Dialectical Behavioral Therapy for Eating Disorders

Eating disorders are complex mental health illnesses that require treatment that is both comprehensive and multifaceted. When such treatment is provided to individuals struggling with eating disorders, they are capable of making profound changes and leaving their disorders in the past and moving towards a future full of hope and purpose.

At Center for Hope of the Sierras, eating disorder treatment is enhanced by the application of four principles of a therapeutic methodology known as Dialectical Behavioral Therapy (DBT).

DBT can help patients eliminate negative behaviors from their lives.

DBT can help patients eliminate negative behaviors from their lives.

About DBT

DBT was originally developed for women with borderline personality disorder. As researchers studied the therapy 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.

Center for Hope’s eating disorder programs integrate the core DBT principles that have been found to be most effective in helping people to overcome eating disorders and find life-long recovery.

Core Principles
At Center for Hope of the Sierras, individuals benefit from a treatment approach that emphasizes the following core principles that are 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 because many individuals suffering from eating disorders have allowed their disorder to replace (or overwhelm) their relationships with other people.

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

By helping our 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. Since DBT places such a premium on validation and acceptance, the non-judgmental principle is particularly beneficial in eating disorder treatment.

At Center for Hope of the Sierras, individuals heal in an environment that is geared toward positive outcomes, which don’t demean the choices they have made in the past or the struggles they are currently enduring.

For example, instead of judging a behavior, individuals learn to describe the consequences of that behavior. This de-emphasizes the desire to assign blame, and instead, focuses individuals 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 individuals whose struggles with eating disorders have caused them to think in rigid “black and white, right and wrong” ways, learning to engage in dialectical thinking allows them to consider – and reconcile – two seemingly divergent concepts.

One of the most common dialectics is acceptance and change. For example, in a program such as Center for Hope, where DBT principles are incorporated into eating disorder treatment, professionals accept individuals 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.”

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