Michael E. Berrett

Implicit family process rules in eating-disordered and non-eating-disordered families.

Family environment has been shown to be one of the factors related to the presence of eating disorders among young-adult females. Clinical experience and theories about eating disorders postulate that implicit family rules are an intricate part of family process that may have a great effect on the creation and maintenance of such problems. This study compared implicit family process rules (specifically rules pertaining to kindness; expressiveness and connection; constraining thoughts, feelings, and self; inappropriate caretaking; and monitoring) in families with a young-adult female diagnosed with an eating disorder-either anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified-and families with a young-adult female without an eating disorder diagnosis. One hundred two families (51 eating disordered and 51 comparison) participated in the study. Mothers, fathers, young-adult female children, and siblings completed the Family Implicit Rules Profile (Harper, Stoll, & Larson, 2007). Results indicated that eating-disordered families are governed by a greater proportion of constraining family rules than are non-eating-disordered families. Additionally, eating-disordered youth reported a lower proportion of facilitative family rules and a higher proportion of constraining family rules than did parents and siblings. Theoretical, research, and clinical implications are discussed.

Spiritual issues and interventions in the treatment of patients with eating disorders

Abstract This article examines the roles of religion and sprituality in the etiology and treatment of eating disorders. After briefly reviewing the relevant research, we discuss the most common and significant religious and spiritual issues that we have observed with patients with eating disorders, including negative images or perceptions of God, feelings of spiritual unworthiness and shame, and fear of abandonment by God. We briefly describe process considerations for sing spiritual interventions and conclude by describing seven spiritual interventions that we have found especily useful in treating eating disorderpatients, including spiritual teachings, spiritual bibliotherapy, and pmyer.

What Works for Treating Eating Disorders? Conclusions of 28 Outcome Reviews

Abstract During the past two decades, hundreds of eating disorder outcome studies and dozens of review articles have been published. It is difficult for practitioners, and even researchers, to find time to read all of these materials. To help practitioners and, researchers more easily become current about eating disorder treatment research. we have distilled and summarized the conclusions of 23 eating disorder treatment outcome review articles that have been published since 1987. We also present some implications for practice and research.

Development and Validation of the Theistic Spiritual Outcome Survey

Abstract The authors developed the Theistic Spiritual Outcome Survey (TSOS) to measure the spiritual outcomes of psychotherapy from a theistic spiritual perspective. A 17-item version of the TSOS was found to have adequate reliability and validity in a sample of college students. Three factors emerged from the analyses that corresponded to the Love of God, Love of Others, and Love of Self subscales. Correlations with measures of psychological outcomes were statistically significant. In subsequent analyses, the TSOS was administered over an 8-week period to a sample of inpatient women with eating disorders and to two samples from inpatient psychological clinics in Germany. The analyses resulting from these studies were also supportive of the psychometric properties and clinical sensitivity of the TSOS.

The Role of Spirituality in the Treatment of Trauma and Eating Disorders: Recommendations for Clinical Practice

The relationships among trauma, eating disorders, and spirituality are complex. Both trauma and eating disorders can distance women from their own spirituality, which undermines a potentially important treatment resource. In this article, we offer suggestions based on our clinical experience for helping eating disorder patients who have suffered trauma to rediscover their faith and spirituality. We describe how spirituality can be used as a resource to assist women throughout treatment and in recovery.

A Theistic spiritual treatment for women with eating disorders

The authors describe a psychological treatment for women with eating disorders who have theistic spiritual beliefs and illustrate its application with a case report. They begin by briefly summarizing a theistic view of eating disorders. Then they illustrate how a theistic approach can complement traditional treatment by describing the processes and outcomes of their work with a 23-year-old Christian woman receiving inpatient treatment for an eating disorder not otherwise specified and a major depressive disorder (recurrent severe).

Can patients with eating disorders learn to eat intuitively? A 2-year pilot study

ABSTRACT The present article reports on a 2-year pilot study that evaluated the effectiveness of an intuitive eating program for patients in an eating disorder treatment center. Standardized measures of intuitive eating and eating disorder and psychological symptoms were administered. Psychotherapists and dietitians rated patients on the healthiness of their eating attitudes and behaviors. Preliminary findings indicated that patients can develop the skills of intuitive eating, and that the ability to eat intuitively is associated with positive treatment outcomes for each diagnostic category (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). We conclude by offering recommendations about how to implement intuitive eating training safely and effectively in inpatient and residential treatment programs.

An exploration of the role of religion and spirituality in the treatment and recovery of patients with eating disorders.

This article reports two qualitative studies that explored how religion and spirituality (R/S) influenced the treatment and recovery process of patients with eating disorder. In Study 1 and Study 2, a total of 83 women who had successfully completed treatment at an inpatient eating disorder treatment center responded to open-ended survey questions about the role of R/S in their recovery. Twelve of the women in Study 2 participated in follow-up phone interviews. Qualitative analysis of survey responses and interview transcripts indicated that although many women believed R/S contributed to the development and maintenance of their eating disorder, most of them also felt it was indispensable to their recovery. Several women believed R/S did not influence or negatively influenced their recovery. The findings from these qualitative studies indicate that some patients with eating disorders who have completed treatment believe that R/S can be powerful adjuncts in eating disorder treatment. The findings also provide rich insight into how R/S may assist in treatment and recovery.

Effects of feedback-assisted treatment on post-treatment outcome for eating disordered inpatients: A follow-up study

Abstract Only one randomized clinical trial (RCT) has examined feedback-assisted (Fb) treatment in an inpatient eating disordered population. Results from this study suggested that those who received Fb treatment were more likely to recover than participants in the treatment-as-usual condition; however, long-term effects of this treatment have not been investigated. This is especially pertinent in eating disordered populations, where outcomes tend to be poor and course of illness chronic. In the current study, fifty-three women from the aforementioned RCT were contacted three to four years after leaving inpatient care to assess their current distress level and psychological functioning. Results suggested no significant difference between treatment conditions. The vast majority of women sought out multiple forms of treatment over the follow-up period, regardless of treatment condition. This is consistent with past research suggesting that women with more severe pathology (i.e. those requiring inpatient treatment) tend to experience a more chronic pattern of symptoms even after intensive treatment. Overall, the superiority of feedback-assisted treatment found at discharge diminished over time and could not be detected at follow-up. Suggestions for further research are delineated.