Workshop Summary Session 3

Educational Session 3: Concurrent Workshops & SIG Panels
Saturday, March 16, 1:00pm -  2:30pm

Workshop: Innovation in Action: Scalable Solutions for Closing Treatment Access Gaps

Jenna Tregarthen, M.A., Recovery Record
Rebecca Eyre, Chief Executive Officer, Project HEAL
Johanna Kandel, Chief Executive Officer, Alliance for Eating Disorders

Abstract: The need for scalable solutions facilitating access to eating disorder treatment services that are efficient, effective and inclusive is now a major public health priority.  Despite some progress being made in addressing treatment access barriers, a staggering number of individuals with disordered eating either fail to seek or fail to receive adequate care. Stigma, prejudice, and discrimination against people with eating disorders can contribute to worsening symptoms and reduced likelihood of seeking treatment. Detection and referral in clinical and community settings remains low, and for those who are ready to seek help, identification of and access to inclusive, qualified and affordable practitioners can be overwhelming and ultimately unsuccessful. It is widely acknowledged that a major shift in intervention practice is needed. Outside of the United States, there exist exemplary models for streamlining patient journey and access to care, however their transferability to the complex healthcare and socioeconomic systems in the United States is low. This workshop will share three breakthrough innovations that have collectively served over two million individuals with eating disorders, attesting to the need that they are addressing. The innovations include a mobile health initiative facilitating private and anonymous help-seeking, a comprehensive and impartial treatment referral and navigation service, and a free clinical assessment, diagnosis and treatment recommendation service.  Interconnection and partnership between these initiatives in support of navigation to care will be shared, along with the key implementation priorities that have underpinned their success, including scalability, affordability, cultural competency and importantly, compassionate connection . In this workshop, three vignettes elucidating treatment access challenges will be shared, increasing participant awareness of systemic barriers commonly experienced by patients. Participants will utilize a framework to identify prescient treatment access challenges faced by their own populations and identify specific actions and resources available to address these needs.

Learning Objectives:

1. Identify and articulate the major systemic barriers that individuals with eating disorders face when seeking treatment.
2. Evaluate the scalability, affordability, and cultural competency of three breakthrough innovative solutions and their potential application in diverse settings and populations.
3. Apply a provided framework to analyze the treatment access challenges faced by their respective populations, recognizing gaps and potential areas for improvement. 

Workshop: Euthanasia & ED in the Netherlands: lessons on how to prevent hopelessness and unbearable suffering

Professor Eric van Furth, PhD, FAED, Rivierduinen Eating Disorders Ursula
Dr. Elke Ribbens, MD 

Abstract: The Dutch health care system offers universal health care, is easily accessible and affordable for all (pop. 17.5 million). General practitioners serve as the gatekeeper to specialized care. Specialized treatment for eating disorders is geographically distributed, of high quality and well organized.
Legislation on euthanasia was first introduced in 2002. Current updated legislation differentiates physician assisted suicide, euthanasia and palliative sedation. Euthanasia is regulated by clear rules and procedures. All cases of euthanasia are reported, registered and independently assessed, retrospectively by Regional Councils on Euthanasia (RTE). The RTE can refer cases to a criminal prosecutor. In 5.1% of all deaths in 2022 euthanasia was reported as the cause of death. 
In recent years a rise in euthanasia in psychiatric patients has been observed. In 2022, 115 people with a psychiatric disorder requested and received euthanasia (1.3% of total). This has led to an intense public and professional debate. In 2018 the Dutch Society of Psychiatry published updated guidelines on euthanasia in psychiatric patients.
Notably, between 2015-2018, 14% of all patients with a psychiatric disorder who requested euthanasia had a diagnosis of an eating disorder. A proportion higher than expected given the prevalence of eating disorders. This led to the current research study in collaboration with the Expertise Center Euthanasia (ECE). The aim of our study was to gain knowledge about these patients to help prevent future patients experience their suffering as unbearable and hopeless. Data will be presented on 84 patients with an eating disorder who requested euthanasia at ECE.
The Dutch legislation and practice of euthanasia is seen as controversial by many countries. The recent increase in the requests for euthanasia by patients with psychiatric disorders has led to much debate in the Netherlands. The workshop will be introduced by Eric van Furth who will present the Dutch law and procedures on euthanasia and the guidelines of the Dutch Psychiatric Association (15 minutes). Next, Elke Ribbens will present the results of our study on 84 patients with an eating disorder who requested euthanasia between 2012-2018 (30 min). The discussion with workshop participants will focus on the lessons learned from this research and how to implement these in everyday clinical practice.

