chapter  4
26 Pages

COUNSELING INTERVENTIONS

Introduction The inspiration for our counseling interventions comes from an eclectic mix of five different models, namely: cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), family-based therapy (FBT), motivational interviewing (MI), and, most recently, acceptance and commitment therapy (ACT). We chose these models for several reasons. In the beginning of our practices, CBT was the most revered and evidenced-based model for the treatment of eating disorders (EDs), namely, bulimia nervosa (BN). The well-thumbed chapters on CBT treatment for anorexia nervosa (AN) and BN in the Handbook of Treatment for Eating Disorders (2nd ed.; Garner, Vitousek, & Pike, 1997; Wilson, Fairburn, & Agras, 1997) and Fairburn, Marcus, and Wilson’s (1993) comprehensive CBT treatment manual for BN and binge-eating disorder (BED) helped launch our evidence-based approach to nutrition counseling in the treatment of EDs. Although CBT has since fallen somewhat out of the limelight, we believe it to be “the mother” of the newer models and the foundation of our work. This is especially evident with the new enhanced version of CBT (CBT-Enhanced), which incorporates many of the nutrition counseling techniques we have used over the years, namely: educating about weight and ED symptoms; weekly weighing; realtime monitoring of eating behaviors; reducing evaluation of shape and weight on self-value; establishing a regular eating pattern; and maintaining and preventing relapse (Fairburn et al., 2009; Karbasi, 2010; Wagner & MacCaughelty, 2011; Wonderlich, 2009).