2017 Eating Recovery Foundation Conference

Denver, Colorado
Friday, August 04, 2017




Session Descriptions - Friday, August 4


Friday, August 4, 8:45-10:15am (General Session 1.5 CE)
Philip S. Mehler, MD, CEDS, FACP, FAED
“Advancing recovery and improving health outcomes with significant learnings from a new, landmark medical study of 1,000 patients”
Description coming soon!


Friday, August 4, 10:30am-12:00pm (General Session 1.5 CE)
Julie Friedman, PhD and Kara Richardson Whitely
“Overcoming Obstacles in the Treatment of Loss of Control Eating: Strategies for Identifying
and Treating Patients with Binge Eating Disorder – A Provider and a Recovered Patient
Perspective”
In this presentation, Dr. Julie Friedman will provide an overview of Binge Eating Disorder, as well as strategies for identification and treatment. Kara Richardson-Whitely is the author of Gorge: My Journey up Kilimanjaro at 300 Pounds, and she shares her personal experience recovering from binge eating disorder.

Friday, August 4, 12:15-1:45pm (Lunch & Presentation - General Session 1 CE)
Doug Weiss, MBA; David Bachman; Nicole Griswold;
Katherine Harner, LCPC; and Stephanie Setliff, MD
“Ah Ha! Moments in the Patient Journey”

Listening in on the patient journey to improve treatment and recovery; perspectives from
a parent, recovered patient, insurance care manager and physician.
In this listening session, attendees will hear from a panel of individuals affected by eating disorders –perspectives of a family member, recovered patient, insurance care manager, and treatment provider. The panel will discuss the relationship between patient-centric treatment and positive treatment outcomes, and use personal voice to represent the Stages of Change Model within the scope of eating disorder recovery.


Friday Breakout Sessions

Friday, August 4, 2:00-3:00pm

Friday Afternoon Breakout 1
Moved to Saturday

Friday Afternoon Breakout 2
Linda Lewaniak, LCSW, CAADC, and Robyn Cruze, MA
Treating Co-Occurring Eating Disorders and Substance Use: Provider Tools and a Recovered Patient Perspective
When our focus is on recovery and a healthy relationship to self, others and community, it is necessary to address how one's pattern of behaviors have gotten in the way of valued living. Our third wave behavioral models stress the importance of tracking the contingencies of all behavioral choices and helping the individual and family move in a direction that is more functional overall. Therefore, if we do not address substance use or related process addictions simultaneously, and the person wholly, the individual is at risk for symptom substitution. This presentation will outline considerations for programs treating these issues together and how to keep the individual and family focused on healing in a direction of vitality.


Friday Afternoon Breakout 3
Ralph Carson, LD, RD, PhD
Targeting Exercise Abuse in Patients with Eating Disorders: Is Incorporating Healthy Exercise an Alternative?

Excessive exercise in patients struggling with anorexia is a paradox since they are underweight and undernourished. Such heightened activity would seem challenging and aversive in a state of fatigued and exhaustion resulting from starvation. Though there are numerous reasons why physical activity should be excluded during treatment; updated research supports that inclusion of exercise can be beneficial and reintroduced under the supervision of a multidiscipline treatment team. This presentation explains the etiologies of compulsive exercise in the eating disorder population and addresses recommendations for designing activity protocols during and following treatment. 


Friday Afternoon Breakout 4
Jennifer Gaudiani, MD, CED
Unique Outpatient Medical Issues in Patients with Eating Disorders: Not Always Measurable, Always Worth Addressing

Patients with eating disorders in the outpatient setting suffer from a wide variety of medical issues, some related directly to their eating disorder, and some present as other unrelated, primary diagnoses. Many patients with eating disorders are viewed with bewilderment or suspicion by the primary care system, where lack of awareness of eating disorder medicine by providers is a barrier that is reinforced by the often somatic, unmeasurable nature of symptoms patients experience. However, excellent outpatient care of patients with eating disorders must include thoughtful, evidence-based, and non-assumptive diagnosis and treatment. In this case-based workshop, medical issues that recur in outpatients with eating disorders will be reviewed in a way that will allow attendees to become better advocates and clinicians for these patients. Topics include intractable nausea and vomiting, postural orthostatic tachycardia syndrome, mast cell activation, resumption of menstrual cycles and fertility, irritable bowel syndrome, pelvic floor dyssynergia, and more.