Learning Objectives:

1. Understand the Dutch law, rules and procedures on euthanasia in their context.
2. Appreciate the data on the Dutch patients with an eating disorder that received euthanasia
3. Learn how to implement strategies to prevent hopelessness and unbearable  suffering.

Workshop: A quality standard to guide high-quality care for eating disorders: Implementation factors

Dr. Jennifer Couturier, McMaster University
Dr. Kathryn Trottier, University of Toronto
Wendy Preskow, President & Founder, National Initiative for Eating Disorders

Abstract: This workshop will provide an overview and practical strategies for use of the Ontario Health Eating Disorders Quality Standard, emphasizing opportunities for quality improvement and implementation considerations. The presenters will demonstrate how the quality statements can be applied to improve care for adolescents and adults with eating disorders, and their caregivers. Discussion with the audience pertaining to potential for application in other jurisdictions, as well as implementation facilitators and barriers will be sought.  

In Ontario, Canada, quality standards outline what high quality care looks like for clinicians, patients and their families, as well as administrators and organizations. They are developed to improve care for conditions where there are large variations in how care is delivered, or where there are gaps between the care provided and the care patients should receive. In February 2022, Ontario Health began development of the Eating Disorder Quality Standard. This process included review and synthesis of existing clinical practice guidelines, recruitment of an expert advisory committee, analysis of available Ontario data, prioritization of outcomes and key topic areas, development of quality statements and indicators, identification of tools and resources to support implementation, and stakeholder consultation. 

The advisory committee prioritized nine areas for improvement including: comprehensive assessment; level of care; transition from youth to adult services; evidence-based psychotherapy; monitoring and medical stabilization; support for family and caregivers; physical, mental health, and addiction comorbidities; promoting equity; and care for people who are not receiving active treatment. 

Application of the Eating Disorder Quality Standard will be illustrated through case examples and discussion. Implementation strategies and tools will also be shared and discussed including development of a provincial centre of excellence for eating disorders, stakeholder engagement webinars, stakeholder interviews, patient guide, synopsis of the standards for clinicians, etc.  Implementation risks, facilitators and barriers will be identified together with participants and strategies for capitalizing on facilitators and overcoming risks and barriers will also be generated collaboratively with the audience in order to apply the standards in their specific context.

Learning Objectives: 

1. Identify the nine key opportunities for improving care for people with eating disorders and their caregivers, as described in the Ontario Health Eating Disorder Quality Standard.
2. Describe the tools produced to facilitate the implementation of the Quality Standard.
3. Discuss some of the barriers to the implementation of the Quality Standard, and strategies for overcoming these barriers.

Workshop: Championing new approaches to body image and eating disorder prevention programs in schools

Dr. Zali Yager, B.Ed., PhD, Embrace Hub
Ciara Mahon, PostDoctoral Researcher, University College Dublin
Denise Hamburger, CEO Be Real USA

Abstract: Schools are a critical setting for body image programs and eating disorder prevention.  As the prevalence and awareness of body image issues and eating disorders rise, many schools and teachers reach out to clinicians and researchers seeking resources and support- so, what can you give them? In this workshop, participants will be engaged in an overview of evidence-based practice for school-based body image programs and eating disorder prevention, and provided with tools and strategies to support schools in reflecting on and removing problematic policies and practice. Attendees will engage with the latest body image curricula and programs for school settings: The Embrace Kids Classroom Program for middle schools, and the Be Real Bodykind Program for High Schools. \Workshop participants will gain experience in delivering aspects of each program, and tools to champion these materials in their region, state, or country. Data from pilot trials of these resources in the U.S, Ireland, and Australia will be presented, participants will leave with a sound understanding of the evidence supporting universal and targeted program implementation in schools.

Learning Objectives: 

1. Articulate the need for evidence-based body image programs in school settings, .
2. Describe strategies to encourage schools to reflect on, and remove triggering policies and practices in relation to bodies, weight, and appearance.
3. Recommend evidence-based programs to local schools and school districts to prevent body image concerns and eating disorders.

