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With the development of third-wave cognitive psychology, such as ACT (Hayes, Stroshal, & Wilson, 1999) a marriage of the cognitive and behavioral, as well as mindfulness components, offers increased potential for enduring change. ACT is efficacious in treating anxiety disorders (Twohig, Hayes, Plumb, et. al, 2010). While research on ACT for eating disorders is limited, results are promising (Juarascio, Foreman, & Herbert, 2010). More specifically, the use of ACT in eating disorder treatment helps facilitate acceptability of interventions by enhancing willingness to engage in necessary, yet painful experiences. One treatment target of ACT is the reduction of experiential avoidance of thoughts, feelings and internal experiences, a frequent and debilitating behavior among disordered eaters.
We seek to present a novel, “Treat to Outcome” approach, driven by APA guidelines, incorporating ACT principles as the framework for residential treatment, with generalizability across all levels of care. This individualized treatment model provides structure and support, commensurate to patient acuity. ERP is integrated with mindfulness and acceptance aspects of ACT to specifically target the etiological factors which serve to maintain ineffective behaviors.
Utilizing increasingly longer therapeutic leaves of absence from the facility, patients transition back into their home environment, while being provided appropriate scaffolding with both RTC and outpatient treatment teams. The individuals apply their new-found insight and skills from the residential setting to their home environment, thus increasing sustainability and recovery maintenance.
Outcomes data will be reported including baseline, discharge, and follow-up assessments, with respect to the efficacy of ACT and ERP.
Tera Lensegrav-Benson, PhD is the Director of Patient Services at Avalon Hills Eating Disorders Program. Dr. Lensegrav-Benson is a licensed clinical psychologist and has presented at numerous national conferences on various health psychology topics and the use of Acceptance and Commitment Therapy for the treatment of eating disorders. For the past 5 years, her clinical practice has focused exclusively in the area of disordered eating. Additionally, she is engaged in teaching doctoral psychology students and holds adjunct faculty status at Utah State University in the Department of Psychology. Dr. Lensegrav-Benson can be contacted via email drtera@avalonhills.org or by phone 435-245-4537
Jennifer Tolman, Ph.D. is clinically trained as a Psychologist and works as Director of Specialty Services at Avalon Hills Residential Treatment Facility. She works with patients, families and outpatient treatment teams, to ensure seamless care as patients move from residential care to lower-levels of care. She directs patient follow-up and provider relations related to the Avalon Hills Treat to Outcome Philosophy. She also oversees the legal advocacy at Avalon Hills, in an effort to ensure patients receive the benefits of Mental Health Parity laws and insurance coverage. She serves as a board member for the Columbia River Eating Disorder Network.
