3 Considerations for Maintaining Recovery in College

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Maintaing eating disorder recovery while in college can be particularly challenging. In this week’s blog post, Clementine Portland Student Intern Erin Holl discusses these challenges and some strategies in how to manage them. 

Eating disorders affect people of all ages and from all walks of life, but are particularly prominent among students in college. College can be an exciting time of newly-found independence and self-exploration, it may also be a time of significant stress and vulnerability. In the interest of recovery maintenance, hope for making the transition into college should be accompanied by identifying and safety planning around the challenges of this environment. The following are three challenges facing college students maintaining recovery from an eating disorder:

Relocation and Roommates

Beginning college often means a new place of living. Relocating housing is stressful at any point in life, but particularly so when that move includes changing regions, leaving family and familiarity, and taking on new roommates. Leaving the familiarity of home can also mean leaving an existing support structure. When relocating to a new region, it is important to proactively establish a new supportive community of friends and professionals. Though some are fortunate enough to find friendships amongst new roommates, these individuals are not always positive influences on recovery maintenance. Living in close proximity to individuals with disordered eating patterns can be a challenge, though one minimized by awareness and planning.

Competitive Environment

The acutely competitive nature of the college environment is no secret. In this culture students are encouraged to test their limits in order to academically achieve at the highest level. Further, the achievements of one student are frequently compared to the efforts of others rather than previous personal achievements. This cultural norm of comparing self to others and forgoing a balanced life in the pursuit of achievement in one area can be a particularly insidious challenge for students maintaining recovery from an eating disorder. Students in such an environment could benefit from intentionally planning for and cultivating balance between work and self-care as well as identifying personal goals and values around achievement. Additionally, students may find that practicing transparency with professors and advocating for alternative educational needs can create a more hospitable academic environment.

Inconsistent Structure and Schedules

Between course schedules shifting every few months, occasional extended breaks, and the increased workload around midterms and finals, college living provides little of the consistency in structure that is important for students maintaining recovery. This lack of structure often results in increased demands for accountability from the individual, particularly in regards to practicing self-care, engaging in appropriate levels of movement, and planning regular meals and snacks. Students may create increased structure by mindfully assessing their individual needs as well as generating and implementing realistic schedules that support sustained wellness. Furthermore, students who initiate participation in regular check-ins with primary support persons minimize the potential for isolation in their increased personal accountability.

The challenges facing students maintaining recovery from an eating disorder during the transition into college can be significant, but are largely able to be mitigated by proactive planning and accessing available supports. The three challenges noted here only begin to address what students can expect to encounter in this period of high stress. Engaging in party culture and risky behaviors, limited funds to provide for basic needs, and social media-driven socialization are just a few of the other obstacles that may present to students pursuing higher education. Fortunately, clinicians have the ability to aid clients in preparing for the college experience with the appropriate knowledge and skills that will support recovery maintenance.

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


What Do I Say to My Child Away in Eating Disorder Treatment?

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Becky Henry is trained as a Certified, Professional Co-Active Coach (CPCC) and uses those skills to guide families to let go of fear and panic, learn self-care skills and become effective guides for their loved one in eating disorder recovery. In this week’s blog post, Becky shares valuable tips of what to say to your child who is away in eating disorder treatment. 

Your child has been away at a treatment center for about a week – maybe just 3-4 days and you get THE CALL! Your child, weeping or crying hysterically on the other end. “MOM! Help get me out of this place! They’re so mean to me!”

First, I am so sorry that this illness takes away our real kids from us. And I’m so sorry that no one gave you help in how to respond.

What do you say?  Hopefully the treatment center gave you a heads up that this is very COMMON.

Your job, once you’ve prepared yourself to be calm, rational and objective is to hang in there. Knowing this is VERY normal as the team is challenging the eating disorder (ED) a lot right now makes it very scary for your child. ED’s voice is VERY loud right now.