Workshop: Difficult discussions & journeys: Listening to the lived experiences of fat members of our community

Carolyn Becker, PhD, Professor, Trinity University
Cyntha Bulik, Department of Psychiatry, University of North Carolina at Chapel Hill, Distinguished Professor of Eating Disorders, Founding Director of UNC CEED
Erikka Dzirasa, Chief MEdical Officer, Arise Health, Inc
Cheri Levinson, Associate Professor, Department of Psychological & Brain Sciences; Pediatrics, Child, Adolescent Psychology, University of Louisville
Chevese Turner, CEO, Body Equity Alliance
Lesley Williams, Senior Associate Consultant, May Clinic 

Abstract: In the early 1970’s, the Gay Activists Alliance challenged professionals who used so-called “conversion therapy” by “zapping” them at conferences. During this time, after a chance conference meeting, a surprising friendship formed between a conversion therapist (Dr. Gerald Davison) and a gay-rights activist (Dr. Charles Silverstein), who was a then graduate student. Despite a profound power differential, this friendship led to a landmark presidential address by Dr. Davison at the 1974 convention of the Association for the Advancement of Behavior Therapy (now the Association for Behavioral and Cognitive Therapies; ABCT) challenging the ethics of that intervention. Almost 50 years later, ABCT faced a 2022 reckoning for its initial role in promoting “conversion therapy.” For many current dual members of the AED and ABCT, the parallels between what 1970’s gay rights activists said about harms committed by well-meaning professionals and what present-day fat activists are saying to our community have been striking. Indeed, 14 authors from the ED community recently came together to write a paper about potential harms from behavioral weight loss treatment for a special issue on harms caused by CBT published by ABCT. The aim of this workshop is twofold. To start, five ED researchers and/or clinicians will discuss their journeys in ‘learning to really listen’ to the lived experiences of our fat activists and our patients who live in larger bodies. We will discuss journeys in rejecting diet culture and the impact that listening has had on research and clinical practices regarding weight loss treatment as well as our evolving views on the role professionals play in promoting and challenging weight stigma. This presentation also will include an activist’s explanation of her lived experiences with harm; she will further share experiences gathered from other activists. The remainder of the workshop will be interactive, aimed at fostering meaningful interaction between differing constituencies of our community around this difficult topic. There is no expectation that all workshop participants will fully agree about the topics at hand. Indeed, the panelists, including the activist, are at different stages in their own journeys of learning and grappling with where we have been and where we need to go as a community. Yet, we collectively believe that progress will only be made if we learn from the past about the importance of listening to those from marginalized communities.

Learning Objectives: 

1. Describe examples of the harms of weight stigma. 
2. Explain why some ED professionals are changing their perspectives on the acceptability of weight loss treatment.
3. Discuss why it is important for professionals in the ED field to listen to the experiences of individuals from marginalized communities.

Workshop: Collaboration, Coalition, and Community: Building Bridges in Eating Disorders Advocacy

Dr. Amanda Raffoul, PhD, Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital
Blair Burnette, Assistant Professor, Michigan State University
Phaedra Longhurst, PhD Student, School of Psychology and Sport Science, Anglia Ruskin University
Jenny Loudon, Co-Founder, Alaska Eating Disorders Alliance
Millie Plotkin, Secretary, Eating Disorders Coalition for Research, Policy, & Action
Wanqing Xu, M.S. Student, Harvard T.H. Chan School of Public Health

Abstract: Advocacy for greater eating disorders (ED) awareness, prevention, and treatment resources is increasingly seen as an important avenue for reducing their burden across diverse populations. The research literature on best practices for health-related advocacy emphasizes the need for researchers, practitioners, industry representatives, and individuals with lived experience across disciplines and fields of practice to collaborate. However, interdisciplinary collaboration may present challenges. For example, in the ED field, diverging priorities (e.g., treatment vs. prevention), framings (e.g., conceptualizations of weight), and interests (e.g., financial, health) may hinder the progress of advocacy coalition-building. This workshop, presented by the Academy for Eating Disorders Advocacy and Communications Committee (ACC), aims to equip attendees with a fundamental understanding of how to build bridges and engage in effective interdisciplinary collaboration for ED advocacy. Through a series of didactic lectures and interactive activities, ACC facilitators with expertise in research, clinical practice, activism, and lived experience will empower attendees to engage in ED-related advocacy within their own scopes of practice. Attendees will be provided with an overview of the research literature on collaboration and coalition-building in advocacy campaigns, including examples of successful ED advocacy across diverse contexts (e.g., regions, special populations). Facilitators will lead a series of guided exercises through which attendees will identify collaborators and pathways of influence in their own networks, along with instructions on how to connect with key individuals post-workshop. The workshop content will emphasize collaboration and coalition-building both within (e.g., between therapists and researchers) and outside (e.g., social media experts) the ED field, drawing on the facilitators’ diverse advocacy experiences. Finally, facilitators will engage attendees in a series of small-group discussions to tackle challenges that often arise in collaboration such as conflicting interests, differing institutional priorities, and limited resources. The workshop will close with a discussion on how to join or build a coalition to achieve tangible advocacy goals. Attendees will leave empowered to begin building collaborations and coalitions that advance ED advocacy in their own networks and communities.

