Background: Emmett Bishop and Bonnie Brennan will take a closer look at affect regulation in the treatment of eating disorders. Understanding and using strategies to target emotion dysregulation will be shared using the Acceptance and Commitment Therapy model. Experiential exercises and skills for all levels of care will be included.
Content Outline
1. Presentation explanation
2. The evolution of affect regulation in the treatment of eating disorders
a. The CBT enhanced model
b. Problems with the CBT approach
c. Third generation therapies and their characteristics
d. Cloninger's Levels of Conciousness
i. The downward spiral of thought in EDs
ii. The upward spiral of thought
e. Affective Origins of Eating Disorders
i. Auto regulation vs. interactive repair
f. Dimensions of Emotional Regulation
i. Gratz and Roemer's Multidimensional Model of Emotion Regulation, 2004
1. Emotion regulation strategies
2. Behavioral control when distressed
3. Emotion understanding and acceptance
4. Emotional approach and tolerance
g. The mind/body problem
h. Using the AAQW-R as a measure of experiential avoidance
3. Acceptance and Commitment Therapy (ACT)
a. Why ACT is useful for eating disorders
b. Using the six core process of ACT to address affect regulation
i. Present moment/mindfulness
ii. Acceptance
iii. Self as context or Transcendent Self
iv. Defusion
v. Values
vi. Committed action and self-directed behavior
c. Experiential exercises
d. Appropriate utilizations strategies at different levels of care
Proposal Abstract
Improving and understanding affect regulation in the treatment of eating disorders using the Acceptance and Commitment Therapy model may provide a useful and creative approach to working with this unique population. Bishop and Brennan will take a closer look at the evolution of affect regulation with the use of third generation therapies, including the CBT model and its challenges. In order to provide a frame for how eating disorders and affective regulation interplay, concepts from Robert Cloninger’s Levels of Consciousness and the downward and upward spirals of thought will be discussed. Building on this frame, discussion of the affective origins of eating disorders and the Gratz and Roemer Multidimensional Model of Emotion Regulation, 2004 will help clinicians to appreciate the importance of the client’s task of affect regulation in the journey of recovery. In addition, a measure for change in experiential avoidance for the eating disordered population will be introduced.
Strategies for working with affect regulation will be given using the model of Acceptance and Commitment Therapy and its six core processes. These strategies will include experience exercises that can increase acceptance, mindfulness and self-transcendence awareness, as well as focus the client on defusing from rule governed beliefs that become barriers to valued living. Clarifying values and moving the client toward committed actions can be important affect regulation skills to increase self-directed behaviors and decrease experiential avoidance. Attendees will practice suggested skills through the use of experiential exercises during the presentation. The presenters will also share their experiences for how these therapeutic approaches may present at different levels of care and how to prioritize the tasks of affect regulation from inpatient care to outpatient care.
Dr. Emmett Bishop has more than 30 years experience treating eating disorders and is the Medical Director of Outpatient Services and Program Development at Eating Recovery Center in Denver, Colorado. He has served on the iaedp™ Board of Directors since 1993 and is a past president. He has been a member of the Academy for Eating Disorders since its inception in 1993 and is an Academy Fellow. Dr. Bishop has been a member of the Editorial Board of Eating Disorders Journal of Treatment and Prevention and the American Journal of Psychiatry, and other professional journals.
Bonnie Brennan is the Senior Clinical Director of Adult Residential and Partial Hospital Services at Eating Recovery Center in Denver, Colorado. In addition to her experience in counseling and marriage/family therapy, she has been instrumental in program and curriculum development and supervision of clinical staff. An engaging speaker and educator, Bonnie is a Licensed Professional Counselor and Certified Eating Disorders Specialist. She is the Education Committee Chair of the Denver Metro iaedp chapter and a national and local member of Association for Contextual Behavior Science. She is frequently featured in web, television and radio media related to eating disorders.
