Highlights: 4 Free Tools To Work Effectively With Anorexia
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Psychology Tools Highlights brings you curated insights, tools and suggestions in bitesize form each month. You can browse, use and share however you choose, and you don’t need to be a member; these highlights are for everyone.
Today we are bringing you some of the key things our eating disorder psychologists have been using and thinking about so far this year.
1. The Importance of Ambivalence To Change
The egosyntonic nature of anorexia
First up is an excellent paper on ambivalence to change in anorexia nervosa. It examines the perceived value of a client’s illness from their own perspective, and the possible hinderances to motivation and engagement with treatment that this can cause. It includes practical suggestions and methods for bypassing pitfalls linked with the egosyntonic nature of AN.
2. Using Behavioral Experiments Effectively
Concerns about how eating will affect weight and fears about losing control are often core maintaining factors in eating disorders, including anorexia.
The best way to find out if these fears will come true is by using behavioral experiments to make dietary changes and see if weight or control changes dramatically (e.g., if a clients ‘scary’ predictions come true).
Keep in mind:
- Make sure all other factors remain constant when experimenting with changes in food intake (e.g., no additional exercise). Otherwise clients might conclude that the only reason their weight didn’t change was because they exercised more.
- Experiment length. Weight naturally fluctuates, so clients will need to make changes for an extended period (e.g., 2 – 4 weeks) to have a good idea of how it affects their weight.
- Manage expectations. Remind clients that weight fluctuates before checking their weight so they don’t jump to conclusions and overinvest in the significance of single weight readings.
3. Ambivalence To Change
Ambivalence about changing can be a real block to recovery from AN (see paper above), and is likely to change according to different symptoms e.g., binge-eating versus restoring weight, and as therapy progresses. Clinicians need to strike a balance between enhancing motivation and pushing for behavior change throughout therapy. There are lots of motivational exercises therapists can use to help resolve ambivalence, including costs-benefits analysis, creative writing (e.g., writing letters to ‘anorexia my friend’ and ‘anorexia my enemy’), and values clarification.
This motivation and ambivalence worksheet can be used to help clients reflect on the advantages and costs of changing vs not changing. You can download this resource and try it for free if you set up a free trial account.
4. Worth a Watch
Glen Waller: CBT For Eating Disorders
Whilst not just relating specifically to anorexia, this is a really good video recording of Professor Waller introducing CBT for Eating Disorders.