus on weight stigma within the context of the military family; Dr. Klein (who is a Colonel in the US Air Force) will focus on features of military service salient to disordered eating risk; Dr. Mitchell will focus on disordered eating and associated risk factors in veterans.

Learning Objectives:

1. To describe features of military culture and experiences that may promote body dissatisfaction, weight bias internalization, and disordered eating.
2. To identify specific military-relevant experiences (e.g., occupational weight stigma; trauma exposure) and co-occurring psychological symptoms (e.g., post-traumatic stress) that may heighten risk for disordered eating and body image concerns.
3. To recognize potential occupational and sociocultural barriers to eating disorder identification, treatment-seeking, and access to specialized care among members of the military family.

Workshop: ARFID Adults - What are we missing? Addressing gaps in the research and practice of treating adults

Lauren Muhlheim, Psy.D., FAED, CEDS-S, Eating Disorder Therapy LA
Ilana Pilato PhD, Clinical Psychologist, Duke University Medical Center

Abstract:Avoidant Restrictive Food Intake Disorder (ARFID) was only recognized as a disorder affecting those older than age 6 as recently as 2013. Thus, many people with ARFID have lived and struggled with it for years without any treatment. Many adults with ARFID have simply had to learn to cope with it on their own and have not had access to appropriate treatment. One treatment, CBT-AR holds promise, and yet many patients are looking for more access, other treatment options, and representation in higher levels of care. Preliminary research has suggested that those with ARFID have high rates of comorbid psychiatric (e.g., Anxiety Disorders, ADHD, Autism Spectrum Disorder, and OCD) and medical illnesses (e.g., various GI disorders). Currently, there are very few resources and treatments available for addressing this population. Many treatment centers have attempted to adapt their existing protocols and programs for this population, however many patients have expressed dissatisfaction with the process and feeling as though they were often treated like they had a different type of eating disorder (e.g., anorexia). Given the paucity of scholarship currently published about adults with ARFID, we will be collecting data from a sample of adults about their treatment experiences to help inform ideas for improving current and future treatments for adults with ARFID in outpatient and higher level of care settings. This workshop intends to address the gaps in current practices when treating adults with ARFID by sharing common themes arising with this group, tricks of the trade, overview of the current evidence-based treatments for ARFID including case examples, inviting lived experience speakers to share their journey throughout years of treatment, strategies for running groups, and offering a framework to use in higher level of care settings. The goal of this workshop is to improve attendee’s comfortability treating adults with ARFID in both outpatient and higher level of care settings. 

Learning Objectives:

1. Identify the common presentations and features of ARFID in adults.
2. Describe common challenges adults with ARFID encounter in traditional eating disorder programs and appropriate ARFID modifications to treatment protocols to address these problems.
3. Identify interventions and/or modifications to protocols to address the needs of adults with ARFID.

Workshop: Broadening our Clinical Impact with Temperament Informed Treatments for AN: TBT-S vs. RO-DBT

Julianna Gorder, PsyD, Clinical Assistant Professor of Psychiatry and Behavioral Sciences, University of Southern California
Dr. Laura Hill, Co-Developer of TBT-S Training, Associate Clinical Professior, Ohio State University and University of California, San Diego
Christina Wierenga PhD, Professor of Psychiatry, University of California San Diego

Abstract: There is growing enthusiasm for applying neuroscience-informed interventions to eating disorders. Advances in the ability to characterize a range of psychopathology on the basis of underlying neurobiology has driven new etiological models and targets of intervention. Additionally, high rates of psychiatric comorbidity among those with eating disorders implore the development and use of treatments that target underlying mechanisms of maladaptive patterns. For instance, accumulating evidence supporting the relationship between temperament (i.e., core biologically-determined personality traits). Psychopathology has guided several emerging treatments that treat to the traits of anorexia nervosa (AN), including Radically Open Dialectical Behavior Therapy (RO-DBT) and Temperament Based Therapy with Support (TBT-S). A number of traits have been identified that increase risk of developing AN and maintain maladaptive behavior. This workshop will identify how each approach conceptualizes and applies temperament traits to enhance and deepen the clinical experience. Consistent with this year’s ICED theme of broadening impact through collaboration, the workshop will also describe how TBT-S draws upon “Support” persons (any person who provides support) to collaborate with the client and therapist or therapeutic team, to facilitate treatment engagement and recovery. Research outcomes of RO-DBT and TBT-S will be outlined. Participants will have the opportunity to try on clinical tools to augment other ongoing evidenced based therapies.

Learning Objectives:

1. Describe how personality traits and behavioral symptoms relate with temperament.
2. Describe two similarities and differences between RO-DBT and TBT-S.
3. Identify how to apply a temperament based intervention, developed from neurobiological research, to broaden your own clinical practice

Workshop: Close Encounters of the 4th Kind - The Medical Care Guidelines Experience

Brooks Brodrick
Amanda Downey, Assistant Professor of Pediatrics and Psychiatry, University of California San Francisco
Vikas Duvvuri
Ellen Rome
Dr. Anna Tanner, Vice President, Child and Adolescent Medicine, Accanto Health

Abstract: The recently updated 4th edition of the Medical Care Guidelines are in danger and the Medical Care Standards Committee needs your help defending them. Many medical providers receive little to no formal training in the diagnosis and management of eating disorders. Although ongoing efforts exist to improve medical education pertaining to eating disorders, these efforts are unlikely to reach meaningful levels in the community for many years. Thus, it is imperative eating disorder specialists of all backgrounds be versed on medical care resources to advocate for clients when dealing with less experienced providers. The 4th edition of the Medical Care Guidelines were designed to assist medical practitioners from all trainings in the prompt diagnosis and appropriate medical management of eating disorders across the age, gender, and diagnostic spectrum. However, efforts are underway to abduct the Medical Care Guidelines and thwart our plans. To defend the Medical Care Guidelines and the soon to be released Psychopharmacology Guidelines, participants must work together in teams to solve problems related to an eating disorder case study. As they work their way through the narrative and scenarios, participants will encounter props including triage information, lab results, and patient samples to enhance the experience and engage with the case study on a physical level. Most importantly, to prevent any future threats, participants are tasked with widely disseminating the guidelines in their communities.

