As a Dialectical Behavior Therapy (DBT) clinician, I don’t shy away from talking about suicide or non-suicidal self injurious (NSSI) behaviors with my clients and loved ones. I am quick to manage crises during phone coaching calls. And I am confident when asking the client to remove their self-harm tool from their room during a session.
Yet, when I have been asked to work with someone with an eating disorder in comprehensive DBT, I feel anxiety and a lack of confidence in my expertise. This is the case for many DBT clinicians.
Why bother learning how to treat eating disorder behaviors as a DBT provider? Why not let someone else do it?
Here are 4 reasons for DBT providers to consider getting training in treating eating disorders:
- Anorexia kills more young women than Borderline Personality Disorder (BPD).
According to Auger et al (2021), Anorexia impacts up to 3% of young women and has the highest mortality rate of any psychiatric disorder. As DBT providers we are intensely trained in assessing suicide and managing risk associated with life threatening behaviors. It makes sense that we are suited to help treat Anorexia Nervosa and other eating disorder behaviors. Let’s get the most from our strengths and expertise in treating life threatening behaviors, and treat a population who is at high risk of dying.
- We treat multi-diagnostic clients who often have some component of disordered eating patterns
We know from extensive research that DBT is adaptable to help a variety of presenting concerns and not just people with BPD. DBT is structured to work on many problematic behaviors across various disorders. Due to the prevalence of eating disorder symptoms in the U.S. population, your clients will likely have disordered eating behaviors and/or body image targets on their treatment hierarchy.
- There is a strong overlap of people who engage in NSSI and disordered eating behaviors.
According to a meta analysis by Amiri and AB Khan (2023), the prevalence of NSSI in eating disorders is 40%; suicide ideation is 51%; and attempted suicide is 22%. Thus, comorbidity is high between eating disorders, suicide and NSSI, and it would be most effective to treat them in the context of DBT.
- It expands your scope of practice so you can feel more confident providing adherent evidence based treatment.
Having eating disorder experience makes you more marketable for hiring and attaining client inquiries. Consider expanding your DBT toolbox and, in turn, have more confidence and competence helping our most vulnerable clients.
CEBT is offering a one day eating disorder training for DBT providers in December 2024. Click here for details and registration.
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About the Author:
Hannah Heffner, LPCC, ATR-BC, DBT-LBC, is intensively trained in Dialectical Behavior Therapy, and is a DBT-LBC Certified Clinician. She has extensive history working with adolescents, young adults and their families who have presenting concerns such as depression, suicidality/self-harm, anxiety, autism, low self-esteem and trauma.