Treatment for Eating Disorders - and many other mental or emotional health difficulties - can feel like a minefield. There are so many options and acronyms that it can be hard to know which treatment to choose, to best suit you. In this blog I'm going to try to clear up some of the confusion and explain the models that are most often offered when treating Eating Disorders, so that you can make an informed choice for yourself or your loved one.
There are many models of therapy, and some may be more appropriate for your needs at any given time than others. When choosing a therapist it may be helpful to understand a little about the approach that they use. I would encourage you or your loved one to have a session with a therapist before deciding to embark on a course of therapy with them, to ensure that you feel that their way of working will meet your current needs. For the purpose of this blog we will be looking at individual therapy rather than group, family or couples therapy, which also have their place in the treatment of an eating disorder.
Cognitive Behavioural Therapy – Referred to as ‘CBT’, this approach is solution focussed, aiming to change dysfunctional behaviours (i.e. vomiting or laxative abuse) which are believed to stem from maladaptive, or unhelpful, thought processes, in order to alleviate distress in the ‘here and now’. CBT doesn’t focus on exploring the past, or explicitly on the relationship between therapist and client. CBT may be delivered as a manualised (using a workbook) therapy with the support of a therapist, or it may be more tailored to your specific problems; you are likely to be given homework to be completed between sessions. CBT is time limited and depending on your problem you would usually be offered between 6 and 20 sessions.
Cognitive Analytic Therapy – Referred to as ‘CAT’, this is again a time limited (6-24 sessions) therapy, which uses the cognitive and behavioural aspects of CBT but also includes some exploration of the experiences and relationships from the past which underpin the thoughts, feelings and behaviours that are being experienced currently. CAT promotes the development of a trusting relationship between the therapist and the client. Elements of this relationship are drawn upon explicitly in the course of the therapy in order to explore how past relationships influence current expectations of others and of yourself.
Interpersonal Psychotherapy – Referred to as ‘IPT’, this is a time limited therapy which takes into account biopsychosocial factors (such as genetics, attachment style and personality) which might affect your capacity to manage distress and focuses on interpersonal, (relationship and social interaction) issues, with the aim of improving social support and relational functioning in the belief that these new support systems and ways of interacting will de-escalate crises and help to alleviate distress when they may arise.
Psychodynamic Psychotherapy/Counselling – This can be delivered as a short term or long term therapy, it focusses on unconscious aspects of behaviour and specifically explores childhood relationships and experiences. The ‘dynamics’ of the relationship between therapist and client are explicitly explored using the ‘transference’ (the term used to describe the feelings that are experienced by the client towards the therapist, which are thought to be reflective of feelings produced by early relationships, that can now be worked through in therapy in a way that might not have been possible before) and counter-transference (the therapist’s corresponding feelings towards the client).
Gestalt Psychotherapy/Counselling – Gestalt therapy focusses on the client as a whole person, inclusive of physical, mental and spiritual aspects. Therapists are likely to foster an environment of experiential experimentation, and so therapy is likely to involve the acting out of scenarios, the use of dreams, and encourages awareness and mindfulness in order to promote acceptance which in itself can support change.
Humanistic – Humanistic counselling and therapy promotes personal-development and self-actualisation, or the reaching of one’s highest potential. The positive, empathic, congruent and genuine relationship between therapist and client is seen as being the catalyst for change. A client’s creativity is likely to be promoted and used as a tool for exploration of all aspects of your ‘self’.
Psychoanalytic Psychotherapy – Psychoanalytic Psychotherapy is an in-depth examination of the impulses, perceptions and thoughts rooted in the subconscious mind of the client which give rise to mental distress, conflict and disturbance. Psychoanalysts actively listen and offer interpretations or understanding of the client’s distress and help the client to think about their difficulties in a manageable way. Psychoanalytic psychotherapy is a longer term therapy and sessions may be held more frequently than the once a week which is usual for other forms of therapy. The transference relationship (as described in the section on Psychodynamic Psychotherapy) is seen as central to the therapeutic experience of psychoanalysis.
Integrative Psychotherapy/Counselling – Integrative Psychotherapists/Counsellors draw on a variety of models and therapy may be short or long term. The integrative therapist aims to tailor therapy to best meet a client's current needs, using techniques, ideas, and perspectives from any or all of the above approaches.
I myself am an Integrative therapist and as such I draw from all of the above models and believe that each model can be useful depending on the current needs of the client. I generally feel that it is useful to explore a clients past to some degree in order to understand current behaviour and thought processes. This I find helps to solidify change, rather than fixing a problem without really understanding its function - which often leads to the development of other problems - as the original 'need' continues to be unmet.The development of a trusting therapeutic relationship is the cornerstone of all of my work, and I often encourage clients to use our relationship to explore themselves and their patterns, and experiment with different ways of being.
If you'd like more information about the services I offer or to book an introductory session I can be contacted on firstname.lastname@example.org, or via my website www.kymnetherton.co.uk or you can follow me on facebook click here