The Initial Evaluation:
Dr. Erwin, the Clinical Director, sees all new patients for an initial evaluation. Dr. Erwin, having worked in the field for over 20 years, asks patients questions about their eating behaviors, how long they feel they have been experiencing difficulty with their body image, eating, and other questions that relate to self-image, self-esteem, and personal history. If a new patient comes with friends or family, Dr. Erwin will usually ask the patient if it would be all right if those persons come in for part of the time to ask questions or provide information.
At the end of the Initial Evaluation, Dr. Erwin will give the patient feedback about how serious he thinks the patient's eating disorder might be and what sort of treatment is needed. If the patient is having a very difficult time and faces an imminent medical emergency, Dr. Erwin will arrange for immediate medical care. But, most often, a plan of outpatient treatment is developed such as weekly psychotherapy, nutritional counseling, and, when the patient is ready, group involvement. The treatment plan is thoroughly discussed with the patient and their family; and there is careful consideration given to such issues as travel to treatment, family resources, school, and extracurricular activities, etc.
Individual Psychotherapy:
Individual psychotherapy sessions are 45 minutes long in the Eating Disorder Program, and most patients have 1-3 sessions per week. The theoretical approach in our program is primarily cognitive-behavioral, and it draws heavily on other orientations, such as family systems, feminist views of personality development, and interpersonal psychology. Our therapists are active, interested individuals who relate to their patients in open, honest ways. We see the search for recovery to be a collaborative effort, and through our experience, understand and empathize with our patients' struggles. Everyone who provides psychotherapy in the program is thoroughly experienced with eating disorders, and has worked in hospitals and clinics. There are four individuals available for individual psychotherapy in the program: Dr. Erwin, Brunella Demarco, Holly Clark, and Lauren Catania. Their backgrounds are provided in the section on Our Staff.
Nutritional Counseling:
Nutritional counseling is provided by Liz Ebner and Hilary Turett , both of whom have Master's Degrees and are registered dietitians. Liz and Hilary have extensive professional and personal experience with eating disorders. After an initial nutritional evaluation, patients begin to develop a path out of their unhealthy eating beliefs and habits with Liz or Hilary as their guide. Liz and Hilary realize that the path to recovery is very difficult, often with setbacks, unique challenges, fearful situations, and deep doubts. They address all of this in their work, along with helping patients understand more about their bodies, what the eating disorder is really doing to them, and what sort of nutritional plan is at the right level of challenge and forward movement. Patients do not have to be weighed or have their body composition measured, although it is often part of the nutritional counseling effort. With our kitchen available, Liz and Hilary often can give examples of foods and labels during the session, which makes the information that much more real and useable for patients.
Medical Management and Medication:
One of the first pieces of information Dr. Erwin looks for in the initial evaluation is the extent to which the patient has received thorough and appropriate medical treatment for the eating disorder. Often, Dr. Erwin will send the patient back to their primary care physician (family doctor or pediatrician). Medical referrals may include a note suggesting bloodwork or an evaluation for delayed gastric emptying (which causes premature fullness after eating, often the result of restricting or purging) or reporting some other symptom the patient describes. If the patient does not have a physician, or is not comfortable with their current doctor, Dr. Erwin will recommend a physician who is very familiar with eating disorders and who has experience medically managing these complex illnesses. Communication and cooperation between Monmouth Psychological and patients' medical doctors is considered a very important part of treatment.
Groups:
We consider Group Psychotherapy to be a very important dimension of treatment. In a group, a person struggling with an eating disorder can learn that the thoughts, behaviors, and issues that they are dealing with are shared with others who they can learn to trust through the group discussion process. In a group, participants feel less alone, and are able to share their commitment to getting better and get the support of others going through the same situation. It also becomes a place to practice honest, effective expression of feelings and ideas.
Family Education:
Helping family and friends better understand what it is like to suffer and struggle with an eating disorder is a very important, ongoing part of treatment at Monmouth Psychological Associates. Family therapy is usually done by the patient's individual therapist, and occurs as it is needed. Friends and families are encouraged to learn more through their own counseling, as well as by using videos and books. Groups just for family and friends are organized on a monthly basis. |
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