Learning Objectives: 

1. Describe the purpose of collaboration in eating disorders advocacy and detail successful examples.
2. Apply collaborative advocacy skills to eating disorders advocacy across a range of professional positions and contexts.
3. Navigate common challenges and barriers to interdisciplinary collaboration in eating disorders advocacy.

SIG Panel: Integrating DBT and FBT to Treat Co-occurring Disordered Eating and Suicidal Behavior

Sponsored by the FBT SIG and the DBT & Suicide SIGBelinda Caldwell, MPH, Eating Disorders Victoria
Dr. Maria Alba, PsyD, Montefiore Medical Center
Celenia DeLapp, PhD Postdoctoral Fellow, Montefiore Medical Center
Lauren Yadlosky, PhD, Montefiore Medical Center
Lucene Wisniewski,PhD, FAED, The Center for Evidence Based Treatment-Ohio
Anita Federici, Ph.D, C.Psych, FAED, The Centre for Psychology and Emotion Regulation
Melanie Fox, PsyD, Montefiore Medical Center

Abstract: Eating disorders are difficult to treat and have high rates of morbidity and mortality. Suicidal ideation and self-injury are also difficult to treat and associated with higher rates of death. When eating disorders and suicidal behavior co-occur, treatment becomes even more challenging for clinicians, patients, and their families (e.g., “If you make me eat that, I will kill myself.”) Fortunately, there are effective evidence-based treatments that target this co-presentation of symptoms. Dialectical Behavior Therapy for Adolescents (DBT-A) is the gold standard treatment for suicidal behavior in youth, and DBT has been proven effective in treating many other disorders, including eating disorders. Maudsley Family-Based Treatment (FBT) is the gold standard treatment for Anorexia Nervosa in youth and emerging adults. DBT and FBT share many similarities including their systemic focus, principle-based nature, nonjudgmental stance, and emphasis on sequential phases of treatment. Training to deliver these treatments is difficult, time-consuming, and expensive; many clinicians shy away from doing this work, especially with systematically oppressed populations where resources are fewer. Clinicians may perceive working with eating disorders and suicidal behavior to be somber. However, inherent to both DBT and FBT is collaboration, and working so closely with families in both phase one of FBT and Multi-Family Skills Group in DBT has many moments of levity and meaning. Panelists will share how using DBT and FBT concurrently can be effective and rewarding. Additionally, panelists will discuss how the integration of FBT and DBT often elicits readily visible improvements.

Learning Objectives: 

1. Understand current research and clinical practice of effective treatments for co-occuring disordered eating and suicidal behavior.
2. Understand the similarities between DBT and FBT models, and how to integrate intervention components from both.
3. Discuss challenges and recommendations from both clinical and administrative perspectives on integrating DBT and FBT.

Workshop: Building Connections and Belonging: Service Reform by authentically embedding a lived experience

Belinda Caldwell, MPH, Eating Disorders Victoria
JD Oullette, Director, Lived Experience, EQUIP Health
Rachael Duck, Manager, Peer Mentoring Program, Eating Disorders Victoria
Bliss Jackman, Team Leader, Lived Experience, Victorian Centre of Excellence in Eating Disorders
Hannah Joseph, Recovery Coach, Eating Disorder Recovery Coaching