Learning Objectives:

1. Describe situations where the Medical Care Guidelines will be beneficial.
2. Employ the recommendations to solve a real-life case scenario in teams.
3. Formulate strategies for disseminating the Medical Care Guidelines in your community.

Workshop: Exploring overlapping intersectionality: Impact of stigma, trauma and a marginalized life experience

Wendy Oliver-Pyatt
Lesley Williams 

Abstract: In our constantly evolving field of work, we are continuously expanding our knowledge and gaining insight into how we can better meet the needs of our patients. Unfortunately, the failure to acknowledge and identify the intersectionality of clients’ identities and experiences, has historically limited the access and efficacy of treatment for clients with a marginalized life experience. In this presentation we will learn the importance of (addressing) intersectionality and how we can better address it in eating disorder treatment. We will explore how living in a perpetually toxic, shaming, and exclusive environment can cultivate poor self-esteem and make marginalized individuals vulnerable to developing eating disorders. We will identify our own biases, acknowledge our own intersecting identities, and look at how stigma and implicit bias (on an individual and a societal level) informs the care we provide. Furthermore, we will identify appropriate tools we can implement in our practice, from the language we use to techniques we employ to the environment we provide, to create a more inclusive and trauma-informed approach that will better meet the needs of our clients.

Learning Objectives:

1. Name 3 categories of individuals who may feel marginalized in traditional eating disorder treatment settings.
2. Provide 3 examples of ways to increase connection and belonging for marginalized patients.
3. T/F: Social justice action can help empower eating disorder patients living in a marginalized life experience.
   
   

Workshop: Fidelity in Family-Based Treatment (FBT) of Eating Disorders

Cara Bohon, VP Clinical Programs, Equip Health
Angela Celio Doyle, PhD, FAED, VP Behavioral Health Care Equip Health
Sarah Forsberg
Daniel Le Grange
Urmi Patel, Director of Clinical Training, Equip Health

Abstract: Fidelity coding (adherence to treatment protocol) is an overlooked aspect of measurement-based care, such that we focus on adherence and outcomes for patients and not providers. Regularly evaluating provider fidelity is one way to ensure an intervention does not drift too far astray from the intended target. Family-based treatment (FBT) is generally considered the first line of treatment for children and adolescents with an eating disorder yet innovative strategies are needed to improve treatment outcomes. Despite being considered the gold standard of care by many for childhood eating disorders, only 50% of therapists who were part of a national eating disorder treatment organization report using FBT. Of providers who report using FBT, fidelity to the model appears low: practitioners report reluctance to weigh patients, provide nutritional advice, and implement a family meal. Thus, it is unclear how closely the FBT model is followed by providers reporting to be implementing FBT. A lack of fidelity engenders questions about whether practicing FBT in this way will be effective in the community given its dissimilarity to the way FBT was delivered in trials. Improving fidelity to FBT could be one way to improve treatment outcomes for patients receiving FBT. Facilitated by FBT experts, this workshop will provide tools for coding fidelity in FBT. Fidelity coding is based on the Family Therapy Fidelity and Adherence Check created by Lock and LeGrange for FBT trials and described in detail by Forsberg and colleagues. The rating accomplishes two tasks: rate the presence or absence of a behavior by a provider and, if a behavior was implemented, the quality of the intervention. The workshop will focus on fidelity coding of FBT from a provider case study perspective. Using mock video sessions, presenters will provide an example and role play of fidelity coding and giving feedback to improve fidelity. Participants will engage in interactive small group discussions of ratings and problem-solve challenges to fidelity coding. By workshop close, participants will have observed and practiced fidelity coding for FBT and leave with concrete tools to integrate coding into clinical training. This innovative workshop will provide participants with strategies to enhance fidelity to FBT, which we expect will ultimately improve outcomes for patients. The workshop focuses on independent ratings of FBT fidelity but strategies can be applied to other approaches or self-ratings.

Learning Objectives:

1. Explain what treatment fidelity is and why fidelity in family based treatment for eating disorders is important.
2. Describe common challenges in fidelity coding and possible strategies to overcome them.
3. Implement strategies for fidelity in supervision in your own practice.

Workshop: Remote Delivery of Trauma-Informed Integrative Therapeutic Modalities for Eating Disorders

Caitlin Kelly
Jacquie Rangel
Emma Riebl
Caitlin Shepherd, Clinical Data Manager, Within Health

