Eating Disorder & Anxiety Therapy

We specialize in the treatment of eating and anxiety disorders for children, adolescents, and young adults as well as parent treatments focused on improving their child’s mental health. Treatments are delivered through individual therapy, family therapy, and/or parent-only sessions.

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Family-Based Treatment (FBT)

FBT is the gold-standard treatment for child and adolescent anorexia nervosa. Research has shown that FBT works faster and yields better treatment outcomes than individual therapies. It is based on the philosophy that parents and family members are uniquely equipped to help their child recover from the eating disorder and therefore need to be centrally involved in treatment. While active parent involvement is necessary in the early stages of treatment to help the client reach a healthy weight and reduce eating disorder behaviors, the ultimate goal of FBT is for children and teens to return to developmentally appropriate “normalcy”, including full autonomy around eating and exercise. I am one of the only FBT-certified therapists in San Diego (http://train2treat4ed.com/certified-therapists-list).

Cognitive Behavioral Therapy (CBT)

CBT is the leading evidence-based treatment for bulimia nervosa, binge-eating disorder, and avoidant/restrictive food intake disorder (ARFID) and is also used to treat various mental health conditions including anxiety and depressive disorders. CBT involves identifying unhelpful thoughts and beliefs and their relationship to ineffective behaviors and uncomfortable emotions. The goal is to develop more adaptive ways of thinking through challenging eating disorder beliefs and making behavioral changes. CBT-Enhanced uses these techniques to address restricting, bingeing, purging, fears of weight gain, and weight and shape concerns among people with bulimia nervosa and binge-eating disorder. CBT-AR and FBI-ARFID are CBT treatments for people with ARFID. The treatments focus on helping people reach a healthy weight, increase eating flexibility and dietary variety, identify and explore internal body sensations, and address common fears (e.g., choking, vomiting, throwing up, body and sensory sensations, novel foods) that make eating difficult.

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Temperament Based Therapy with Support (TBT-S)

TBT-S helps clients and their supports understand their neurobiologically-influenced temperament and personality traits and use a strengths-based approach to work with these traits in ways that promote recovery. Both clients and their supports learn about trait-based research findings, identify tools and strategies that align with the client’s temperament, and practice putting them into action to work toward their recovery goals. I am very fortunate to have been trained by the developers of TBT-S at the UCSD Eating Disorders Center.

Exposure & Response Prevention (EXRP)

EXRP is a proven behavioral treatment for anxiety disorders (social phobia, OCD, specific phobias, panic disorder and agoraphobia, separation anxiety) that can also be used to treat specific eating disorder symptoms (e.g., body dysmorphia, fear of internal body sensations, fear of weight gain or specific foods). The more we avoid something, the more anxious we feel about it. Over time, this can result in a cycle of anxiety and avoidance that can be very life-interfering. Exposure and response prevention helps people face their (objectively safe but very scary and intimidating!) fears. When this is done repeatedly, clients learn they won’t die, “go crazy”, or never stop feeling anxious, can tolerate so much more than they think, and, potentially, the worst things they feared would happen didn’t actually come true. Over time, clients might find that they feel more comfortable facing these faces or can better manage the anxiety that arises when they do.
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Family & Support Involvement

An eating disorder is a crisis for the entire family. Many clients come to treatment feeling scared, guilty, or ashamed. Their family supports blame themselves, walk on eggshells around their loved one, and aren’t sure how to help. We know eating disorders thrive in isolation, and our first goal is to help clients and their supports speak openly about their experiences and concerns. Bringing families together in treatment can reduce the shame, guilt, and blame that both clients and supports may feel, help supports better understand the eating disorder, and allow the family to work together. Adult clients may wish to involve family members, partners, friends, coaches, or trusted mentors in their treatment. In addition to family therapy, we also offer parent consultations and individual therapy for siblings affected by the eating disorder.

Parent Coaching

We offer parent coaching for parents and caregivers of children with eating disorders, anxiety disorders, and OCD. We use parent-focused treatments that are based on the novel idea that parents can promote effective and healthy behavior in their child, improve parent-child relationships, and provide anxiety relief for their children by changing their own behavior. Two treatments we utilize in parent coaching are Behavioral Parent Training (BPT) and Supportive Parenting for Anxious Childhood Emotions (SPACE). BPT uses reinforcement techniques to promote healthy, prosocial behaviors, while SPACE helps parents respond more supportively to their children’s anxiety and reduce the (unintentionally) unhelpful ways in which they may be accommodating it. Parent coaching sessions can be parent-only or combined with family therapy.
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    Learn more about our virtual parent course here:

    https://www.nationaleatingdisorders.org/new-directions-eating-disorders-treatment-introducing-our-virtual-parent-training-course/