Why Providers Must Stand Up and Join the March Against ED

This post was written by our Community Outreach Coordinator as a guest blog for the March against eating disorders.  It was originally posted on marchagainsted.com and has been cross posted here with their permission.


Teacher
Nurse
Barista
Artist
Accountant
Grandmother
Student
CEO
Musician
Author
Mom
News Anchor
Military Officer
College Athlete
Dad

They care for you, entertain you and bring you joy.  They protect you and teach you, create things for you.  They help you and mentor you. They are varied. They are diverse. They are important.

They are people you might see every day.

And they are people we might see every day in the course of providing care and treatment for individuals and families impacted by eating disorders.

MOM March 2014At The Center for Eating Disorders at Sheppard Pratt, we see numerous people each day struggling with anorexia, bulimia, binge eating disorder, ARFID and other feeding and eating disorders.  These individuals with eating disorders are varied.  They are diverse. They are important.

This is why we were proud to participate in the inaugural March Against Eating Disorders on Capitol Hill last fall and why we are eager to return this year on October 27th for an even larger and more impactful event. As physicians, therapists, dietitians and nurses specializing in the treatment of people with eating disorders, we see the daily struggle, the medical repercussions, the fear and the impact of eating disorders on relationships, careers and families.  But we also see the hope, the healing and comfort that comes with treatment and recovery.  That is why it’s so important for those of us in the field to stand up and share our voices too.

Why do we march?  

  • We march because eating disorders continue to be stigmatized, sensationalized, overlooked and underfunded despite having the highest mortality rate of any mental illness.
  • We march because no one chooses to have an eating disorder.  Eating disorders are highly heritable illnesses, meaning 50-80% of a person’s risk for developing an eating disorder is genetic. Additional causes are varied and complex.
  • We march because no family should hear “it’s just a phase, she’ll grow out of it.” from a medical professional before they make it through our doors. A lack of specialized eating disorder training for physicians delays detection and appropriate referrals. Delaying treatment delays recovery.
  • We march because 20-30% of our patients are men who thought they were the “only one” and suffered in silence for a long time. Eating disorders don’t discriminate and treatment shouldn’t either.
  • We march because parents do not cause eating disorders but eating disorders can cause heartache for parents and family members. Guilt, blame, stigma and outdated stereotypes can prevent families from getting the help they deserve. Current research supports an understanding that caregivers can play a positive and integral role in helping a loved one to heal from their eating disorder.
  • We march because eating disorders can be deadly but they can also be overcome.  Early intervention and evidence-based treatment makes a difference.
  • We march because no one should have to get sicker before they can get well. Insurance coverage for eating disorders must not be a barrier to quality care.
  • We march because we live together in a culture that equates weight loss with health, yet we work every day with individuals whose weight loss is associated with osteopenia, hair loss, fatigue, cardiac arrhythmia and infertility.  We support a movement that embraces health-focused goals for our schools and communities instead of weight-focused goals.

These are just some of the reasons why we are excited to stand with The Alliance for Eating Disorders Awareness, The Eating Disorder Coalition, and MAED – Mothers Against Eating Disorders at The #MarchAgainstED in our nation’s capitol.  Join us on October 27th to take a stand and help increase awareness about eating disorders.

Why will you march?  

Register now at www.MarchAgainstED.com

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Written by Kate Clemmer, LCSW-C, Community Outreach Coordinator at The Center for Eating Disorders at Sheppard Pratt for www.MarchAgainstED.com

The original posting of this blog is available at: http://www.marchagainsted.com/blog/why-providers-must-stand-up-and-join-the-march-against-ed

 

THE ILLUSIONISTS Film Screening – Meet the panel of experts…

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On June 7th, hundreds will gather in Baltimore to be among the first to see an exclusive screening of the much-anticipated international documentary The Illusionists. In addition to viewing the full-length film, event attendees will have a unique opportunity to ask questions and converse with a panel of experts including the film’s director.  Meet the panel members below and be sure to reserve your seat for the event.

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Panel Members:

elena_headshotELENA ROSSINI
Writer & Director of ‘The Illusionists’

Elena Rossini is an Italian filmmaker and multimedia producer. Notable film projects include DOVE SEI TU, a feature-length narrative film set in between Milan, the documentary DIRECTION, and IDEAL WOMEN, an experimental short film juxtaposing beauty ideals in the art world vs. mass media, commissioned by ARTE Web and the Louvre Museum. In 2009, Elena launched a multimedia platform – No Country for Young Women – whose aim is to promote the visibility of professional women and to provide real role models for young girls from entrepreneurs to NASA engineers, illustrators, architects, filmmakers, non-profit directors, award-winning novelists, and more.

Since 2011 when The Illusionists was funded through a crowdfunding campaign, Elena has worked tirelessly as writer, producer, cinematographer and director. Elena is also a photographer and a blogger. Her photos and articles have appeared in Jezebel, indieWIRE, Adios Barbie and Gender Across Borders.  Elena will travel from her home in Paris to be a part of this exclusive advance screening and panel discussion.

 

tmaronickThomas Maronick, JD, DBA
Professor of Marketing
Towson University

Dr. Maronick is a Professor of Marketing in the College of Business and Economics at Towson University in Towson, Maryland.  He holds a BA in Philosophy from St. Thomas Seminary, an MBA from the University of Denver, and a Doctorate in Business Administration (DBA) from the University of Kentucky with a major in Marketing. It also includes a JD from the University of Baltimore, School of Law. Dr. Marnonick is also an inactive member of the Maryland Bar. At Towson University he teaches undergraduate and graduate courses in strategic marketing and marketing research and has also taught graduate and executive development courses in marketing, consumer behavior, and marketing research at a number of universities in the Baltimore and Washington DC area. In addition to his role as professor, Dr. Maronick’s professional background includes serving as Director of the Office of Impact Evaluation in the Bureau of Consumer Protection at the Federal Trade Commission (FTC) from 1980 – 1997 where he served as the in-house marketing expert for all divisions of the Bureau, advising attorneys and senior management on marketing aspects of cases being considered or undertaken by Commission attorneys. Dr. Maronick was also responsible for the evaluation of research submitted by firms being investigated by the Commission and for the design and implementation of all consumer research undertaken by the Bureau during that period. Since leaving the Commission in 1997, Dr. Maronick has served as an expert witness in marketing-related cases and has testified in Federal and State courts.  His areas of expertise include: marketing, deceptive advertising, public policy, research, and expert witness/litigation support.