Friday Afternoon Breakout 5
Deborah Michel, PhD, CEDS, and Brittany Gilchrist, MA, LPC
Integration of Spirituality into Evidence-Based Practice

Spiritual belief systems have recognized forms of mindful meditation as valued practice for many years. The recent interest in, and practice of, mindful meditation along with increased research in this area, is an example of how components of spirituality can be integrated into evidence-based practice. As evidence-based therapies and empirically supported treatments have moved to the forefront in caring for the emotional health of those who seek eating disorders treatment, addressing spiritual needs may be neglected. Holistic patient care occurs when both emotional and spiritual needs are discussed. Many elements of evidence-based practice naturally integrate with patients’ spiritual belief systems. When they are combined, the aspect of evidence-based practice that is rooted in patient values, preferences, and characteristics can often be addressed. An integrated model of spirituality and evidence-based practice in eating disorders treatment will be presented including experience techniques and illustrative case examples.

Friday, August 4, 3:15-4:45pm (General Session 1.5 CE)
Bonnie Brennan, MA, LPC, CEDS; Zach Rawlings, MA, LPC, PsyD Candidate; and Lisa Constantino, MA, LPC
“Treating Eating Disorders within the LGBTQ+ Community”

Although the LGBTQ+ community has gained much social and political success in the past few years, the mental health of many of its members still struggles. The most recent CDC report indicated that LGBTQ+ members between the ages of 10 and 24 are four times more likely to commit suicide than their straight peers. Of men who are in eating disorder treatment, 42% of them are gay (even though gay men constitute only approximately 5% of the population). Another study found that trans college students are five times more likely to develop an eating disorder than their cis-gendered peers. Although there are similarities between treating heterosexual and LGBTQ+ individuals, some consideration should be given to this community considering the higher levels of mental distress among its members. This seminar will focus on some of the etiology for the development of eating disorders, and recommended clinical practices when working with LGBTQ+ individuals.

Friday, August 4, 5:45-7:30pm (Dinner & Presentation - General Session 1 CE)
Panel discussion with Margo Maine, PhD, FAED, CEDS;
Beth McGilley, PhD, FAED, CEDS; and Jenni Schaefer; moderated by Julie Holland Faylor,
MHS, CEDS, F.iaedp
“Recovery Then, Now and Later”
This plenary panel addresses the concept of recovery as it’s been conceptualized and experienced over time. Moderated by Julie Holland-Faylor, MHS, CEDS, Dr. Margo Maine will lead the panel, reviewing her seminal qualitative examination of recovered patients in 1985, comparing their experience to those recovering in the 21st century. Jenni Schaefer will follow this historical perspective with current reflections on her experience of the shift from recovering to being fully recovered, how her recovery was impacted by recovered vs. non-recovered professionals and their use of self-disclosure. Dr. Beth McGilley, recovered for more than 30 years, will discuss the personal and professional challenges she’s faced as a recovered therapist, and her efforts to create an empirically derived consensus definition of recovery. Finally, the panelists will address the populations who’ve been overlooked in the recovery literature, including males, children, mid-lifers, patients with binge eating disorder, and ethnic and sexual minorities.

Session Descriptions - Saturday, August 5

Saturday, August 5, 8:30-10:00am
Session hosted by Eating Recovery Center Family Institute
Adele Lafrance, PhD, CPsych
“Emotion-Focused Family Therapy”

Parents and caregivers DO NOT cause eating disorders. In fact – what we know is that parents and caregivers are the best resource for recovery – they just need some support, some skills and some coaching. Emotion-Focused Family Therapy is an incredible resource for parents and caregivers of individuals struggling with an eating disorder, regardless of their age. The essence of this new approach is to afford families a significant role in their loved one’s recovery from an eating disorder, and to empower parents and caregivers with specific skills to be effective in this role.  The premise for the work is based in a deep belief in the healing power of families. Through education, video demonstration and skills practice, parents and caregivers will become equipped with practical strategies with respect to 1) meal support & symptom interruption, and 2) emotion coaching (and relationship repair if applicable). Parents and caregivers will also be supported to 3) identify, work through and overcome many fears and obstacles that surface in this challenging and novel journey. The specific skills taught are meant to be effective regardless of the affected individual’s age or motivation for change.