Keep loving him/her where he/she is at. Trust the model. Remind him/her that he/she is safe and that this is part of the process.  Remind him/her to lean on the staff when he/she needs support, that is what they are there for. Tell him/her she is brave. Acknowledge how scary and hard this is for him/her. Tell him/her you will always love him/her and be there for him/her. And that he/she can do this – one step at a time.

It might be useful to have something like this by your phone (or in your phone):

“Honey, I’m so sorry, it sounds so very hard and scary. I’m so proud of you for working so hard. I know. I love you. It will get easier. uh huh. yeah. WOW. Bummer. That sounds really scary. I know you can do this. Please remember to take one moment at a time. I love you.” 

And then repeat it each time he/she calls.

Know that ED is fighting for his very existence and is not going to give up easily.  When ED feels threatened he ups the ante.  This is what your child is up against. He/she needs you to be strong and not back down.

Then it won’t shred you to bits. As much. Loving a child is painful sometimes. Keep loving your child where they are at. Even when you want your child healthy and back home with you. For now you can do this.

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Sea Glass Grant: Recovered Living

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At Monte Nido & Affiliates, we save lives while providing the opportunity for people to realize their healthy selves. One of the ways we want to help provide opportunities for individuals to realize their healthy selves is through our Sea Glass Grants opportunity. We are excited to share our newest Sea Glass Grant recipient, Recovered Living, an organization providing coaching to those who aren’t able to obtain support in underserved locations, providing both in-person support and online. Read more about this amazing organization below! 

How did Recovered Living come about?

My own recovery experience inspired me to create a service for people who did not have access to face-to-face support.

After flying home to to New Zealand after 7 months with Monte Nido I realized the ‘Treatment Bubble’ had well and truly burst. The nearest eating disorder therapist was 6 hours drive away so I knew if I wanted to stay in recovery, I needed to get creative in finding a team.

I found a therapist and a dietician that worked online and figured out that lunchtime in New Zealand was dinnertime in California. I would Skype with my recovery friends at mealtimes and in this way created my own virtual IOP. No matter where I was in New Zealand, my entire team was at my fingertips via my laptop.  This is how I recovered.

In my recovery journey I saw many people relapse and even die as a direct result of lack of available treatment options. I became determined to bridge the gap for people who did not have access to face-to-face support and create something different that addressed the gap.

How has Recovered Living helped you in your recovery journey?

Recovered Living was a dream of mine years before it was a reality. When recovery was tough for me or the temptation to go back to my eating disorder was strong, I would remind myself that I couldn’t be a role model for others if I went back to my eating disorder. Helping others and being a leader in the recovery field was a very strong motivator for my recovery.

Who is Recovered Living? 

Recovered Living is 100% Kristie at the minute! I often refer to Recovered Living as ‘we’…because it truly has a life-force of its own. I have my Kristie life and there is another being in my life called Recovered Living that I am in relationship with.

It is getting close to the time that I need another coach to help meet demand – Recovered Living will soon be ‘us’!

What feeling do you most associate with Recovered Living?

Only one?  Hope. The most important thing in the world. Inspiration. Authenticity & Effervescence!

Walk me through the Recovered Living process, how do people currently hear about the services you provide?

Recovered Living provides two distinct services.

Transition Assistance is a 24/7 service where a Recovery Coach will move into a clients home to help them transition. This can be moving from Residential to PHP, from School to Home…or anything in between. When the Recovery Coach leaves, they can continue supporting clients via online sessions.  With such a detailed insight into Client’s lives, we have noticed people’s recovery wobbles are more like a dance move than a dive.

The other service Recovered Living provides is online Meal and Snack Support, Recovery Coaching and At-Home Cooking Sessions. This means we have clients all across America, Australia, New Zealand, Canada and Europe.

We recently started a free online ‘Support Space’ group for family and friends of Recovered Living clients. An eating disorder does not just affect one person in the family, it affects every person in the family. We believe families deserve support too!