 

Laura.Sproch.2015a_portraitLaura Sproch, PhD
Psychologist & Research Coordinator
The Center for Eating Disorders at Sheppard Pratt

Dr. Laura Sproch is a licensed clinical psychologist who serves as the Research Coordinator and outpatient individual, family, and group therapist at the Center for Eating Disorders. Currently, Dr. Sproch is initiating treatment outcome studies, managing quality improvement projects, and developing novel research projects in an effort to contribute to the field’s understanding of effective eating disorder treatment methods. Dr. Sproch received her Ph.D. in Clinical/School Psychology from Hofstra University in Hempstead, NY where she completed her dissertation examining cognitive similarities between differential eating disorder diagnoses. Dr. Sproch originally joined the CED team in 2011 as a postdoctoral fellow on the inpatient and partial hospitalization units acting as a family, individual, and group therapist. She has also worked with adolescents and adults struggling with disordered eating at a variety of levels of care, including at Friends Hospital in Philadelphia, PA and ‘Ai Pono: The Anorexia and Bulimia Center of Hawaii in Honolulu, HI. Her professional interests also include cognitive behavioral therapy, family-based treatment, behavioral modification, and school psychology.

 

Panel Moderator:

Dr. Crawford headshot_portrait

Steven Crawford, M.D.
Co-Director
The Center for Eating Disorders at Sheppard Pratt

In addition to his leadership role at The Center for Eating Disorders, Dr. Steven Crawford serves as Assistant Chief of Psychiatry at St. Joseph Medical Center, University of Maryland and as an Associate Professor at The University of Maryland where he helps to train medical students on effective screening and care for individuals with eating disorders. As an extension of this commitment to professional training, Dr. Crawford also serves as Director for Eating Disorders fellowship at The Center for Eating Disorders. He is Past President of the Maryland Psychiatric Society and Chair for the Committee on Scientific Activity for MedChi.  Dr. Crawford has participated in numerous research studies including NIMH federally funded research for an international collaborative study on the genetics of Anorexia Nervosa as well as the Family Therapy Treatment of Adolescents with Anorexia Nervosa. His numerous publications include the chapter on Eating Disorders and Substance Use Disorders for the fifth edition of Substance Abuse: A Comprehensive Textbook. After more than 25 years of specializing in the field of eating disorder treatment, Dr. Crawford has become a trusted resource for his patients, colleagues and the community.

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Questions about the panel or the event?  Call (410) 427-3886 or email kclemmer@sheppardpratt.org

 

 

 

FOOD LOGS: How they can help with eating disorder recovery (& why you might still be avoiding them)

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coffee-writing-stuart-milesFood logs are one of a variety of therapeutic tools used during treatment for an eating disorderFood logs – also referred to as food records or food journals – can take many forms.  Some people prefer to jot things down free form in a personal notebook while others do best filling out the prepared charts provided by their dietitian.  Many others have gone tech-friendly and use an app on their phone to track info and share it with providers. Regardless of the form it takes, a food log does much more than track your food.  A helpful format for food logs will include the time of day, a description of the meal or snack, actual food and beverage intake, location/setting of the meal and, most importantly, an individual’s thoughts and feelings before, during and after eating. Completing food logs and subsequently reviewing them with a registered dietitian can be a pretty powerful part of the recovery process. Not surprisingly, and perhaps because they can be so powerful, many individuals also experience some resistance to using them.  If you’ve ever been encouraged to complete food logs as part of your treatment for an eating disorder but had trouble starting or committing to the process, we thought it might help to know why a dietitian would recommend doing them and the specific ways in which they can aid in the recovery process.

Completing food logs throughout the week maximizes time spent in session with your providers. Weekly nutrition counseling sessions are often 30 minutes long.  It could potentially take up the most of that half hour to do a 24 or 48-hour verbal recall of your meals during the session. It’s easier to get down to business if the logs are already done. Plain and simple.

Food logs are like x-rays. If you hurt your arm and asked your doctor to put a cast on it, she would require you to get an x-ray first to see if, how and where it was broken. If you refused, she broken-armwould only be able to give you broad advice, like “take a Tylenol and get some rest.”  (If you’ve broken a bone before you probably know that wouldn’t help a whole lot). On the other hand, if your doctor could look at the x-ray of your arm she could fit you for the exact type of splint or cast needed, assign the proper amount of physical therapy, and provide individualized prescriptions for your pain.  In much the same way, food logs allow the dietitian to give you tailored advice and individualized strategies, rather than simply relying on a general, one-size-fits-all nutrition goal.

Food logs provide insight into your bigger picture. Sure, your food logs communicate specific details from each meal, but they also show trends and patterns over the course of the week related to meal times, location, hunger/satiety  cues, situational triggers and thoughts. Dietitians can often see connections on the food logs that patients don’t always see themselves. Seeing “the forest for the trees”  allows the dietitian to offer the most useful and beneficial feedback to the patient. Let’s say you arrived home from work late and ate an entire large pizza. Looking back on the food log we may see that you had an 8-hour gap without a meal that caused you to feel extremely hungry. Perhaps a goal would be set to have an afternoon snack available for those situations to help you get to dinner hungry, but not ravenous. On the other hand, maybe you had a stable breakfast, lunch, and afternoon snack, but your dietitian notices you hadn’t allowed yourself pizza in six months despite the fact that it’s one of your favorite foods. A more appropriate goal in that situation would be to practice food habituation with pizza (exposure to a food over time makes the food less compelling) and having a support person around when you’re eating it for a while. The bottom line: It’s harder to learn from the incident when we only see it from one angle. Food logs help us both have more perspective on why things happen, to know whether the set-up was physical or emotional and how to address the physical and emotional needs going forward.