Saturday Morning Breakout Sessions
Saturday, August 5, 10:15-11:45am


Saturday Morning Breakout 1
Jocelyn Lebow, PhD
Integrative Cognitive-Affective Therapy for Adolescent Eating Disorders (ICAT-A)

Despite the relatively high prevalence, serious comorbidities and life-threatening consequences of bulimia nervosa (BN) and binge eating disorder (BED), few well-validated treatments exist for these conditions in adolescents. The few treatments that have been empirically studied have remission rates of less than 50%. There is a clear need for additional treatment options for these young patients. Integrative Cognitive-Affective Therapy (ICAT) has shown promising results for adults with BN and BED, and it follows that the treatment might have similar efficacy in adolescents. This presentation will introduce a modified version of ICAT, developed specifically for use with an adolescent population (ICAT-A). Modifications include adapted materials with increased relevance for the developmental needs of younger patients, as well as additional modules designed for the inclusion of parents/guardians. Clinical applications and future directions will be discussed.


Saturday Morning  Breakout 2
Lara Schuster-Effland, LCSW
Finding Optimal Activation: Behavioral Interventions for the Over and Under Activated Eating Disorder Client

Eating disorders inevitably immobilize our clients due to the high intensities of fear and distress, the common way our clients cope is to seek relief by avoiding the things, persons, and places they think cause this distress.  Eating disorders also immobilize due to loss of positive experiences and our clients struggle to find the energy and motivation to try to regain back the things they have lost.  We can use exposure therapies to help our clients face the things they fear and avoid.  Also, the use of behavioral activation to help them regain connection and positive feelings in their life.  These therapies have similar processes and similar outcomes, however, sometimes it is hard to know which therapy to use to help our clients achieve what they are looking for.

Saturday Morning  Breakout 3
Kristie Amadio, B App. Soc. sci (Counseling). Mcouns
Revolutionizing Recovery: Innovative Uses of Video Platforms in the Treatment of Eating Disorders
Not everyone has ready access to face-to-face support.  Online practice is a fast growing field reaching all demographics and countries.  Targeting the post-residential continuum of care, this presentation will explore the effective uses and scope that videoconferencing technology offers individuals and clinicians.  It will discuss current systems designed to mitigate the barriers of technology in treatment and will share available HIPPA compliant technology resources that can be used by professionals in the eating disorder field.

Saturday Morning Breakout 4
Marci Evans, MS, CEDRD-S, LDN, cPT
When Elimination Diets Aren’t The Answer: Effective and Safe Solutions to Support Eating Disorder Recovery and Gastrointestinal Health
Gastrointestinal complaints plague over 90% of eating disorder patients at all levels of care. These complaints compromise quality of life, exacerbate negative body image, and stall efforts toward full recovery. In this information packed session, eating disorder expert Marci Evans will explain the complex intersection of GI and eating disorders, how to provide a detailed and purpose-driven assessment, laboratory testing and medical procedures specific to the GI system, and the newest research relating to the microbiome. You will leave with a multi-faceted toolbox of non-triggering interventions to vastly improve the quality of life of your patients.

Saturday Morning Breakout 5
Kathryn Bruno, MT-BC and Rachel Haines, MA, R-DMT, LPC
Listening and Moving: Exploring the Use of Music Therapy and Dance/Movement Therapy with Individuals Struggling with Eating Disorders

At first glance, creative arts therapies may appear to only offer individuals with eating disorders an alternative and enjoyable way to express themselves. Indeed, these therapies often facilitate those opportunities, but they simultaneously facilitate progress on a range of important goals that are vital to recovery from an eating disorder. Through explication of research, dynamic case examples, and experiential learning, this presentation will explore how music therapy and dance/movement therapy support physical, emotional, social, and cognitive treatment goals. The presenters will highlight opportunities for clinicians to collaborate with creative arts therapists, as well as how to integrate the arts into their own practice in both the inpatient and outpatient settings. Attendees will actively engage in the learning process by moving, listening, and playing instruments.

Saturday, August 5,1:00-2:30pm
Craig Johnson, PhD, FAED, CEDS and Anne O’Melia, MS, MD, FAAP
“Caring for the Chronically Ill Patient”
Description coming soon!