People have found Recovered Living from all over – we get lots of people from Google searches, word of mouth referrals or from our social media platforms. Something we always offer clients is the opportunity to talk with us first, before making any commitments. We will connect via video call with any new client to hear their story and to talk about how we can help them move forward in recovery. If we seem like a good fit and you want to move ahead – we will design a support schedule that works for your individual needs. We are available nights AND weekends – we get that recovery operates outside office hours – so do we!

What is your favorite part of the day-to-day start up process?

It is not one moment that is my favorite so much as the feeling of a driving and vibrant passion inside me. Sometimes I get so excited I don’t want to close my eyes at night!!

How can people get involved?

If you think Recovered Living is a service that could help someone you know, please spread the word!  We have a Facebook and Instagram account, as well as a monthly blog (you can sign up for our newsletter on the website).

Have spare time on your hands? We currently have volunteer opportunities available to help get an upcoming project off the ground. We always welcome support!!!

What advice would you give to someone in their recovery who has a dream?

Do it!  Something that helped me in recovery was the mantra, ‘bigger jeans, bigger life’…now I say ‘bigger dreams, bigger life’!   

What are your hopes and dreams for Recovered Living?

I hope Recovered Living reaches every corner of the world that has access to the internet.

I dream of a time where treatment for people will be affordable, help is available and support is practical.  No matter where you live.

I hope Recovered Living helps to promote the benefits of telemedicine, giving rise to the critical mass that is creating a change in treatment options.

I dream of the client that will one day become a Coach. The client that follows their calling and becomes the person they wish they had in their recovery – themselves.

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Supporting Eating Disorder Recovery Through the Holidays

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Clementine Briarcliff Manor Registered Dietitian Megan Fahey, MS, RD, CDN discusses eating disorder recovery through the holidays in this week’s blog post. Megan outlines tips to offer you or your loved one support around the holiday table.

It is once again the most wonderful (and stressful) time of year! Along with shopping, decorating and gift giving, cooking and baking are included on the never-ending to-do list. From Thanksgiving dinner through New Year’s celebrations, food undeniably plays a central role at holiday gatherings. For an individual struggling with an eating disorder, or working to maintain recovery from one, the overwhelming focus on eating can take away from celebratory experiences with family and friends. The following are tips to offer you or your loved one support around the holiday table.

Plan Ahead.

Schedule holiday plans in advance in order to make any necessary adjustments to your meal plan. Gather details on the location and timing of each event, as well as the type of food served. Work with your dietitian prior to a holiday party to create a balanced plate from the dishes that will be available. Focus on incorporating a variety of textures, colors and flavors to enjoy. Keeping in line with a 3 meal + 3 snack meal plan model, try selecting appetizers or desserts for one or more of your “snacks” to normalize your style of eating for the holidays. If you or your loved one have food allergies or dietary restrictions, be sure to collaborate with the hostess and bring alternative dishes as needed. Although the meal plan is a tool to help you navigate decisions around food at the table, it is important to maintain flexibility around timing of eating and selection of food. Becoming attuned to your physical body will ultimately shift your focus away from an external meal plan. Eating disorder recovery is possible when you provide yourself permission to nourish yourself based on your body’s internal cues and desires.

Ask for Support.

This is a time of year to connect with those around us. Open up to a trusted family member or friend to communicate whatever support you may need to follow your established meal plan. Identify particular food behaviors you are working on and explain how your “ally” can best support you at the table. Maybe you need a second set of eyes assessing your portion sizes, or someone to pace with you during the meal. It may be stepping aside before and/or after the meal to briefly process your emotions and check in with your hunger / fullness levels. Eating disordered thoughts and urges are isolating, even when surrounded by a room full of people. Reach out and ask someone to help you process the emotion of the holiday to help resist eating disorder urges before, during and after the meal.

Be Mindful.