Food logs provide a way to monitor progress. Nutrition therapy is about making changes that improve your relationship with food and your health. We tend to set small weekly goals that create momentum towards overarching goals and bigger changes over time. How will either of us know if the goals are met if we don’t keep track of them? Keeping a food log provides an objective look at progress from week to week and month to month.  It also takes the pressure off of you and your dietitian to recall from memory all of the details of your food and symptom use from the past month.  Rest assured, as you heal from your eating disorder you will have many more important things to use your brain for!

Returning to a normal and healthy relationship with food means appropriately responding to hunger and fullness signals. It’s impossible to do that if your signals are broken from chaotic or disordered eating. The best thing to get your digestive system and metabolism back on track is structured eating – meaning adequate amounts of food with adequate frequency.  Food logs aid in structured eating accountability, and structured eating over time sharpens your signals. Food logs and structured eating can provide the training wheels to help you get to a place of intuitive eating.

Food logs help connect your mind with your body.  Putting your pen to paper before, during or after a meal increases mindfulness with eating which can decrease mindless eating. Logging intake with your thoughts improves your ability to tell the difference between emotional hunger and physical hunger.  This practice also increases awareness to how certain foods make your body feel – energy, mood, mental clarity, digestive happiness, etc. Being aware of how foods make your body feel is important in working towards more sustainable and fulfilling eating practices.

Keeping up with food logs can help prevent relapse during transitions.  If you’ve ever received care for an eating disorder in an inpatient or partial hospital setting, you know the transition into outpatient or even intensive outpatient treatment can be difficult as you are once again responsible for completing more meals on your own. One way to help maintain the stability or progress you made in the higher level of care is to continue to self-monitor your intake and associated emotions during that transition and promptly discuss any specific challenges you encounter with your outpatient providers.  If you’re completing food logs, it’s easier to catch a slip-up before it becomes a full-blown relapse.

As mentioned earlier it’s not uncommon for individuals to question the benefit of food logs or to experience some resistance to the idea of completing them. A common reaction from patients is that, “writing down everything I eat makes things worse“ or “I don’t like doing food logs because it reminds hands with pen.africa and freedigitalphotosme of acting on my eating disorder.” As providers, we completely understand that rigidly tracking food and exercise can often be a symptom of the eating disorder.  That being said, there is a big difference between keeping a detailed, private food diary and collaborating with a dietitian to complete food logs during treatment. For one, the end goals are very different. If you tracked your food before it was probably to monitor strict adherence to dangerous eating disorder behaviors or dieting techniques. Those logs probably involved weighing, measuring, and counting calories and were done to benefit the distorted rules of the ED, not to honor or nourish your body. Conversely, the goal for food logs in treatment is to monitor weekly goals, help normalize eating behavior and to improve your relationship with food. When doing food logs with a dietitian, there is no good vs. bad, no shaming, no judgement. The role of the dietitian is not to be the food police waiting to condemn you. Rather, their role is that of a supportive detective. To examine the data, to see if there is something that is setting you up for problematic eating behaviors and then provide you with education and ideas to help make improvements going forward.

Still not sure? Here are a few additional tips for those of you who may have lingering fears about food logs…

For those that are embarrassed to show anyone… Does it make you nervous or uncomfortable to think about showing someone else a record of your daily eating behaviors? If you are worried that your dietitian will be shocked, grossed out, alarmed, or otherwise disturbed by your food log it can be helpful to think of the dietitian like any other specialist.  Take a dermatologist for example. You might feel nervous or uncomfortable during an annual skin check but to the dermatologist, that’s what they do everyday – they look at freckles and moles all day long.  Food logs and weights can be things that feel vulnerable to share, but remember, those are just pieces of data that the dietitian analyzes and they’ve seen and heard it all before. It’s their job to look at meal patterns and associated thoughts/behaviors. Vulnerability takes courage, but being courageous can lead to positive change. If you’re feeling shameful about sharing your food logs, remember this quote from AA – “secrets thrive in the dark and die in the light.” Being honest with your dietitian and allowing him or her to see your food logs is one of the first steps in moving away from the pain of the eating disorder.

For those who struggle with perfectionism… Food logs aid in improving nutrition behaviors just like practicing an instrument aids in learning the skill of playing an instrument. Writing down logs is intended to keep you in the mindset of practicing your nutrition goals for the week. The more often you practice a particular skill, the more it becomes a habit over time. That progression will not be perfect, and that’s a good thing. Even when you have a rough week and the goals aren’t met, food logs are still very helpful!  As providers, we actually learn more from the rough days than we do from the stable days. The logs allow us to see and discuss what some of the barriers might have been to meeting the goal, so we know what to try or be mindful of the following week. Portraying a “perfect” day of eating when it’s not what actually happened is not helpful.  Recording struggles or slip-ups in a food log allows us to work together to correct the focus and try again. Just like it takes practicing a song on the piano before you can play it without looking at the music – food logs keep you intentional in your practice of positive nutrition behaviors before you can naturally engage in the behaviors without the logs.

For those who don’t want to be stuck doing food logs for the rest of their lives (a.k.a. everyone)… Food logs are used to benefit an individual’s relationship with food and establish normal eating.  To that end, the goal is never for someone to be reliant on tracking their intake or completing food logs for the rest of time.  Rather, this is a temporary tool to help bridge the gap between eating disordered and eating intuitively. It might seem counter intuitive to spend your time tracking food in an effort to heal from a disorder that caused you to obsessively focus on food.  But if your goal is to one day be free from disordered eating, it can help to remember this: learning a new behavior often requires focusing on it more before you can focus on it less.

If a dietitian has recommended that you try doing food logs and you were never quite ready to give it a try but you continue to struggle with your ED, it might be worth taking some time for self-reflection. Would it be worth trying something new?  Consider what you would do if your car was stuck in the mud and the first two tow trucks to the scene couldn’t pull you out because they didn’t have the right tools. What would you say to a third one that came along with a different towing device?  Trying something new can sometimes help you to get unstuck. Even if you have tried food logs before and just couldn’t commit to the process, perhaps approaching an old tool with a new perspective or deeper understanding of how it works, could make all the difference.

