1 CE hour; $45
Overview.
MED-DBT Module 7 introduces clinicians to dialectical dilemmas as predictable and clinically meaningful patterns that arise in the treatment of multidiagnostic eating disorders.
Participants will learn how opposing behavioral and emotional tendencies (e.g., vulnerability vs. self-invalidation, apparent competence vs. active passivity) reflect the interaction of biological vulnerability and invalidating environments. The MED-DBT model also introduces new dialectical dilemmas commonly observed in patients with multidiagnostic eating disorders.
The course emphasizes how failure to recognize these dilemmas can lead to clinician polarization, invalidation, and treatment drift – particularly when working with complex presentations involving co-occurring conditions (e.g. suicidality, trauma, neurodiversity). Participants will develop skills in applying a dialectical stance to maintain balance between acceptance and change, improve therapeutic alliance, and enhance treatment effectiveness.
Attention is given to how systemic, cultural, and identity-based invalidation shapes the presentation and interpretation of these dilemmas, ensuring clinicians apply this framework with cultural humility and responsiveness.
Behavioral Learning Objectives
At the end of this workshop, the attendee should be able to:
- Identify at least four core dialectical dilemmas commonly observed in multidiagnostic eating disorder treatment.
- Illustrate how interactions between biological vulnerability and invalidating environments contribute to the emergence of dialectical dilemmas.
- Apply a dialectical framework to clinical scenarios in order to reduce polarized or invalidating responses.
- Demonstrate strategies for maintaining a dialectical stance that balances acceptance and change in complex treatment situations.
Instructor Credentials
Lucene Wisniewski, Ph.D., FAED, is a recognized clinician, trainer, researcher, and an Adjunct Assistant Professor of Psychological Sciences at Case Western Reserve University, who has taught over 150 workshops on Cognitive Behavioral and Dialectical Behavior Therapies internationally and has over 40 publications in peer reviewed journals and invited book chapters. She specializes in complex, co-morbid eating disorders, and is the Owner and Chief Clinical Officer of the Center for Evidence Based Treatment serving clients across the United States and Wisniewski Psychology Services, PLLC in New York.
Anita Federici, PhD, CPsych, FAED, is a Clinical Psychologist and the Owner of The Centre for Psychology and Emotion Regulation. She serves an Adjunct Faculty position at York University and is a distinguished Fellow of the Academy for Eating Disorders (AED).
Wisniewski and Federici have co-authored a book on MED-DBT that is scheduled for 2025 release by Guilford Press.
Recommended readings
Federici, A., & Wisniewski, L. (2026). Treating eating disorders with dialectical behavior therapy: A comprehensive guide. Guilford Press.
Wisniewski, L., & Ben-Porath, D. D. (2015). Dialectical behavior therapy and eating disorders: The use of contingency management procedures to manage dialectical dilemmas. American Journal of Psychotherapy, 69(2), 129–140.
Touyz, S., Hay, P.,et al. (2024). Involuntary treatment for people with severe and enduring anorexia nervosa: A rapid review. Journal of Eating Disorders, 12, Article (pagination varies by format).
Ziser, K., Resmark, G., Giel, K. E., Becker, S., Stuber, F., Zipfel, S., & Junne, F. (2018). The effectiveness of contingency management in the treatment of patients with anorexia nervosa: A systematic review. European eating disorders review : the journal of the Eating Disorders Association, 26(5), 379–393.
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