Mindfulness practices such as deep breathing will activate the parasympathetic nervous system and ease the muscles of the digestive tract. Your mindset while eating impacts not only the quantity of food you consume, but also how well your body is able to digest and absorb the nutrients present in the meal. Take a moment before the first bite to place both feet on the floor and take a few deep breaths to help calm your nervous system and ground yourself at the table. Although it sounds simple, mindful breathing will restore oxygen to the brain, helping you think clearly and make more effective decisions.

Create New Traditions.

It is not uncommon for holiday discussion to revolve around food, often times referencing the “good” or “bad” qualities of each component of the meal. This can be especially triggering to hear if you are working to establish a more nourishing relationship with food and your body. Although it is not possible control the attitudes of those around you, try introducing games or music at your family gathering to help shift the focus from food talk to interpersonal connection. Set a goal to interact with family members in a different way by engaging in conversation around shared interests or offering non-appearance related complements to at least 3 people. Remember that most people experience some level of anxiety at holiday gatherings and may also benefit from creating new traditions for the day.

Give to Yourself. 

During this season of giving, it is extremely important to tend to your own needs. There is such a beautiful energy in the spirit of the holidays, which can be overshadowed by your anxiety around food and eating. Create time in your schedule for self-care, incorporating relaxing activities to balance social holiday events. Implement a gratitude practice to connect with the abundance of your life. You have worked so hard on this journey of eating disorder recovery and are inherently worthy of experiencing all of the joy of the holiday season.

 

Clementine invites you to an open house celebration for our newest location, Clementine Malibu Lake, opening in December, on November 30th at 5pm! Learn more here

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Article Spotlight

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Join us in reading inspirational and informative articles we have cultivated from across the web. If you have found an article you feel is inspirational, explores current research, or is a knowledgeable piece of literature and would like to share with us please send an e-mail here.

 

Adolescence and the Power of Mistakes Psychology Today

6 Ways to Build Trust with Your Body in Eating Disorder Recovery Angie Viets Blog

Halloween in Recovery: To Celebrate or Not to Celebrate? Recovery Warriors

How to Reach out to Someone in Eating Disorder Recovery  OnBeing

What Dads Need to Know About Parenting a Child who has an Eating Disorder More-Love

A Meditation Ritual to Relieve Stress & Anxiety Mind Body Green

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


A Day in the Life: Recovery Coach

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Clementine Portland Lead Recovery Coach Alexa Fleming offers an inside look into how she spends her days. Alexa works closely with the Portland team to provide the highest quality care to the adolescents working toward full recovery. Read on to learn more about Alexa and Clementine Portland…

 

What is your your role at Clementine?

My name is Alexa Fleming. I am the lead recovery coach at Clementine Portland. I have a Bachelor’s degree from the University of Portland. Being a recovery coach for both Monte Nido and Clementine over the last 2 years have been the most rewarding job I have ever had, so here is a glimpse into a day in the life of recovery coaches.

How does your day start?

My shift starts at 7am, I am the first person on shift in the morning, so the house is usually quiet and just waking up for the day. While the nurse is waking up the adolescents I make some coffee, read the communication log, and start heating up breakfast. While the food is warming up I get ready for the adolescents that portion their meals to come in and get their plates ready. Two by two the adolescents who portion their meals come into the kitchen to prepare their plates, following the clear guidelines for their portion, posted on the kitchen whiteboard. During breakfast, we sit and talk about silly things that happened the night before, dreams that occurred overnight, or whatever else they want to talk about. Once everyone is finished eating, the adolescents that have kitchen privileges are responsible for collecting the dirty plates and putting them in the dishwashers. After breakfast the adolescents go to school for the next 2 hours, and I have time to get the clinical office prepped for the day ahead. Recovery coaches are either in the kitchen helping prepare meals and snacks, or in the milieu spending time with the clients.

What is the best part of your day?

