At Center for Hope of the Sierras, Core DBT Principles Help Clients Overcome Eating Disorders

Eating disorders are complex mental disorders that resist simple solutions.

But that doesn’t mean that a few core fundamentals can’t play an important role in an effective eating disorder treatment program.

At Center for Hope of the Sierras, a residential recovery program in the foothills of the Sierra Nevada mountains, eating disorder treatment is enhanced by the application of four principles of a therapeutic methodology known as dialectical behavioral therapy (or DBT).

About DBT

If you or someone you know has been struggling to overcome an eating disorder, you have probably spent considerable time and effort educating yourself about causes, symptoms, effects and treatment options.

But your research may not have yielded much information about DBT. Don’t worry -- that doesn’t mean that you’ve been lax, or that DBT isn’t an effective (or accepted) approach for eating disorder treatment.

DBT was originally developed for women with borderline personality disorder. As researchers studied the procedure further, they discovered that it is also effective for women who are struggling with eating disorders.

An Emphasis on Validation & Acceptance

Developed by Dr. Marsha Linehan and her colleagues at the University of Washington, DBT incorporates principles of cognitive behavioral therapy while placing an emphasis on validation and acceptance. According to a 1993 article by Dr. Linehan, any effective form of comprehensive psychotherapy (such as DBT) must meet the following criteria:

1. Enhance and maintain the client’s motivation to change.
2. Enhance the client’s capabilities.
3. Ensure that the client’s new capabilities are generalized to all relevant environments.
4. Enhance the therapist’s motivation to treat clients while also enhancing the therapist’s capabilities.
5. Structure the environment so that treatment can take place.

Though the Center for Hope’s eating disorder programs don’t incorporate all of the components of DBT, they do integrate core principles that have been found to be most effective in eating disorder treatment.

Core Principles

At the Center for Hope of the Sierras, eating disorder patients benefit from a treatment approach that emphasizes the following core principles (all of which are also integral to DBT):

1. The primacy of the therapeutic relationship
2. A non-judgmental approach
3. Differentiate between effective and ineffective behaviors
4. Dialectical thinking

The Primacy of the Therapeutic Relationship

The relationship component plays such an important role in eating disorder treatment at Center for Hope of the Sierra because many eating disorder patients have allowed their disorder to replace (or overwhelm) their relationships with other people.

Through DBT treatment, these women are once again able to develop and maintain healthy and effective relationships with other people, and are able to place their relationship with food in its proper context.

By helping clients learn to develop and maintain healthy interpersonal relationships, Center for Hope therapists provide them with a means of addressing stresses and pressures without descending back into their disorder.

A Non-Judgmental Approach

As with many mental health challenges and behavioral issues, eating disorders are often accompanied with a sense of shame and self-loathing. Because DBT places such a premium on validation and acceptance, the non-judgmental principle is particularly beneficial in eating disorder treatment.

At the Center for Hope of the Sierras, clients heal in an environment that is geared toward positive outcomes -- but which doesn’t demean or otherwise cast aspersions upon the choices they have made in the past or the struggles they are currently enduring.

For example, instead of judging a behavior, DPT patients learn to describe the consequences of that behavior. This de-emphasizes the desire to assign blame, and instead focuses clients on discovering how behavioral changes can allow them to achieve the outcomes that they desire.

Differentiating Between Effective & Ineffective Behaviors

The emphasis on a nonjudgmental approach goes hand-in-hand with the third core principle, which involves differentiating between effective and ineffective behaviors.

This approach removes shame and guilt from the process, as behaviors are not evaluated as “good” or “bad,” but instead are discussed in terms of the outcomes they lead to.

Freed from having to defend themselves from subjective criticisms, clients at Center for Hope of the Sierras can instead focus on determining which behaviors will allow them to achieve the lives they desire.

Dialectical Thinking

Dialectical thinking is about balance, not extremes.

For women whose struggles with eating disorders have caused them to think in rigid “black and white, right and wrong” ways, learned to engage in dialectical thinking allows them to consider – and reconcile – two seemingly divergent concepts.

One of the most common dialectics is acceptance & change. For example, in a program such as Center for Hope, where DBT principles are incorporated into eating disorder treatment, professionals accept clients just as they are, while simultaneously teaching them how to change.

As one Center for Hope therapist put it, “The thing I frequently say to people is ‘I know you’re doing the best that you can, and you need to do better. It’s acceptance of who they are just in this moment, as well as encouraging them to change to be more effective in their lives.”

About Center for Hope of the Sierras

Center for Hope of the Sierras provides a small, intimate environment that is ideal for healing and recovery. The Center offers residential and partial hospitalization programs for women and adolescents (ages 16 and above) who are struggling with anorexia nervosa, bulimia nervosa and related eating disorders.

The mission of Center for Hope of the Sierras is to welcome each client with an excitement about their willingness to heal and with respect for the courage it takes to enter treatment. The Center’s treatment philosophy emphasizes compassion, dignity and a commitment to each individual’s unique healing process.