Abstract: Trauma has been identified as a nearly universal experience for those struggling with psychiatric disorders. Individuals with eating disorders are no exception, with studies showing higher rates of lifetime traumatic events and trauma symptoms compared to those without eating disorders. A history of trauma exposure as well as symptoms of PTSD/C-PTSD have been associated with poorer treatment outcomes, highlighting the need for a trauma-informed approach (TIA) to eating disorder care. Beyond conventional trauma-focused psychotherapeutic interventions, there are a number of integrative therapeutic modalities that have shown benefit both for individuals with eating disorders and those who have experienced trauma. These modalities, including breathwork, art therapy, and psychodrama, are thus well-suited for a TIA to eating disorder care. Guidelines have been developed for a TIA and applied with success to eating disorder treatment; however, with the proliferation of remote care options, more attention needs to be paid to how trauma-informed care can be effectively delivered via telehealth. This workshop therefore aims to synthesize empirical literature, expert opinion, and practical clinical experience to provide recommendations for the remote delivery of trauma-informed integrative therapeutic modalities for eating disorders. This workshop will provide an overview of the key assumptions and principles of a TIA. Assessment instruments and strategies will be shared, including ways that clinicians can utilize a TIA while screening for trauma exposure and symptoms and assessing appropriateness for remote care. In addition, presenters will discuss how different integrative therapeutic modalities can be offered for individuals with eating disorders through a telehealth platform while adhering to a trauma-informed framework. Didactic components will include brief introductions to each modality along with reviews of supporting evidence, potential benefits/risks, and specific techniques for working with clients with eating disorders and trauma histories/symptoms in a remote setting. Presenters will use interactive case examples to illustrate a trauma-informed assessment approach and will conclude each section with a guided experiential exercise based on that integrative modality. Participants will leave this workshop with tangible tools that they can implement when assessing and supporting clients in remote eating disorder care.

Learning Objectives:

1. Describe a minimum of two screening measures that can be used to assess trauma and/or client appropriateness for remote care.
2. Discuss at least one benefit and one risk of remotely providing each of the integrative therapeutic modalities covered.
3. Identify at least three strategies for implementing fundamental principles of a trauma-informed approach when practicing these integrative therapeutic modalities via telehealth.

Workshop: Targeting intolerance of uncertainty: a new avenue to optimalizing treatment for anorexia nervosa

Jojanneke Bijsterbosch
Lot Sternheim
Dr. Elske Van den Berg, Novarum
Annemarie van Elburg

Abstract: During recent years several specialized psychological treatments for adults with anorexia nervosa (AN) have been developed and emerged from guidelines as first-option psychological interventions. Recent (network) meta-analyses suggest that recommended treatments do not outperform control conditions. Outcomes, however, are obscured by low‐quality and heterogeneous studies. Can we understand why specialized interventions do not seem to enhance clinical outcome? Do we need to focus on different angles when treating AN, for adults as well as for adolescents? Findings suggest that anxiety, intolerance of uncertainty (IU) in particular, may affect the course of eating disorder treatments. IU refers to the excessive tendency to evaluate uncertainty as negative on a cognitive, emotional and behavioral level. Building research highlights elevated levels of IU in adults and adolescents with AN, and studies show strong associations between higher IU and more severe AN pathology alongside higher levels of anxiety and depression. First studies show a relationship between higher IU and poorer daily functioning (i.e. emotion processing and social problem solving). It is likely that IU interferes with treatment outcomes, and in particular with treatment engagement. Namely, seeing that AN treatments inherently involves uncertainty (i.e. a changing body, creating new behaviors and a new identity), those with high IU may be less likely to engage in these treatments. In this workshop we aim to provide: 1)a clinical picture of what IU may look like in the treatment room, i.e. tools, tools to recognize/ diagnose IU in patients with AN (20 minutes), 2)an introduction to an IU intervention, as based on an existing treatment protocol (20 minutes), and 3)a short training that covers the key aspects of this treatment protocol (30).The workshop will start with an overview of the current status quo of evidence-based treatments for adults and adolescents with AN and why we may need to target non-AN related symptoms (10 min), followed by an overview of the scientific evidence for IU as a potential treatment target in AN (10 min). We will encourage workshop participants to engage actively in all learning components of the workshop, i.e. to imagine what IU looks like in the treatment room, discuss experiences in dealing with IU-type anxieties, learn about the benefits of an IU intervention but also to think about potential difficulties when delivering intervention to patients with AN.

1. Being aware of the current status quo of evidence-based treatments for anorexia nervosa.
2. Gain knowledge about intolerance of uncertainty in anorexia nervosa.
3. Understanding the potential benefit of an add-on intervention for intolerance of uncertainty for improving eating disorder treatment engagement and ultimately enhancing clinical outcomes.

Workshop: What can we learn from TrEATment seekers: Collecting real world clinical data in ED research

Dr. Phillipa Hay, DPhil, FAED, Professor of Mental Health, Western Sydney University and Director of Mental Health Research SWSLHD
Gabriella Heruc, Adjunct Associate Professor, ENRG, Western Sydney University 
Dr. Deborah Mitchison
Dr. Susan Byrne

Abstract: The purpose of this workshop is to increase skills and knowledge to facilitate the collection of meaningful, real world clinical data in the eating disorder field. This will be achieved by presenting a road-map of how to develop a clinical registry. Presenters are partners of the TrEAT Clinical Eating Disorder Registry - a successful registry of treatment seekers contributed to by private and public eating disorder clinics across Australia and New Zealand that has been running since 2016. Multiple disciplines, treatment models, and programs (outpatient, day patient, and residential) are represented in this real world data, facilitating comparisons and integrated learnings. Under the classic scientist-practitioner model, the registry is used as a clinical outcomes monitoring tool, providing clinicians with data to support assessment, measure change, and facilitate clinical decision-making throughout treatment. The other major use of the registry is for research. This is facilitated by a process where researchers and students can apply for access to the registry and work alongside clinicians in a co-design model to answer important clinical research questions grounded in real-world data. Research coming from this registry has already increased knowledge for example on differential latency to treatment across diagnoses, perceived barriers and predictors to treatment access, and clinical validations of questionnaires. In this workshop we will provide a practical demonstration of how we have managed to conceptualize, develop and maintain this clinical registry, drawing on clinical and academic partnerships, and reflecting on our challenges and learnings. We will also showcase some of the research that has been made possible through the registry. The workshop is most suitable for researchers and clinicians who are interested in developing or becoming involved in a clinical registry. Attendees will have the opportunity to ask questions and to develop their own registry proposal with feedback from the presenters.