CED-2014-19334-Mandala-FINALNot wanting to try food logs or other therapeutic tools suggested by your team, can be a form of avoidance. Consider whether you might be avoiding an awareness of particular behaviors or feelings.  Are you trying to avoid being accountable to make changes?  Are you avoiding acknowledgement of your body’s basic needs?  If any of these resonate with you, try being honest with your dietitian or therapist about why you may have been resistant to doing food logs in the past.  Ask for some strategies to make them more manageable or less anxiety-producing. Food logs do take time and you may not always like doing them, but there’s no denying that they can play an important role in facilitating positive change with the support of your treatment team. At the end of the day, doing food logs is temporary. A healthy relationship with food and your body lasts a lifetime.

Written by Hannah Huguenin, R.D. and Kate Clemmer, LCSW-C

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Are you struggling with an eating disorder but you’re not sure where to go for help? Contact The Center for Eating Disorders at Sheppard Pratt at (410) 938-5252 to do an initial phone assessment or visit eatingdisorder.org to learn more.  You may also want to check out our upcoming free events and workshops.

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Hannah Huguenin MS, RD, LDN

Registered Dietitian

Hannah Huguenin received her Bachelor of Science degree in Dietetics with a minor in Chemistry from Olivet Nazarene University in Illinois. She received her Masters degree from the University of Kansas Medical Center in Kansas City where she also completed her Dietetic Internship. During this internship, Hannah completed a rotation on an acute care eating disorder unit at the Research Medical Center in Kansas City. She has been with The Center for Eating Disorders since 2008, and provides individual nutritional counseling for the outpatient population. In her role at the Center, she provides ongoing support to help patients decrease eating disorder behaviors, meet their nutritional goals and improve their relationship with food through nutrition education.
 
 
Kate Clemmer, LCSW-C
Community Outreach Coordinator

Kate Clemmer earned her Master of Social Work degree from the University of Maryland, Baltimore in 2005 with a focus on Management & Community Organization and a specialization in Child, Adolescent & Family Health. Before joining the Center for Eating Disorders in 2008, Kate provided school-based therapy to adolescents and families in Baltimore City and coordinated a multi-school health education and prevention program. As the CED’s Outreach Coordinator, Kate currently facilitates trainings and workshops in the community, provides outreach to individuals interested in the Center’s services and coordinates the Center’s annual community events. These events include an annual Symposium for health professionals, the Love Your Tree Body Image Campaign, and National Eating Disorders Awareness Week. Kate also facilitates the Center’s community support group for individuals with eating disorders and their friends/family, held on Wednesday evenings.

 

Photo credit: freedigitalphoto.net and (in order) Stuart Miles, Boaz Yiftach, Africa

Exciting Developments at The Center for Eating Disorders’ Intensive Outpatient Program

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An Intensive Outpatient Program (IOP) for eating disorders can be important for individuals who are transitioning out of an inpatient or partial hospital setting but would still benefit from more support and structure than is typically offered through weekly outpatient therapy.  The Center for Eating Disorders’  IOP provides 16 hours per week of intensive treatment in the evenings to allow individuals to fully engage in school, work and family during the day while continuing to focus on their recovery.

In the past six months, the IOP has seen some exciting changes and updates in programming. The program has returned to (a newly renovated!) space on the ground floor of the Sheppard Pratt B building, just downstairs from the inpatient and partial hospital units. Our multidisciplinary treatment team now includes members from psychiatry, psychology, art therapy, nutrition, occupational therapy, and social work.

Some of the recent exciting additions to IOP include:

  • Medical DirectorHeather Goff, MD has stepped into the role of Medical Director for the IOP, leading the multidisciplinary treatment team in providing care for patients. She also provides psychiatric treatment to all patients, including weekly assessments and medication management.
  • Clinical CoordinatorMorgan Krumeich, PsyD joined the IOP team in 2014 as our new clinical coordinator. She also leads group therapy and works with patients on an individual basis.
  • Collaborative Care Group – IOP now offers a weekly collaborative care group for parents, caregivers, and supports. Run by IOP social worker Annie Hanley, this group is similar to those offered at other levels of care, but is tailored specifically to the needs and issues that may arise during IOP treatment and associated transitions. All support persons are highly encouraged to attend this free weekly group, held on Tuesdays from 6:30PM-7:30PM.
  • Occupational Therapy – Occupational therapist Rachel Dehart has joined the IOP team and runs weekly OT groups for adults. Adolescents also have the opportunity to meet with an occupational therapist as needed. OT groups in IOP focus on the unique needs of individuals with eating disorders, including time management, grocery shopping, clothes shopping, involvement in the community, work or volunteering, and school.
  • Individualized Nutrition Consultations – With two dietitians now on the IOP team, Caitlin Royster and Kelly Daugherty, we continue to offer weekly nutrition groups for all patients. Additionally, dietitians are working to provide individual assessments and nutrition consultation for patients on a weekly basis.

The Intensive Outpatient Program is designed to work closely with individuals, their families, and outpatient providers in order to offer the most comprehensive care possible. And of course, we always work to incorporate patient feedback in order to ensure the IOP is continuously developing and meeting the needs of individuals, families and the community.

If you have questions about the Intensive Outpatient Program, please call (410) 938-5252 or email EatingDisorderInfo@sheppardpratt.org.