Abstract: Whilst the lived and living experience workforce (LLEW) has been a feature of the broader mental health sector for decades, it is an emerging professional discipline within the eating disorder sector. Given that current evidence on the impacts of the LLEW in eating disorders, highlights a significant impact on the recovery journey, it is crucial that treatment and psychosocial services consider embedding a LLEW workforce, and provide access for clients to these services.
Safe and effective use of lived experience (LE) in supporting eating disorder recovery, whether supporting individuals with an eating disorder or their families/supports, requires service planning, training, support and supervision and is maximized when underpinned by a co-design approach.
Based in the USA and Australia, workshop presenters come from a range of eating disorder settings, and engage the LLEW in numerous ways to support those impacted by and treating, eating disorders. 
In Australia, Eating Disorders Victoria (EDV) provides LE led services such as one on one and group peer mentoring programs for individuals, across diagnoses and stages of illness, including longstanding eating disorders, and for families/supports at different stages of the recovery journey. 
The Victorian Centre of Excellence in Eating Disorders (CEED)  provides LE led expertise for services and clinicians, to enhance their family inclusive practices, as well as providing individual carer consultations. 
In the USA, at EQUIP Health clinical expertise is combined with LE to provide families and young people the comprehensive support they need to undertake virtual Family-based treatment (FBT). 
Engaging with her personal LE, Hannah Joseph a recovery coach, provides LE informed and led recovery support to individuals and families.

The workshop will provide a combination of learning, showcasing exemplar services and peer work/codesign considerations, interactive activities and sharing of useful resources. The workshop is pitched at those seeking to enhance the impact of treatment and psychosocial support through engaging with the LLEW. 

Learning Objectives:

1. Enhance participants knowledge of the impacts the lived experience workforce contributes to eating disorder recovery. 
2. Identify how a lived experience workforce forms part of a treatment team . 
3. Understand codesign and coproduction values in service design. 

Workshop: ARFID Symptoms and Co-Occurring Overvaluation of Shape/Weight: Implications for Nosology, Assessment, and Treatment

Dr. P. Evelyna Kambanis, PhD, Massachusetts General Hospital/ Harvard Medical School
Sandra Mulkens, PhD, Department of Clinical Psychological Science, Maastricht University, The Netherlands
Dr. Kendra Becker, Massachusetts General Hospital
Dr. Kamryn Eddy, Massachusetts General Hospital
Dr. Jenny Thomas, Massachusetts General Hospital

Abstract: DSM-5 prohibits co-occurrence of ARFID with traditional eating disorder (ED) psychopathology, stating that ARFID cannot be conferred if an individual endorses overvaluation of shape/weight. Despite this key diagnostic distinction between ARFID and other EDs, clinical evidence describes ARFID symptoms co-occurring with other ED symptoms or onsetting during a course of ARFID treatment, challenging the notion that co-occurring overvaluation of shape/weight should preclude an ARFID diagnosis. In this workshop, participants will be oriented to the co-occurrence of ARFID symptoms and overvaluation of shape/weight and implications for nosology, assessment, and treatment. They will participate in active learning activities, including a discussion of experiences/challenges assessing and treating ARFID symptoms with co-occurring shape/weight disturbance; reviewing a series of scores/statements made by a patient to identify the most appropriate diagnosis; and choosing from evidence-based interventions to create a modular treatment for a case with co-occurring ARFID symptoms and shape/weight disturbance. First, Drs. Thomas and Eddy will begin by discussing assessments for ARFID and shape/weight-related EDs, and how to: (1) evaluate the overvaluation of shape/weight criterion when assessing ARFID to prevent instances of under- or misdiagnosis; and (2) triangulate assessments to identify cases of diagnostic overlap. Next, Dr. Kambanis will present her work on diagnostic crossover from ARFID to other EDs, focusing on both retrospective and prospective classification. Then, Dr. Mulkens will introduce her work on the cross-sectional overlap between ARFID and binge-eating disorder. Finally, Dr. Becker will discuss the emergence of shape/weight disturbance during treatment for frank ARFID and review the integration of evidence-based treatments to treat cases with ARFID symptoms and co-occurring overvaluation of shape/weight for maximum effect. The co-occurrence of ARFID symptoms with shape/weight disturbance and diagnostic shift from ARFID to other EDs represents an important clinical phenomenon that is neither robustly documented nor well understood. Following the workshops, participants will be able to critically evaluate and navigate the complex interplay between ARFID and traditional ED psychopathology, fostering a more nuanced understanding of these conditions and gaining insights into their conceptualization, assessment, and treatment. 

Learning Objectives: 

1. Following the workshop, participants will be able to conduct a nuanced assessment of the shape/weight criterion for ARFID to arrive at an accurate diagnosis.
2. Following the workshop, participants will conceptually understand how to integrate interventions for cases with overlap between frank ARFID and another eating disorder.  
3. Following the workshop, participants will be able to describe the cross-sectional overlap between ARFID and other eating disorder symptoms, as well as preliminarily describe diagnostic crossover from ARFID to other eating disorders. 