Saturday Afternoon Breakout Sessions
Saturday, August 5, 2:45-3:45pm


Saturday Afternoon Breakout 1
Kate Daigle, MA, LPC
Conceiving A Healthy Recovery: Exploring the Connection Between Eating Disorders and Shame Related to Fertility, Pregnancy, and Postpartum Recovery
There is insufficient research on the intersection of eating disorders with fertility and pregnancy issues, yet research has shown that 20.7% of patients struggling with infertility have had an eating disorder. Psychotherapy with this population can reveal shame rooted in unexpected difficulties in conception, pregnancy or early motherhood. The lack of open discussion around these topics increases internalized judgment and self-criticism. This presentation will focus on issues arising from challenges conceiving, sustaining a healthy pregnancy, and mother-child bonding in women who have had an eating disorder. Discussion will examine research linking the presence of AN, BN or BED to fertility issues and experiential exercises exploring how to process this with clients. Following this presentation, attendees will be able to identify three fertility issues linked with eating disorders, have specific tools to work with clients experiencing fertility issues, and an understanding of how eating disorders affect the mother-child attachment in recovery.

Saturday
Afternoon Breakout 2
Sara Gould, PhD, ABPP and Beth Harrell, MS, RD, LD, CEDRD-S
What You Don’t Know CAN Hurt: The Importance of Care Coordination in Caring for Clients (and Yourself)

Eating disorders cannot be treated successfully by a single discipline or with fractured care. Specialists understand that communication among providers results in the best outcomes. We will highlight examples of successful and unsuccessful coordination as patients move among providers and across levels of care. These examples will facilitate discussion of both the crucial impact of care coordination and how to coordinate effectively. All levels of care will be discussed, as will communication strategies facilitating transitions as the patient moves from one level to another. Finally, difficult cases and the longevity of eating disorders treatment require personal self-care for providers. Care coordination can support self-care by providing an avenue for case consultation, preventing isolation, and helping providers emotionally “release” a patient to a different team or discipline. Examples will be provided of both care coordination enhancing provider self-care and of poor care coordination draining provider emotional resources.

Saturday Afternoon Breakout 3
Jill Sechi, MS, RDN, CEDRD-S, LD and Meredith Cook, LPC-S, CEDS-S
Don’t Tell my Dietitian, But…: The Ten Commandments of Collaboration

Treating clients with eating disorders on an outpatient basis is much more than 1 hour a week. Effective collaboration involves frequent communication, being on the same page, and supporting the client and family all with the intention of moving toward recovery. A collaborative approach in the treatment of eating disorders can no doubt be daunting. Obstacles arise in working to respect other provider's opinions while not stepping on toes, avoiding client splitting, and navigating scheduling challenges to provide effective communication. "Thou shalt" takes on a whole new meaning as we explore The Ten Commandments of Collaboration


Saturday Afternoon Breakout 4
Rebecca Wagner, PhD
Get Your ACT Together: A Guide to Recovery from an Eating Disorder

Recovery from an eating disorder is complex and takes time. Along the way, developing skills, building relationships, gaining independence and learning to feel better about oneself are vital. Evidence-based treatments and supporting exercises designed to foster recovery will be presented to aid eating disorder patients cultivation of a life worth living. 

Saturday, August 5, 2:45-3:45pm
Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS; Elizabeth Easton, PsyD;
and Cindy Pikus, PhD, CEDS
“Avoidant-Restrictive Food Intake Disorder (ARFID) 2.0: Interventions and Case Study
Discussion”
In this presentation, Dr. Ovidio Bermudez will define and describe the new diagnosis included in the DSM-5, Avoidant/Restrictive Food Intake Disorder (ARFID), and how to effectively recognize and manage the illness.  Dr. Bermudez will discuss the definition of ARFID types including Avoidant, Aversive, Restrictive, Mixed Type, and  ARFID “Plus,” as well as the developmental context of ARFID, and will discuss relevant research papers published within the last five years.  Presentation slides include citations regarding data available on epidemiology, disease course and prognosis.  Finally, he will outline the four critical steps in managing the illness, which include initial assessment, four types of specialty assessments (Medical, Psychiatric, Nutrition, and Psychotherapist), education of patient and families, and interventions.  In the second half of the presentation, Dr. Cindy Pikus and Dr. Elizabeth Easton will discuss case examples of patients with ARFID (two adults and two children) to illustrate the assessment, diagnosis, and treatment of ARFID.  Throughout, the presenters will highlight best practices and recommendations to most effectively treat this patient population.

 

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