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Meet the IOP Staff

Heather Goff, M.D.
Child & Adolescent Psychiatrist
Medical Director, Intensive Outpatient Program
Dr. Goff joined the Center for Eating Disorders in 2011. A child and adolescent psychiatrist, she is board-certified in both Adult Psychiatry and Child & Adolescent Psychiatry, providing her a developmental perspective that enhances her work with patients of all ages. Her initial medical training was at New York Medical College, followed by a residency in Adult Psychiatry at Yale University, where she was a chief resident in 2005-2006. She then went on to complete a fellowship in Child and Adolescent Psychiatry at the Yale Child Study Center, where she was again chosen to be a chief resident in 2007-2008. Upon completion of her post-graduate training, Dr. Goff joined the Yale faculty, with joint appointments in the Department of Psychiatry and the Child Study Center. As a clinician-educator, she was the teaching attending for one of the adolescent inpatient units. She also served as Director of the Child Study Center at Madison, where she provided direct outpatient care to children, adolescents and their families. While at Yale, Dr. Goff was also a fellow at the Edward Zigler Center in Child Development and Public Policy, leading to her interest in the intersection of the media and social policy in the development and treatment of eating disorders. In her role at CED, Dr. Goff spent one year treating individuals in the inpatient and the partial hospital programs. In 2012, she transitioned to a new role as Medical Director of the Center’s Intensive Outpatient Program and is also completing assessments and evaluations for children and adolescents in our outpatient department.

Erin Birely, LGPC
Mental Health Counselor
Erin Birely graduated from Loyola University in Maryland in 2012 with a Master of Science degree in Counseling Psychology. She completed a year of internship at the Center for Eating Disorders from 2011-2012, and subsequently began working full time in 2012. She is currently working towards her LCPC certification. Erin provides individual check ins and goal setting with patients. Additionally she facilitates DBT groups focusing on symptom management and emotion regulation, and IPT groups focusing on processing interpersonal difficulties, as well as leading the Multi-Family and Supports Group on Wednesdays.

Kelly Daugherty, RD, LDN
Clinical Dietitian
Kelly Daugherty received her Bachelor of Science degree in Dietetics from Saint Catherine University in Minnesota. She completed her dietetic internship with an emphasis in clinical nutrition at Johns Hopkins Bayview Medical Center in Baltimore, MD. During this internship, Kelly completed rotations on an acute care eating disorder unit at Johns Hopkins Hospital in Baltimore and at the Center for Eating Disorders. Kelly joined the CED team in November 2014. She completes nutrition assessments, teaches nutrition groups and assists patients with menu planning in the inpatient, partial hospital, and intensive outpatient programs.

Caitlin Royster, RD, LDN
Clinical Dietitian
Caitlin Royster received her Bachelors of Science in Nutritional Sciences with a concentration in Dietetics from Cornell University. She completed her dietetic internship with a focus on clinical nutrition and nutrition research at the National Institutes of Health in Bethesda, MD. Caitlin joined the Center for Eating Disorders in July 2014. Here she conducts nutrition assessments, teaches nutrition groups, and assists patients with meal planning in the inpatient, partial hospitalization, and intensive outpatient programs. Prior to joining the Center for Eating Disorders, Caitlin worked in an acute care setting providing medical nutrition therapy and nutrition education to patients. Caitlin is passionate about neutralizing food for her patients and takes a non-diet approach to nutrition education.

Rachel Dehart MS, OTR/L
Occupational Therapist II
Rachel Dehart graduated with a Bachelor of Science Degree in Public & Community Health from the University of Maryland, College Park in 2007. She received her Master of Science Degree in Occupational Therapy from Towson University in 2010. Rachel is currently an occupational therapist on the Children’s Short-Term Inpatient Unit where she adapts and grades activities to meet various physical, emotional, and cognitive levels of children aged 3-12. Rachel facilitates Life Skills and Time Management occupational therapy groups in the CED Intensive Outpatient Program to assist patients with re-engagement in meaningful occupations at home and within the community.

Annie Hanley, LGSW
Family Therapist
Annie Hanley graduated from University of South Carolina with a Masters of Social Work in 2014. She is currently certified as a Licensed Graduate Social Worker and is working towards her LCSW-C licensure. Prior to joining the Center for Eating Disorders, Annie provided individual and family therapy at an eating disorder treatment center at both the inpatient and outpatient levels of care. She also has experience using the Trauma-Focused CBT model to work with children who have experienced trauma. In her current role, Annie works as a family therapist in the inpatient, partial hospitalization and intensive outpatient levels of care. She also facilitates groups in the intensive outpatient program (IOP), including the Tuesday IOP Collaborative Care group for family members and support people. Her past research includes examining the role of peer influence on eating disorder development.

Brianna Garrold, ATR
Clinical Art Therapist
Brianna Garrold received her BA in Fine Arts from Notre Dame of Maryland University in 2010 (formerly College of Notre Dame of Maryland) and her MA from The George Washington University in Art Therapy in 2012, with additional coursework in counseling and Trauma-Informed Care. Currently, Brianna works with inpatient, partial hospitalization, and Intensive Outpatient Program patients using the art process to help patients identify and express their emotions, manage anxiety, and treat body image distortions. Brianna received her ATR in September 2014, and is currently working towards completing the LCPC, and the LCPAT, Licensed Clinical Professional Art Therapist.

Morgan Krumeich, Psy.D.
Clinical Coordinator, Intensive Outpatient Program
Dr. Morgan Krumeich graduated from The George Washington University in 2014 with her Doctorate in Clinical Psychology. Prior to obtaining her doctoral degree, Dr. Krumeich obtained a Masters in Clinical Psychology from The George Washington University as well as a Masters in Education (specializing in Applied Child Studies) from Vanderbilt University. She previously spent two years at Sheppard Pratt as a psychology extern at The Lodge School, where she conducted individual therapy, in addition to co-leading group and family therapy. Dr. Krumeich completed a year of internship as a school psychologist in the Newark Public School System before returning to Sheppard Pratt in 2014 to become Clinical Coordinator at the Center for Eating Disorders Intensive Outpatient Program. Dr. Krumeich has specialized training in working with children and adolescents, but she has experience (and enjoys!) working with individuals of all ages.

 

Support for Parents & Families: Navigating the World of Eating Disorder Treatment & Recovery

Join us on Thursday February 24th, 2011  to hear from a panel of parents who’ve been through the treatment process in various forms with their own children.  Listen to their stories and join the conversation during a special Q/A with the panel members and several treatment specialists from CED. You can read more about the event and meet our panel members below, then download the Event Flyer or visit our website to register for this free event.