The best part of my day is spending time with the adolescents during their free time. I really cherish this time because I get to see the adolescents outside of their eating disorders. They’re (for the most part) not engaging in eating disorder behaviors and are just hanging out, being teenagers. If they are choosing to engage in their eating disorder, I get to help them see the benefits of connection (or choosing their healthy selves) by playing games, watching silly YouTube videos, and just sitting and engaging in conversation. During times like these I really get to know the clients as people and it gives all of us a break from facing the eating disorder head on. During this time, it reminds me that full recovery is possible and gives me hope that someday these adolescents can live full, happy and recovered lives.

Tell us about any groups you run.

One of the best parts of my week is facilitating Movement Group. In this group we do everything from capture the flag, to water balloon fights in the summer, to low impact circuit trainings. The main purpose of this group is to get girls back into their bodies and begin rebuilding their relationship with movement and provide an example of healthy/balanced exercise. Many of our clients report over-exercise as a behavior in their eating disorder, so this group can be rather challenging at times. We always start off group by setting intentions for the activity and finish group by reflecting and doing an eating disorder vs. healthy-self dialogue as a group.

How do you work with your team to support your clients?

One of the best ways that we work as a team to support our clients is by having a weekly Recovery Coach meeting. In this meeting, I make sure to provide time for the RC’s to process any challenging situations that may have occurred throughout the week and offer feedback and support on how to handle these types of situations in the future. We also go over the adolescents’ contracts and talk about any challenges or privileges that they have for the week. By going over this information it allows all of us to get on the same page before the new contract week starts.

Can you remember a unique challenge that you helped a client overcome?

Throughout my time with Monte Nido and Clementine there have been many instances where I have helped adolescents overcome unique challenges. In fact, I would say that this is the reason why each program has recovery coaches. Our jobs are to handle these challenges, whatever they may be, in the moment, with the adolescent. Sometimes this can look like de-escalating a screaming adolescent in the parking lot during a meal outing, or sitting in the pouring rain with someone who thinks they want to throw in the towel and give up on their recovery. Being a recovery coach is being there, every day, whether it’s a good day or a bad day and facing whatever challenges come up, head on.

How do you wrap up your day?

My day wraps up by giving the report to the next RC that is on shift. We talk about what happened throughout the day and what needs to happen in the evening. Report is often given while portioning afternoon snack.

Do you have a passion or hobby of yours that you are able to draw from when working with your clients?

One of my biggest passions and hobbies is nature. Whenever I can I am outside camping, hiking, backpacking, and exploring the beautiful landscapes of Oregon. Being at the Clementine house surrounded by forest and little Christmas trees has really helped me bring my passion into my work at Clementine. A coping skill that I use in my life is stepping outside and breathing in the cool air after a good rain, feeling the sun on my face in the summer, or going on a walk and shifting my focus onto my senses; and being in this environment at Clementine allows me to teach and pass on this skill to all of our clients.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Identifying Eating Disorder Red Flags in Your College Students

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Becky Henry, a coach for parents of kids with eating disorders, and Kathleen MacDonald of the Eating Disorders Coalition identify potential red flag warning signs that your college student might be developing an eating disorder. Becky and Kathleen bring over 30 years of combined personal and professional experience in the field of eating disorders, as: parent & coach and someone who suffered an eating disorder while in college, is now recovery & previous policy director.


Most college students, have been primed on how not to gain the “fresh man 15.” But likely haven’t been primed on just how dangerous trying to avoid gaining weight as a freshman can be. If you are reading this article you likely have some concerns about your college student’s health. We want to help you feel capable of helping your child, and give you motivation to take action if you notice any of the following “red flags”:

  • Isolating from friends and family, or events
  • Dieting and/or skipping meals
  • Cutting
  • Anxiety and/or depression
  • More prominent or obsessive exercising
  • Becoming very secretive and irritable, especially about food or meals
  • When your child comes home for their 1st break (ie: fall, winter), you notice a change in weight that you haven’t noticed before (this could be a gain or loss)
  • Abrasion on knuckles (a result of self-induced vomiting)
  • Use of laxatives, diet pills/diuretics, self-induced vomiting, enemas
  • Trips to the bathroom during, or immediately following, meals
  • Increasing criticism of their body or the body’s of others
  • Increased talk about food, weight, calories, fat, etc.
  • Complaining of being cold (especially fingers and toes)
  • Increased consumption of diet soda or water
  • Increased perfectionism
  • Rules and rituals around food
  • Avoiding eating favorite foods
  • Discomfort in fitted clothes, wearing loose clothing