Learning Objectives:

1. Understand how to develop and maintain clinical-research partnerships.
2. Know how to develop and maintain an online registry.
3. Know how to use a registry for clinical and research purposes.
   

Workshop: Changing expectations of how clinicians, researchers, and organisations engage with lived experience - a consumer and psychologist's perspective of the new landscape

Shannon Calvert
Dr Anthea Fursland,  Swan Centre, Perth, Western Australia

Abstract: Expectations are rapidly evolving. Many clinicians and researchers are starting to recognise and value the insights of people with a lived experience of mental ill-health, including eating disorders. However, they are challenged to confront their own beliefs and prejudices. Is it possible for professionals and those with lived/living experience to engage in a true collaboration with both sides listening and valuing the others' perspectives? Is it desirable? Or is it preferable to retain some aspects of the professional realm and others in the realm of consumer/patient/client/carer? Unfortunately, there is still a widespread stigma surrounding mental ill-health, and there are clinicians who remain suspicious of facilitating the inclusion of lived experience into research and clinical practice. Yet how can they support the notion of reducing stigma if they hold on to beliefs that lived experience expertise cannot make valid, equal contributions to the discussion? And what about those professionals who have lived experience? Many clinicians and researchers have a lived experience of mental ill-health, including eating disorders, but keep their history secret because of the stigma, believing there is too much at stake to "come out" to their colleagues for fear that their accomplishments may be invalidated if their past is disclosed. If the eating disorder sector is to embed voices of lived/living experience, we also need to explore our attitudes regarding professionals who acknowledge having their own lived experiences. Reducing the stigma of either being a health professional with a history of mental ill-health or being a designated Lived Experience workforce member will only be achieved by everyone being brave, bold, and willing to integrate lived experience perspectives in our workforce. These are exciting times when professional organisations can create space for designated Lived Experience roles and opportunities where consumers, carers, family, and kin can contribute their lived experience expertise. It is incumbent on the eating disorder sector to advocate, practice, and embed genuine collaboration and partnership between health professionals, researchers and those with lived experience. This workshop will explore how the eating disorders sector can incorporate a meaningful blending of clinical, research and lived experience skills. 

Learning Objectives:

1. Understand the importance of going beyond the mere representation of people with lived experience to change the understanding of the broader mental health, eating disorder sector.
2. Advocate and inform on why embedding co-design, co-production, and collaboration actively promotes best-practice approaches to integrate lived experience expertise across all areas of the mental health and eating disorder systems.
3. Demonstrate how principled leadership and allyship can embed collaborative and inclusive approaches in workplace/organisations, in ways that support authentic, trust-based relationships with those with lived experience of mental ill-health and eating disorders.

Workshop: Eating Disorder Advocacy 101: Patient, Provider, and Researcher Perspectives

Amy Egbert
Ms. Jenny Loudon, Co-Founder, Alaska Eating Disorders Alliance (AKEDA)
Kym Piekunka
Amanda Raffoul PhD, Instructor of Pediatrics, Boston Children's Hospital/Harvard Medical School
Dr. Shelby Saulnier, Clinical Psychologist, Arbor Psychology

Abstract:  Given the increasing prevalence and severity of disordered eating across populations, there is an urgent need to advocate for greater prevention and treatment resources. However, there are deficits in eating disorder advocacy across disciplines and professions, including gaps in advocacy training among clinicians, researchers, and people who have experienced eating disorders in their lives. Early progress to address the advocacy deficit have resulted in preliminary advancements in public policy changes that directly impact the nature and course of eating disorders (e.g., the Anna Westin Act, a U.S. bill to increase funding for provider training). Despite early progress, additional eating disorder advocacy is urgently needed at micro- (e.g., advocating for individual patients) and macro-environmental (e.g., global policy changes) levels to improve prevention efforts and treatment outcomes globally. Additional advocacy efforts aimed at addressing eating disorder research, prevention, and treatment may promote more robust improvements. This workshop, co-presented by the Academy for Eating Disorders (AED) Advocacy and Communications Committee (ACC) and the Lived Experience Advocacy & Engagement special interest group, is designed to educate and empower attendees on tangible ways to initiate and get involved with eating disorder advocacy. Attendees will be given an overview of what advocacy is and apply their new knowledge through hands-on activities designed to be put into action post-workshop. The workshop content will be tailored to discuss special considerations for advocacy across different professions and roles, including experts by experience, providers, and researcher perspectives. Finally, the workshop facilitators will model and provide attendees the opportunity to role-play advocacy interactions from their unique perspective using case examples drawn from the facilitators’ own experiences. The workshop will close with a discussion on the current status of eating disorder advocacy globally, including avenues for involvement with the AED broadly and the efforts of the ACC more specifically. Through didactic and applied educational methods, this workshop will provide participants with digestible and tangible insights into the realm of eating disorder advocacy to inform their future efforts.

Learning Objectives:

1. Learn how to become an advocate for eating disorders across levels of connection.
2. Identify ways to promote inclusive and supportive advocacy, and address risks inherent to advocacy that is not.
3. Empower actionable steps towards increasing eating disorder advocacy across disciplines on micro and macro levels.
   