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For someone with an eating disorder, the positive role of the family in the recovery process cannot be underestimated.  Parents, spouses, siblings and close support people can make a world of difference for someone who is struggling with an eating disorder, especially as they work towards recovery.  But its not easy.  It takes a lot of patience and presents many challenges for parents and support people who have never before been forced to learn about the complexities of an eating disorder or navigate the world of treatment. Just as the individual with the disorder experiences intense fears, personal hardships, and emotional angst throughout the illness and recovery, so too do those who support them.  It can be torturous to have an eating disorder but in many ways, it can be just as difficult to care deeply for someone who does.

Parents in particular, despite the age of their son or daughter with an eating disorder, can be met with incredible fear, stress and frustration as they try to weed through a completely new landscape of physical and mental health complications, what to say and what not to say to someone in treatment, and how to respond to irritability, refusal to get treatment, or general isolation from the rest of the family.  And while each family has their own unique experience, two things are very common when approaching the recovery process with a loved one:  1) you will have a lot of questions, and 2) you may feel very alone.  That being said, it can be very beneficial to talk with other families who understand what you’re going through and can offer knowledgeable, experienced support.

This year, in honor of National Eating Disorders Awareness Week, The Center for Eating Disorders at Sheppard Pratt will be hosting a Panel Presentation and Q/A event featuring parents who’ve experienced the difficult job of supporting a loved one with an eating disorder.  This free event is designed to create a safe place for families and support people to gather, ask questions and seek feedback from those who’ve been in the trenches themselves.  The panel will also include specialists from the Center for Eating Disorders who will answer questions about the treatment process, types of therapy, health and medical concerns,  nutrition issues, and all things affecting recovery.

All of the parent panel members come to the table with different experiences, different strengths and different outcomes but they all have an important story to tell and a hopeful message to share.   If you have questions about supporting a loved one, or you would just like to listen and know that you are not alone, please join us for this special event in Baltimore on Thursday February 24th at 7:00 pm.

~  MEET The PANEL ~

PARENT & FAMILY Panel Members:

Jane Cawley – Jane and her family helped her daughter, then age fourteen, recover from anorexia nervosa with family-based treatment in 2004. Ever since, she’s worked tirelessly as an advocate for eating disorders, actively helping parents find and better understand information on eating disorders and the treatments available.  She co-chairs Maudsley Parents and serves on the steering committee of NEDA’s Parent, Family, and Friends Network.  She was also recently interviewed for a PsychCentral blog entitled, What Parents Need to Know About Eating Disorders: Q&A with Jane Cawley

Katherine BloomKatherine is the loving mother of Kira Bloom, who lost her struggle with bulimia nervosa on May 21, 2009 at age twenty-five.  Katherine now speaks out to honor her daughter’s memory, the importance of treatment and to share what she has learned in hopes of sparing another family a similar tragedy.

Jean R. – Jean and her family learned to navigate the world of eating disorders when their daughter was diagnosed with anorexia nervosa in 2000.  Through their daughter’s journey they became acquainted with an ANAD support group, and in the spring of 2007, she volunteered to be on the Eating Disorder Network of Maryland board.  Jean has also been involved with Supporting Each Other, a support group for family members and friends of those who have loved ones struggling with disordered eating.  As an educator, Jean sees the importance of education to spread awareness and understanding about this dangerous disease.

TREATMENT SPECIALIST Panel Members:

Steven Crawford, MD – Dr. Steven Crawford is a board certified psychiatrist and Associate Director of The Center for Eating Disorders.  Dr. Crawford has spent over 20 years devoted to the treatment of individuals and families impacted by eating disorders.  He remains committed to providing the best possible treatment for every patient at CED, ensuring a comprehensive continuum of care, state-of-the-art programs and a staff of highly qualified, specialty trained practitioners.  Dr. Crawford also serves on the faculty at the University of Maryland where he trains medical students on prevention, identification, early intervention and evidence-based treatment for eating disorders.

Dina Wientge, LCSW-C – Dina Wientge has been a part of the CED staff for more than 14 years. She received her Masters in social work from the University of Maryland and trained at Johns Hopkins University .  Dina provides family therapy for patients in CED’s inpatient program and oversees all aspects of the Center’s family therapy programming.   She is one of a select group of clinicians from across the country who have been specially trained and certified to provide Family Based Treatment (FBT) for eating disorders.

Debbi Jacobs, LCSW-C – Debbi Jacobs earned her MSW from the University of Maryland, Baltimore, School of Social Work in 1999.  Prior to joining the team at The Center for Eating Disorders, she provided individual, couples and family therapy at the Jewish Family Services in Baltimore with a particular interest in trauma and loss.  Debbi currently provides individual and family therapy at CED’s outpatient department with a concentration in providing support for families engaged in the Maudsley method of re-feeding.

Samantha Lewandowski, MS, RD, LDN – Samantha Lewandowski received her BS in Nutrition from the University of Delaware and her Masters in Health Promotion Management from The American University.  Samantha, a Registered Dietitian, joined the CED staff in 2006, and her main role is working on nutritional goals with patients and their families in the outpatient setting.  As Nutritional Care Coordinator, she also supervises the outpatient nutrition staff, coordinates nutrition programs and provides community workshops and professional trainings on the prevention and treatment of eating disorders.

All family members, support people and health/mental health professionals are welcome to attend.  Download the Event Flyer or visit our Events Page to pre-register and reserve a seat.

If you have questions about this panel or any of our other NEDAWeek events, please call The Center for Eating Disorders’ Outreach Coordinator at (410) 427-3886.

2010: Looking Back on a Year of Eating Disorder Awareness, Outreach & Education

2010 has been one of the busiest community outreach years to date here at The Center for Eating Disorders.  We are very glad to have welcomed many of you to our events for the first time.  In addition to providing requested trainings and workshops in the community CED also hosted five major community events on the Sheppard Pratt campus.  These are just a few of the many highlights from the past year…

In January of 2010 CED kicked-off the year with a day long conference  entitled, Promoting Self-Esteem & Positive Body Image: A Program for the Jewish Community. Despite a lingering snow storm, over 100 community members attended including parents and adolescents, educators and school staff, medical and mental health providers as well as rabbis and Jewish community leaders from Baltimore and surrounding areas.