What happens if you see a few, or more, of these red flags? Your heart rate might have increased and your mind is racing with thoughts like, “Oh my gosh, does my child have an eating disorder?!”  We encourage you to take a deep breath. Many of the signs and symptoms we listed above can unfortunately be typical of a college student who is experimenting with behaviors that they witnessed on campus, and they might not indicate a full blown eating disorder. Still, these are very dangerous behaviors and signs, which need to be monitored closely, especially if your child is predisposed to developing an eating disorder.

How do you help?

You’re already doing the first right thing by reading recent articles from respected leaders in the eating disorders field. We encourage you to be careful of older, outdated, information on eating disorders, as there is a lot out there that is inaccurate and not based on current research. For example, in the past, the dieting that college students engage in to avoid the media-devised, “freshman 15” was seen as “a phase” and something all women did. Now we know that dieting can evolve quickly and be the precursor to developing an eating disorder.

Next, you want to talk with your loved one. Share your concerns and what you have noticed. Be direct and compassionate. Listen but do not let them brush off your concerns with classic phrases such as, “I’m fine!” or, “There’s nothing to worry about, just look at me!” Those phrases deserve further conversation, ask what they mean by that and tell them what you don’t think is “fine” about their behaviors, mood and symptoms.

Be mindful not to “kvetch” with your son or daughter about your weight-loss goals, body dissatisfaction and/or suggest dieting together. Too often these things are seen as a sign that, “See, if mom is doing it, then it must be OK. I must be fine.”

Then, you’ll want a plan in place for next steps if indeed you discover that your loved one is suffering from more than just a few unhealthy behaviors regarding their body, nourishment and the freshman 15. If you realize that the red flags you’ve noticed are signs of something more serious (trust your gut), then you need to get your student to an eating disorder professional ASAP. You can find great resources here and on our websites at www.eatingdisorderscoalition.org and www.eatingdisorderfamilysupport.com

During this process, remember that boundaries are a beautiful thing. Boundaries are not mean or uncaring, (though it may feel that way when you’re learning them). And sometimes boundaries include invoking “tough-love.” You may need to dig deep and find a strength you didn’t know you had, in order to set some tough love into place and help motivate your student to participate in seeking an evaluation and potentially stay home from school to attend treatment.

These are just a few tips for how to recognize an eating disorder and how to get help for your loved one if they are suffering.

The better informed you are, the better you can help your loved one.  

Remember that eating disorders are serious, but there is hope. People can and do recover and treatment works. There is a wide-range of treatment options available, including on college campuses, so please know you are not alone and there is help available.

Most of all we encourage you to remember that: If your loved one isn’t healthy enough to return to college, it’s OK –there is NO harm in taking time off for treatment.

Remember:

  • College will be there, waiting for you to pay tuition, when your loved one is healthy.
  • If your college student had cancer, a semester (or two, or five) off in order for them to receive chemotherapy wouldn’t likely cause you to think twice; in fact you’d likely view treatment as “urgent.”
  • A semester (or two, or five) off, in order for your loved one to get treatment for a dangerous and all-too-often deadly eating disorder, is just as urgent.
For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

The Sun and Wind Dispute: Navigating Motivation and Readiness for Change in Adolescents with Eating Disorders

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Clementine Miami Pinecrest Clinical Director Bertha Tavarez, PsyD discusses treating an adolescent who is resistant and treatment ambivalent. Dr. Tavarez offers some strategies to help strengthen the therapeutic alliance and build the groundwork necessary for full recovery. 