   
   
   

Educational Session 3: Concurrent Workshops & SIG Panels
Saturday, June 3, 1:30pm -  3:00pm

SIG Panel: Addressing weight stigma in higher levels of care for eating disorders

Sponsored by the Weight Stigma & Social Justice SIG and Professionals and Recovery SIG

Erin Harrop, LICSW, PhD, Assistant Professor, University of Denver
M. Cole
Kiki Kline
Rebecka Peebles
Shira Rosenbluth
Cait Scafati

Abstract: Weight stigma impacts healthcare experiences and outcomes across a broad range of illnesses and populations. In recent years, eating disorder (ED) researchers, clinicians, and advocates have begun discussing the impact of weight stigma in higher levels of care (HLOC). In this SIG panel, members of the Weight Stigma and Social Justice SIG and the Recovery and Professionals SIG explore the topic of weight stigma in HLOC for EDs. All presenters are ED researchers or clinicians, in addition to having lived experience. First, author SR will share how she encountered weight stigma during HLOC. She will also identify typical well-intentioned ED interventions that may be harmful, and then describe the Health at Every Size® model for treatment for EDs in larger bodies. Next, author EH will share data from a longitudinal mixed methods study of 39 atypical anorexia patients, with diverse identities in terms of gender (23% trans and nonbinary), age (18-74 years), race (28% people of color) and sexual orientation (64% sexual minorities), and describe the sample in terms of rates of treatment (28% untreated), level of care received, and treatment delay (mean=11.7 years, SD=11.3). They will also share qualitative themes regarding weight stigma in HLOC, including inadequate nutritional rehabilitation, low meal plans and goal weights, unhelpful interventions, fat-shaming in the milieu, and being treated differently by providers. Participant-created artwork and quotes will also be shared. Next author KK will share results from her narrative, phenomenological qualitative study exploring the lived experiences of 10 adults (age 18-57) in HLOC. Results include themes of the impact of staff bodies on clients, weight change in treatment, inconsistency of body acceptance and treatment goals of body change, and disregarding bodily cues. Then, author MC, a clinician with atypical anorexia, will share about their experience of being referred to HLOC, but not being able to access treatment. MC will highlight the impact of race, body size, and socioeconomic status. Throughout, all presenters will reflect on their social identities (gender, race, body size, sexual orientation, socioeconomic status), and how those identities impacted their experiences. In the second half of the panel, co-chairs (CS and RP) will facilitate a discussion with panel members and the audience regarding how to ethically address issues of weight stigma in HLOC for EDs.

Learning Objectives:

1. Identify three ways that higher weight patients may experience weight stigma in higher levels of care for eating disorders.
2. Describe the principles of Health at Every Size in treating higher weight patients with eating disorders. Discuss how patients intersecting identities (e.g., race, gender, body size, socioeconomic status) may impact experiences of higher levels of care.

SIG Panel: Ethical Dilemmas in Eating Disorder Care

Sponsored by the Inpatient/Residential SIG

Jennifer Goetz MD, Child/Adolescent & General Psychiatrist, McLean Hospital/Harvard Medical School
Wayne Bowers PhD
Jennifer Campbell LICSW, Center for Evidence Based Treatment Ohio
Jillian Lampert PhD, MPH, RD, Accanto Health | The Emily Program and Veritas Collaborative

Abstract: 

Learning Objectives:

1. Following this presentation participants will be able to outline the ethical dilemmas and principles in conflict in the care of individuals with eating disorders.
2. Participants will be able to describe how the concepts of capacity and civil commitment can be utilized in the care of individuals with eating disorders.
3. Participants will be able to understand the ethical implications of providing care on an involuntary (or compulsory) basis as well as the ethical implications of not providing care on an involuntary basis for patients with eating disorders.

SIG Panel: Under-represented populations in eating disorder research: Exploring barriers and solutions

Sponsored by the Epidemiology & Public Health Practice SIG

Ariel Beccia, Boston Children's Hospital/Harvard Medical School
Natasha Burke
Jerel Calzo
Samantha Hahn, Assistant Professor, Central Michigan University College of Medicine
Dr. Helena Lewis-Smith, Senior Research Fellow, University of the West of England

Abstract: There is now strong and consistent evidence that marginalized populations (e.g., LGBTQ+ people) are disproportionately affected by eating disorders, disordered eating behaviors, and body image concerns as a result of structural vulnerabilities and systemic inequities. However, these same populations have historically been – and continue to be – excluded and/or erased from mainstream epidemiologic research; as such, the distribution and determinants of eating disorder disparities remain poorly understood, undermining our ability to intervene. In this Epidemiology & Public Health Practice SIG Panel Discussion, we will explore the likely causes of and potential solutions to these critical gaps in the eating disorder literature, with a focus on highlighting implications for researchers, practitioners, and policy makers. Our expert speakers will cover four specific populations who have been shown to experience disproportionate eating disorder risk and/or disparities in accessing care across global contexts, including LGBTQ+ people, racial/ethnic minorities, rural communities, and older adults, as well as the intersectionality between these and other dimensions of social identity/position (e.g., body shape and weight, socioeconomic status). The first half of the panel will feature a series of flash talks in which speakers review: (a) what is known about eating disorder risk in these populations from available epidemiologic research; (b) historical and contemporaneous reasons why these populations remain under-represented in the eating disorder literature and in epidemiology more broadly; and (c) what is needed to overcome identified barriers regarding the collection, analysis, and dissemination of data. The second half will be dedicated to an open discussion with audience engagement (e.g., polls, break-out groups, and Q&A) to strategize across disciplines and foster new ideas regarding ways to make our research more inclusive. Ultimately, this SIG panel aims to shed light on a highly concerning social justice issue in the eating disorder field, with the goal of raising awareness, sparking discussion, and coming up with urgently needed solutions.

Learning Objectives:

1. Identify under-represented populations in the eating disorder literature, and the reasons for such under-representation.
2. Consider the research, clinical, public health, and policy implications associated with excluding and/or erasing the experiences of marginalized populations in eating disorder research.
3. Explore potential solutions to documented barriers for including marginalized populations in epidemiologic research on eating disorders and related outcomes.