One month later we celebrated National Eating Disorder Awareness Week with a keynote presentation by author and parenting expert Rosalind Wiseman.  In her talk,  Positive Parenting for a Healthy Self-Image, she spoke candidly about relating to kids and adolescents in ways that build self-esteem and body confidence.  That same week in February, we honored student artists from across the state of Maryland at the annual “Love Your Tree” poster art exhibit and awards ceremony. Bel Air High School Freshman, Kiley Baker was honored as her original artwork was unveiled as the official 2010 Love Your Tree poster. More than 130 art pieces were on display and over $1,200 in scholarships and prizes were awarded to participating students and teachers. (Don’t forget: the deadline for this year’s LYT Poster campaign is Dec. 17th, 2010!!!)

Before NEDAWeek 2010 ended, CED therapist, Craig Boas, LCSW  facilitated a community workshop called Mindfulness 101: An Experiential Exploration of DBT Practices for Eating Disorder Recovery and Everyday Life. In addition to these local events, we also launched a blog series called Nurture:  A mind and body wellness blog for moms and mothers-to-be. The blog entries helped to provide support around issues of fertility & pregnancy, eating disorders, body image, media and motherhood.  

In August of 2010, we were honored to host a community presentation by author and parent, Harriet Brown the very  day after the release of her book, Brave Girl Eating: A Family’s Struggle With Anorexia. Her talk was inspirational for the many parents and professionals in the audience and stimulated much discussion about Family-Based Treatment (FBT).  The Center for Eating Disorders is one of a small number of sites across the country that has clinicians who are specially trained and certified to provide FBT for eating disorders.

We switched gears in September 2010 for a focus on continuing professional education for providers.  Five eating disorder treatment experts from across the country converged in Baltimore to present at CED’s professional symposium, Eating Disorders: State of the Art Treatment.  Almost 200 physicians, nurses, psychologists, social workers, dietitians and other treating professionals attended the day long conference to learn about topics such as Family-Based Treatment for EDs, Psychopharmacology and Cognitive Remediation Therapy.  Several of our expert presenters provided guest blogs for us in advance of the symposium.  You can read them by clicking on the links below:

Several days after the symposium, CED staff members, including CED Associate Director, Dr. Steven Crawford, teamed up with fellow advocates from across the country on Capitol Hill to take part in a Lobby Day organized by The Eating Disorder Coalition (EDC).  We spent time meeting with Maryland representatives in congress and senate, discussing how important it is for them to sign on in support of the FREED Act.  It was an empowering day and CED is looking forward to being a continuing sponsor of the EDC in the new year.

Most recently we were incredibly excited to host our fall outreach event,  Intuitive Eating: Making Peace With Food,  featuring Evelyn Tribole, MS, RD, a nationally acclaimed nutrition expert and bestselling author.  There was a tremendous response from the community, and over 200 people from across Maryland and surrounding states converged in Towson on November 21st to hear Ms. Tribole’s engaging presentation.  After the talk, many attendees lined up to speak with her personally about their stories of success with Intuitive Eating.  If you missed the presentation, check out the pre-event Q & A with Evelyn Tribole on our blog.

Many thanks to all who have attended and collaborated around these events.  As we move towards 2011 and a new year we maintain a commitment to providing events and outreach opportunities with the following goals:
  • Increase awareness about the growing prevalence of eating disorders and their consequences
  • Provide opportunities to help individuals, families, schools and organizations prevent eating disorders and promote positive body image
  • Encourage early intervention and improve access to care while decreasing stigma associated with seeking help
  • Support individuals and families throughout the recovery process
  • Enhance professional knowledge and competency through continuing education events for medical and mental health providers

Upcoming community outreach events:

www.EatingDisorder.org

CED on Facebook

CED on Twitter (@CEDSheppPratt)

In 200 Words or Less…

Recently, someone asked us to summarize The Center for Eating Disorders at Sheppard Pratt in “200 words or less”. Not an easy task but one that ended up producing a concise and helpful, up-to-date summary of the CED program which we thought would be helpful to share on our this blog.

The historic Gatehouse at the entrance to the Sheppard Pratt Campus

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Since 1989, the Center for Eating Disorders at Sheppard Pratt has been committed to the pursuit of emotional and physical wellness for children, adolescents and adults with eating disorders. Services are provided by an interdisciplinary team of professionals across a full continuum of care which includes a 26-bed Inpatient Program, 12-hour/day Partial Hospital Program, an evening Intensive Outpatient Program, outpatient therapies and support groups.

The Center combines a behavioral program to assist in the management of eating disorder impulses with an evidence-based, multi-modal therapy program. Individual and group therapies include cognitive-behavioral therapy, dialectic behavior therapy, interpersonal therapy, body image therapy, art therapy, movement therapy, occupational therapy, and nutritional counseling. Family therapy at The Center is guided by a Family-Based Treatment approach (Maudsley model) and family systems theory.

The Center is located on a beautifully landscaped suburban campus in Baltimore and participates with most insurance plans. Recovery occurs with the achievement of medical, nutritional and psychological stabilization. The Center supports the development of healthy coping mechanisms as a replacement for eating disorder behaviors. Specialized treatment tracks are available for individuals struggling with trauma disorders or substance abuse in addition to their eating disorder.  Prevention, education and outreach services are also available.

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In case you want more than 200 words….you can take a virtual tour of the program and listen to video interviews from our staff here.   Additional information & details about admission are available by calling (410)938-5252, or emailing EatingDisorderInfo@sheppardpratt.org.

You can also visit our website at www.EatingDisorder.org and follow CED on Facebook for program updates and motivational, recovery-focused status updates.

Utilizing Transference & Countertransference to Deepen the Treatment of Eating Disorders, with Kathryn Zerbe, M.D.