Workshop: Pediatric Rumination Disorder: Clinical manifestations & remote behavioral therapy modalities

Dr. Andra Vazzana, PhD, NYU Langone Health
Bridget Hussain, PhD, RD, CDCES, CDN, Assistant Professor of Public Health, Fairfield University

Abstract: Rumination Disorder (RD) is characterized by the persistent, repeated regurgitation of recently ingested food, which may be re-chewed, re-swallowed, or spit out.  RD is associated with faltering growth, dental erosion, dyspeptic symptoms, anxiety, depression and social rejection. With prevalence estimates ranging from 3-8% in children/adolescents, RD is relatively rare and often misdiagnosed or unidentified, resulting in delayed treatment or unnecessary invasive tests that can traumatize young patients.  Clinical training in RD is minimal and treatment protocols typically focus on developmentally disabled populations (for whom prevalence rates is arguably higher).  The marked social, psychological and nutritional impairments associated with RD underscore the need for providers to be better trained in recognizing and treating this disorder.  In this workshop, we will describe the clinical manifestations, pathophysiology and differential diagnoses of RD, as well as its medical and nutritional complications and functional impairments.  We will review the current literature on the management of pediatric RD in developmentally disabled and normative populations.  We will include nutritional strategies for helping RD patients to weight restore while reducing dependence on liquid-based nutritional supplements that are often recommended for weight gain.  The workshop will include a case study where empirically-based treatment strategies for developmentally disabled RD patients were adapted for a middle school aged boy with a prolonged history of RD.  Case-based active learning activities will include practice identifying barriers to treatment, detecting signs and symptoms of RD, developing treatment goals,  selecting appropriate interventions and harnessing parent-child relationships to enhance outcomes. Participants will engage in small group interactive role-plays in which they teach habit reversal and diaphragmatic breathing techniques to a child (including ways to increase efficacy by lengthening the breath over time).   Lastly, audience engagement activities (break-out groups, Q&A) will be used to strategize ways to cultivate a sense of belonging and foster social connections in these often isolated and stigmatized individuals. 

Learning Objectives:

1. Identify clinical manifestations, treatment goals and intervention strategies of RD.
2. Teach optimal implementation of diaphragmatic breathing to children and their parents.
3.  Adapt and apply nutrition recommendations to promote healing, growth, and a healthy relationship with food.

Workshop: Multifamily Version of Guided Self-Help Family Based Treatment for Anorexia in Adolescents

Aileen Whyte, PhD, Stanford University School of Medicine
Brittany Matheson, Clinical Assistant Professor, Stanford University School of Medicine
Eliza Van Wye, Clinical Research Coordinator,  Stanford University School of Medicine
James Lock, Professor of Psychiatry & Pediatrics, Senior Associate Chair, Departmen of Psychiatry, Stanford University School of Medicine

Abstract: Guided Self-Help Family Based Treatment (GSH-FBT) for eating disorders in adolescents has shown preliminary efficacy in pilot investigations. This treatment, delivered by videoconferencing, has the potential to expand access to care, decrease costs, and increase dissemination compared to traditional therapist-directed treatment approaches. We have adapted single-family GSH-FBT into a multifamily group format (MF-GSH-FBT). In this workshop we will aim to 1) describe GSH-FBT treatment. Short videos of the GSH-FBT platform for parents will be shown in order to allow participants to become familiar with the structure and format of GSH-FBT treatment. 2) We will describe how we adapted single-family GSH-FBT into a multifamily group format (MF-GSH-FBT). 3) We will discuss the challenges clinicians encountered in adapting to the role of facilitator/ coach rather than therapist. 4) We will discuss challenges clinicians encountered in managing group process issues. 5) We will discuss the benefits and challenges of delivery of group treatment in an online format. 6) We will discuss feedback obtained from participants in the multifamily groups in regard to their experiences of treatment. 7) We will present preliminary data on feasibility, acceptability and efficacy of MF-GSH-FBT treatment. We encourage workshop participants to actively participate in all aspects of the workshop.

1. Understand the structure and format of Guided Self-Help FBT (GSH-FBT).
2. Understand the structure and format of multifamily version of GSH FBT (MF-GSH-FBT).
3. Understand the clinical challenges in delivery of MF-GSH-FBT.