Workshop: Are Autism and Eating Disorders Related?

Kate Tchanturia
Ms Zhuo Li, PhD Candidate, King's College London

Abstract: Autism is often overlooked in standard eating disorder (ED) treatment programmes. Research suggests that between 23% to 35% of patients with anorexia nervosa (AN) also present autistic features. These patients tend to benefit less from standard ED treatment programmes, with poorer outcomes (higher anxiety and depression, poorer social and work adjustment), and longer inpatient admissions. The PEACE (Pathway for Eating disorders and Autism developed from Clinical Experience) project has developed a range of resources and treatment recommendations for individuals with co-occurring ED and autism. This workshop will focus on approaches to adapting treatment for this population, integrating research evidence and learnings from clinical implementation of the PEACE pathway at South London and Maudsley, Eating Disorders Service in the UK. In our translational clinical work at PEACE, we have developed a website (www.peacepathway.org) where patients, clinicians and carers can benefit from various free resources; we have published a book, Supporting Autistic People with Eating Disorders (2021, Jessica Kingsley Publishers); we were also the first specialist ED service in the UK to be awarded accreditation from the National Autistic Society for being autism-friendly. Economic and qualitative evaluations of the pathway have shown: (1) the feasibility of implementing and scaling up the PEACE Pathway across other regions in the UK; (2) Joint effort in developing the pathway by patients, clinicians and carers, and their satisfaction with the implementation; (3) Approximate cost savings of £275,000 GBP in our inpatient unit, as patients benefit more from the individualised treatment and spend shorter time in the hospital. This workshop will outline the theoretical framework and research evidence behind the PEACE Pathway, and introduce its development, implementation, obstacles, and future directions. During the interactive component of the workshop, attendees will be invited to try out different elements of PEACE resources, for example: tools facilitating communication such as communication preferences record and conversation cards, tools addressing sensory preferences.

Learning Objectives:

1. Reflecting on the research evidence on autism and eating disorder comorbidity.
2. Awareness of adaptations for clinical benefits. 
3. Explore potential solutions to documented barriers for including marginalized populations in epidemiologic research on eating disorders and related outcomes.

Workshop: A Practical Guide to Offering Virtual Eating-Disorder Treatments in Individual and Group Modalities

Dr. Linda Booij, Professor of Psychiatry, McGill University/Douglas Mental Health University Institute
Lea Thaler, Ph.D., Psychologist, Douglas University Institute/McGill University
Annie St-Hilaire
Howard Steiger

Abstract:

Learning Objectives:

1. Following this training, participants will be able to understand the advantages and disadvantages of virtual therapy for eating disorders compared to in-person therapy, based on recent research findings.
2. Following this training, participants will be able to be familiar with different therapeutic strategies when offering outpatient or day program treatment for people with eating disorders offered in a virtual format.
3. Following this training, participants will be able to be familiar with practical approaches to managing crises and other unexpected challenges when delivering virtual therapy to people with eating disorders.

Workshop: Families in the Virtual Village of Eating Disorder Care

Dr. Deborah Michel, National Clinical Director of ERC At Home Virtual Services, Eating Recovery Center
Kristie Simmons
Casey Tallent

Abstract: This workshop will focus on family involvement in the virtual care of eating disorder patients in an intensive outpatient program. The availability of telebehavioral healthcare for the treatment of eating disorders has substantially grown over the course of the COVID-19 pandemic, resulting in increased capacity to meet treatment demand for those who would not otherwise receive care due to various barriers such as treatment deserts, transportation, or schedule conflicts. Though still preliminary, data is beginning to surface on the efficacy of eating disorder treatment delivered via telehealth. For the child and adolescent population, it is well-established that family inclusion is critical and there is ample evidence supporting family-based treatment. Support system involvement for adults, often including family members, has also been demonstrated to be of great value. Telebehavioral healthcare is well poised to enhance family involvement in many aspects of care such as family therapy, psychoeducation, caregiver skills, and family support groups given the convenience and accessibility of virtual treatment. In this presentation, a data-informed model of virtual intensive outpatient (VIOP) care is outlined utilizing information gleaned from literature review as well as data and feedback obtained from patients, family members, and support persons over the course of large-scale VIOP programming. A review of current literature will be presented on the effects of COVID-19 on mental health as well as eating disorders specifically. Clinical best practices for ethical and comprehensive involvement of family members for all populations will be highlighted and discipline specific best practices delineated for psychotherapists as well as dietitians. Case vignettes will be used to highlight clinical topics as well as stimulate audience participation.

Learning Objectives:

1. List three findings on the efficacy of telebehavioral health in eating disorder treatment. 
2. List three treatment modalities in which families may participate in virtual eating disorder treatment.
3. Identify clinical best practices for family involvement in eating disorder treatment for therapists and dietitians.

Workshop: Navigating Complexities in Gender Affirming Eating Disorder Care: Working with Non-Affirming Parents

Jonathan Levine, Therapist, Equip Health
Ethan Lopez, Peer Mentor, Equip Health
Jessie Menzel, Senior Director of Program Development, Equip Health
Scout Silverstein, Senior Program Development Lead, Equip Health