Following an incredibly positive response to her April 2009 presentation on integrated treatment for eating disorders, we are thrilled to welcome Kathryn Zerbe, M.D. back to Baltimore for our 2010 annual professional symposium.  Dr. Zerbe will present, along with 5 other distinguished experts, at Eating Disorders: State of the Art Treatment on Saturday September 25th, 2010.  Her much anticipated  presentation will focus on psychodynamic approaches and the use of transference and countertransference to enhance clinical practice in the treatment of individuals with eating disorders.

Kathryn Zerbe, M.D. is a Professor of Psychiatry and Obstetrics & Gynecology at Oregon Health & Science University.  She also serves as the Director of the Oregon Psychoanalytic Institute and has authored over 60 clinical papers and four books including, Integrated Treatment for Eating Disorders: Beyond the Body Betrayed.  Dr. Zerbe is a Distinguished Fellow of the American Psychiatric Association and a Fellow of the Academy of Eating Disorders. She has been repeatedly selected as one of “America’s Top Doctors” and is a highly sought after speaker both in the united states and internationally.

Find out more about Dr. Zerbe’s work and her upcoming presentation in Baltimore by reading her insightful and thought provoking responses to our questions below.  And don’t miss your chance to attend all six expert presentations on September 25th, 2010. (This event has been approved for 7 CME/CEUs). REGISTER soon!  Space is limited

Q & A with Kathryn Zerbe, M.D.

The title of your upcoming talk in Baltimore is “Resiliency, Vulnerability and Growth: Utilizing Transference and Countertransference Reactions to deepen the Treatment of Eating Disorders”.  What specific role does vulnerability play in this process?

KZ: Bewilderment, boundaries, and burnout — these are just a few of the concerns that clinicians are liable to struggle with when treating patients with an eating disorder.  Recognizing that in our quest to be helpful to our patients, we also face a potential undertow because the work to preserve life is taxing in the short run and often takes a commitment of time, energy, and sacrifice in the long run.  Clinicians ‘in the trenches’ know these facts, but what do we do to help ourselves to deal with the hurt feelings that arise when tenacious negative transferences arise, or when we are in a seemingly unwinnable battle with 3rd parties, or experience powerlessness when the patient refutes our counsel?  Awareness to these vulnerabilities, and others, are the first line of defense in staying attuned, steadfast, and nimble in robust clinical practice.

What would you say is the biggest barrier clinicians may face in trying to implement improved strategies for utilizing transference and countertransference in the clinical setting?

KZ: “To know thyself’ and “To be true to thyself’ have been laudable goals since the time of Socrates and Shakespeare, respectively, but such ideals are easier to write about in the abstract than to achieve in real time.  With the daily challenge of managing a lively practice and tending to one’s busy personal life, it is easy to put one’s own needs on the back burner.  Taking a small amount of time weekly to think about the impact of clients is enormously helpful.  In this way, one works on the feelings and clinical formulation one has about each specific person in practice but is simultaneously humbled by what each person teaches us by sharing their unique history and viewpoints.

 

What are the potential consequences of ignoring or ineffectively addressing transference and countertransference issues in the therapeutic process?

KZ: Like most clinicians, I feel extraordinarily blessed to be working in this field where one has the opportunity to witness individuals grow and change over time.  However, burnout is a formidable foe to contend with because change is often difficult, slow, and painful for the patient.  Sensitive clinicians pick up on, or in technical parlance, “contain,” these feelings.  To avoid burnout and to keep the work fresh, invigorating, and growth promoting, the therapist  who ‘knows himself or herself’ best is in a better position to assist the patient, and this is a ‘work in progress’  that is never done until one retires from practice altogether.

In your upcoming presentation, you will discuss strategies for managing “cultural countertransference”. Can you briefly define this term in the context of treating individuals with eating disorders?

KZ: Therapists as well as patients are prone to having conscious and unconscious reactions to media stereotypes, idealized body images, and culture norms as a whole.  We clinicians are in a better position to help our patients by becoming more aware of these potential ‘blind spots’ to  the  prevailing cultural  in ourselves and thinking them through.  Recovery can be enhanced by a timely discussion and critique of noxious cultural norms in therapy.  Both patient and clinician can make use of reading, media, movies, self-scrutiny, and ongoing dialogues with peers or consultants to become more cognizant of our largely unconscious idealization and overvaluation of beauty.   However, as Dr. Catherine Steiner Adair of Harvard University pointed out when she defined the term ‘cultural countertransference,’ in the early 1990s, we must also be wary that too much focus on the culture can be a defense to deepening the patient’s treatment.

Overall, what do you hope symposium attendees will take away from your presentation at The Center for Eating Disorders on September 25th?

KZ: If participants emerge from my talk (which will use art history slides to demonstrate concepts and to provide encouragement for each therapist to bring his/her unique creativity and tenacity to the therapy hour) with permission to ‘take care of yourself’ as you take care of the patient, I will be very happy, indeed.  Perhaps there will be an idea or two that will be new to the ear, but more likely the listener will simply take more seriously the need for ‘time outs’ and the pragmatic and psychodynamic reasons that undergird that need and recommendation.  One of my heroines, Eleanor Roosevelt, said “Do something that is scary everyday!”  I keep that saying on my desk as a reminder that our daily work as clinicians presents us with mysteries and a summons for personal growth that we can’t predict when we get to the office in the morning.  The more tools that we have in our therapeutic hip pocket, the better!  So, I’m looking forward to gaining wisdom from the other speakers who come first and hearing the comments and questions from the audience to, very selfishly, enhance my individual practice!

Our enduring thanks to Dr. Zerbe for taking time out of a busy schedule to provide such thorough answers. Be sure to join us on September 25th for what is sure to be an engaging and enlightening presentation.  Download the Eating Disorders: State of the Art Treatment PROGRAM BROCHURE (pdf) for registration details and deadlines.

If you’d like to order or find out more about Dr. Zerbe’s publications, please click on the links below.  These titles will also be available for purchase at the upcoming symposium.