By Heather Thompson-Brenner PhD
Read or Download Casebook of Evidence-Based Therapy for Eating Disorders PDF
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Extra resources for Casebook of Evidence-Based Therapy for Eating Disorders
Throughout the exposure, the patient is coached to remain fully present, and to be aware of his/her experience. The therapist helps prevent avoidant behaviors by coaching to look at the food, bring the food close, and experience textures and flavors, as well as to talk about how the food tastes and the experience of swallowing the food, and feeling sensations of fullness or digestion. , a “take-home message”). Specific practice assignments are created at the end of each session to be conducted repeatedly between sessions.
Over the course of the session, Emily reported multiple fears. She described fear of feeling fullness, fear of the unknown caloric content (as milk and sugar were unmeasured), and fear of the feeling of anxiety itself. , more “harmful”) than hot beverages. Therapist: Let’s try again to lean into the anxiety, in the same way or a different way, and see what happens. You can try taking another big sip, you can add more milk or sugar to what you already have, or you can take one of the cups of coffee, milk, and sugar that I mixed ahead of time.
Phase II: Exposure Hierarchy Challenges (Sessions 4–9) In the middle portion of AN-EXRP, exposure content moves up the individual’s hierarchy as rapidly as possible. The aim is “to reduce the power that your feelings have over you,” and this is stated to the patient. The more specific goals of this phase are to reach the top third of the hierarchy, to expand from snack or single-item exposures to full meal-based exposures, to increase between-session practice, and to note decreased use of rituals and avoidant behaviors in self-monitoring.