Abstract: Transgender and gender expansive (TGE) youth are 4-8 times more likely to struggle with an eating disorder (ED) relative to their cisgender youth counterparts. Family acceptance and support is a primary driving factor for physical and mental health for TGE youth.The American Academy of Pediatrics’ gender-affirming care model states gender variations are not disorders and gender presentations are diverse and vary across cultures. Mental health disparities most often develop from stigma and discrimination, rather than from one’s intrinsic gender experience. There are a lack of resources focused on how ED care providers can navigate the complexities of providing affirming care for TGE youth who live with unsupportive and non-affirming parents. While TGE youth experience improvement in Eating Disorder Examiniation Questionnaire (EDE-Q) scores with ED treatment, suicidality is higher at the start of treatment relative to cisgender youth, and does not significantly improve throughout the treatment course. A strong and affirming family support system has been demonstrated to decrease suicidality in TGE youth by up to 82%, and suicide attempts from 57% to 4%. This workshop will offer tools to navigate difficult situations with non-affirming caregivers, such as resistance to using pronouns, denial of gender diversity, hesitancy in supporting medical transition, working effectively with caregivers who hold discordant levels of support, and helping caregivers who exhibit primarily fear-based responses to their child’s expressed needs. We’ll discuss common difficulties ED care providers face, and will invite participants to share examples. We’ll introduce a five-pronged communication approach for use with non-affirming caregivers. Participants will engage in small group interactive role plays around working with non-affirming caregivers. By the end of this session, participants will have practiced idea generation through collective expertise and will leave with several new skills and strategies to integrate into practice. Aligned with AED’s themes of broadening impact and ‘enhancing visibility through collaboration and outreach’, we aim to arm attendees with the skills required for delivery of gender affirming care through effective caregiver engagement, thus providing opportunity for improvement in treatment outcomes. This dynamic workshop will provide participants with tools required to meet the needs of a complex, underserved and overlooked population.

Learning Objectives:

1. Understand common reasons parents face difficulties in supporting their transgender and gender expansive children.
2. Identify evidence-based research and resources that can be used in helping align non-affirming parents with the treatment team approach in providing gender-affirming care.
3. Adopt a five pronged communication approach to navigating complexities with non-affirming parents which includes providing validation, introducing evidence base, asking open ended questions, providing encouragement, and offering resources.

Workshop: Reconnecting for Recovery: Leveraging power of families through Multifamily Therapy for YA with AN

Dr. Mary Tantillo, Professor of Clinical Nursing/Director Western NY Comprehensive Care Center for Eating Disorders, University of Rochester School of Nursing

Abstract: This workshop will describe an innovative conceptual framework for understanding eating disorders as diseases of disconnection, as well as a relational/motivational Multifamily Therapy Group (MFTG) approach (“Reconnecting for Recovery” – “R4R”) for young adults with Anorexia Nervosa (AN) that leverages the power of families to repair disconnections and improve perceived mutuality. Participants will learn interventions that help young adult patients and families gain emotional and relational skills needed to work collaboratively in recovery to foster increased connection with self/one’s body and others. The workshop will include didactic instruction, a video-segment of a simulated Reconnecting for Recovery Multifamily Therapy Group, and large group discussion.

Learning Objectives:

1. Discuss the relational re-framing of eating disorders as “diseases of disconnection.”
2. Describe how a relational/motivational MFTG leverages the power of families to effectively identify and repair disconnections associated with AN in young adulthood.
3. Discuss two R4R MFTG interventions that promote emotional and relational skills needed to repair disconnections and foster connection with self and others.
   
   

Workshop: Treating Insomnia in Your Eating Disorder Clients: Moving Beyond Sleep Hygiene to Empirically Supported Techniques from Behavioral Sleep Medicine

Dr. Angeline Bottera PhD, Postdoctoral Fellow, University of Chicago
Dr. Kara Christensen, Assistant Professor, University of Nevada Las Vegas
Kyle De Young, Associate Professor, University of Wyoming

Abstract: Insomnia disorder is a mental health condition characterized by difficulty falling asleep and/or staying asleep accompanied by significant daytime dysfunction. Its occurrence is common among people with eating disorders (EDs) and is associated with higher ED severity and poorer treatment response. In addition to their impacts on EDs, insomnia symptoms on their own are highly impairing, resulting in poorer concentration, memory, emotion regulation, physical health, and quality of life, underscoring the importance of addressing insomnia symptoms in treatment. Furthermore, treating insomnia may reduce risk for other disorders that commonly co-occur with and exacerbate EDs, including MDD, GAD, PTSD, and substance use disorders. Emerging evidence from insomnia treatment trials have demonstrated marked improvements in comorbid psychopathology (e.g., depression, anxiety) following treatment of insomnia, challenging the common assumptions that insomnia disorder should always be a secondary diagnosis and that it is not a distinct disorder. Moreover, many people continue to report clinically significant insomnia symptoms even after remission from an ED, as ED treatments on their own do not target the behavioral components that maintain insomnia symptoms. Consequently, high-quality insomnia-specific treatments are needed to address these symptoms. Despite high need for effective insomnia treatment among people with EDs, many providers are not yet trained to adequately treat these symptoms. A recent survey found that only 5% of clinical psychologists received training in treating sleep disorders during their career, despite most reporting a desire to learn more about sleep medicine. Moreover, when addressing insomnia in clinical practice, many providers opt for sleep hygiene as a first-line approach despite a robust evidence-base supporting the superiority and necessity of other behavioral techniques (i.e., stimulus control, sleep restriction/titration). For ED treatment providers to adequately assess and intervene on insomnia, education on how to address the relation between eating and sleep behaviors is critical. In this workshop, participants will be oriented to techniques beyond sleep hygiene that are employed in behavioral sleep medicine. They will learn 1) how to assess for insomnia, 2) the principles behind behavioral techniques for insomnia, and 3) how to apply these techniques in clinical practice.

Learning Objectives:

1. Following the training, participants will be able to evaluate clients for insomnia symptoms.
2. Following the training, participants will be able to set plans for implementing stimulus control for clients with EDs.
3. Following the training, participants will be able to interpret sleep diaries to apply sleep restriction and titration for clients with EDs.

Workshop: Two novel treatments for Avoidant Restrictive Food Intake Disorder (ARFID) in children: Comparing and contrasting family-based treatment (FBT-ARFID) and psychoeducational and motivational treatment (PMT)

Nandini Datta PhD,Post-Doctoral Fellow
James Lock
Brittany Matheson
Dr, Aileen Whyte, Associate Clinical Professor and Director of the Child and Adolescent Eating Disorders Clinic, at Stanford University School of Medicine

Abstract: Avoidant Restrictive Food Intake Disorder (ARFID) is associated with medical complications related to malnutrition as well as psychosocial impairments that significantly affect quality of life for children and their families. Currently, there are no well-established evidence-based treatments for ARFID in children. However, intervention development for the treatment of ARFID in youth is underway. This clinical workshop will present an overview of two novel treatments for ARFID in low-weight youth: Family-based Treatment for ARFID (FBT-ARFID) and Psychoeducational and Motivational Treatment (PMT). Our research team is currently comparing these two treatments in a large, adequately powered randomized clinical trial of 100 children ages 6-12 years old with low-weight ARFID (NCT04450771; R01MH110538). Both treatments are being delivered virtually via videoconferencing platform. The workshop will cover the research background and theoretical rationale for the development of these two treatments for this population. Previous pilot study data will be briefly reviewed. We will then compare and contrast these two treatments and share case materials from our on-going trial. All patient cases will be de-identified to protect confidentiality. We will cover the aspects of play utilized in the PMT arm and present materials developed during the “motivation for change” sessions, including stories, drawings, puzzle sheets, imaginative play, and creative session products. As part of the workshop, participants will have a chance to practice implementation of the strategies and participate in mock role play sessions to better understand this treatment approach. The workshop will also discuss how to implement FBT-ARFID utilizing the interventions outlined in the recently published manual. Throughout the workshop, the presenters will highlight developmental adaptations, cultural considerations, and discuss how common comorbidities, such as ADHD and Autism Spectrum Disorder, impact treatment structure and clinical progress. Finally, we will conclude with future directions as well as practical tips for working with children with ARFID and their families over videoconferencing. Active discussion and audience participation will be encouraged throughout the workshop.

Learning Objectives:

1. Identify key clinical interventions in two treatments for children with low-weight Avoidant Restrictive Food Intake Disorder (ARFID).
2. Compare and contrast interventions utilized in a family-based approach (FBT-ARFID) and individual approach (PMT) for children with ARFID.
3. Understand the role of parents and families in the treatment of ARFID in children.

Workshop: What Ever Happened to…Family Therapy for Bulimia Nervosa (FT-BN): Recent Overhaul and Update of FT-BN

Dr. Julian Baudinet, Consultant Clinical Psychologist, Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED)
Gladys Ellis
Natalie Pretorius
Juliet Rosewall
Mima Simic
Stamatoula Voulgari

Abstract: Despite the relatively high prevalence rate of bulimia nervosa (BN) in adolescence, little focus has been given to treatment development in recent years. While Family Therapy for Bulimia Nervosa (FT-BN) is the NICE (2017) recommended first-line treatment, only 25-40% of adolescents are abstinent from binging and purging behaviours by the end of treatment and a large proportion of young people are hesitant to involve their parents. There is not much difference in outcomes between family and individual approaches, suggesting that the key mechanism of change within treatments remains unclear. Adolescents struggling with BN often experience multiple difficulties in addition to their eating disorder, including high rates of comorbidity, self-harm, reduced emotion regulation capacity and low self-esteem. Parents of young people with BN also experience high rates of burden, and criticism within families is higher than with other eating disorders. This highlights the need for comprehensive treatments that engage individuals and their families on multiple levels and that have the flexibility to target multiple factors simultaneously.

1. Understand why and how FT-BN has been updated and put this in the context of recent developments in the field.
2. Describe key theoretical principles underpinning FT-BN.
3. Learn about, understand and experience how to facilitate FT-BN skills.

Workshop: The development and delivery of the Single Session Intervention

Dr. Susan Byrne, Clinical Psychologist & Honorary Fellow, University of Western Australia, School of Psychological Science
Dr. Anthea Fursland, Swan Centre, Perth, Western Australia

Abstract: With unconscionably long waiting lists throughout the world, particularly since COVID-19, there is an imperative to provide evidence-based assistance to patients while they are waiting for treatment. The Single Session Intervention (SSI) was developed at the Centre for Clinical Interventions (CCI) in Perth, Western Australia, in response to long waiting lists. An SSI, conducted by an experienced clinical psychologist, is offered to newly referred individuals or families (ideally within 2 weeks of receipt of the referral) during which patients and families are given crucial information regarding eating disorders, with a focus on their particular presentation. The aim of an SSI is to provide psychoeducation, develop a preliminary formulation, offer strategies and empower patients and their families to start making changes as soon as possible and motivate them towards recovery whist they are waiting to commence treatment. Published results from CCI have indicated that after completing an SSI, underweight patients gained an average of 2 kg (5.5 lb) and, overall, there was a statistically significant reduction in EDE-Q scores, binge eating and self-induced vomiting episodes by the time patients attended their first treatment session (up to 7 months later). Since the publication of these data, additional data have been collected from other eating disorder practices around Australia which have adopted the the SSI and evaluated the outcomes. This workshop will provide an overview of the rationale behind, and the development of, the SSI and describe the content of the SSI and the specific SSI protocol , with video demonstrations (role plays) and opportunity for practice and discussion.

Learning Objectives:

1. Cite clinical changes observed between delivery of the SSI and the commencement of treatment.
2. Appreciate the importance of stance and a personalized approach when delivering psychoeducation.
3. Apply learnings to their assessment and treatment of clients.