“The sun and the wind were having a dispute as to who was more powerful. They saw a man walking along and they had a bet as to which of them would get him to remove his coat. The wind started first and blew up a huge gale, the coat flapped but the man only fastened the buttons and tightened up his belt. The sun tried next and shone brightly making the man sweat. He took off his coat.” – Anonymous

The metaphor of the sun and the wind is an accurate depiction of the challenges that many clinicians face while working with adolescent patients. Although we may have access to the gravity of our patient’s clinical needs, simply communicating our concerns and providing much needed skills can be met with resistance. Our patients remain “locked in” to their emotional experience while simultaneously feeling “locked out” of the insight and motivation needed to increase their receptivity to much needed skills development. The adolescent, preoccupied with exerting and maintaining control and autonomy, may hold tightly to their coat, rendering our intentions to provide care futile.

So how do we, like the sun, create shifts in awareness and influence change?

The power of reflection

It may be tempting to adopt the roll of cheerleader (“You can do this!”) or problem solver (“Why don’t you try this?”). When an adolescent patient presents with resistant talk (“I don’t want to be here”) or talk that inhibits change (“I got straight A’s with ED, what’s the problem?”). Often the simplest and most effective way of building rapport and loosening the grasp of resistance is to simply reflect the patient’s message in your own words. Often, patients are primed for persuasion and direction. Reflection statements can contribute to feelings of validation and interpersonal trust.

Resistance as an interpersonal process / Resistance as developmentally appropriate

It is important to keep in mind that resistance is both developmentally appropriate for adolescent patients and an interpersonal process that occurs within the therapeutic alliance. Although, we may expect a certain degree of resistance on a developmental level, we can provide corrective experiences around resistance that still promote autonomy. A clinician may benefit from awareness about the resistance that is brewing in a session, abstain from engaging in a power struggle, and promote an alliance with the patients’s desire for autonomy.

Highlight intrinsic control

An effective technique that facilitates a shift from resistance talk to change talk is the clinician’s emphasis on the patient’s access to her personal control. A clinician may reflect the pros and cons experienced by the patient:

Patient: “I got straight A’s with ED, what’s the problem? Gosh! That was so hard!”

Therapist: “It sounds like you did well in school this year, but ED made it more difficult.”

A clinician may also reflect a patient’s choice within the constraints of the treatment environment while having the knowledge of the consequences. For example, the patient may be informed of her choice to select what day an exposure is initiated or asked to reflect on her choice to not participate in a group while being aware of consequence of losing a daily privilege as a result.

Shifting focus  

If resistant talk persists, the clinician can shift the focus to another closely relevant therapeutic topic that may tie into the overall theme beneath the resistance. For example, if the patient states, “I don’t want to take medications and that’s final!” the clinician can say, “Ok, how about you tell me how you’re feeling about your overall health today?”

Working with patients experiencing resistance and treatment ambivalence can be challenging. However, there are great opportunities at this treatment phase that can strengthen the therapeutic alliance and build the ground work necessary for lasting change. Motivational interviewing and person-centered techniques are an integral component of the clinical work at Clementine adolescent treatment program.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Maintaining Recovery in College: Part Two

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Senior Director of East Coast Clinical Programming Dr. Melissa Coffin, PhD, CEDS continues our series on tips for women entering or returning to the collegiate environment after treatment. We hope these tips will assist you in navigating this transition and embolden you to truly enjoy your college experience.

Dr. Coffin has been a pivotal member of Monte Nido & Affiliates since 2008 and has extensive experience in the treatment of anorexia nervosa, bulimia nervosa, binge eating disorder and compulsive over-exercise. She has presented nationally on eating disorders, body image, food rules and self-care at conferences by the National Eating Disorder Association, the Binge Eating Disorder Association, and the International Association for Eating Disorder Professionals.

Embrace change. College is an exciting time in life and it is ripe with new opportunities. Be open and flexible to the changes that come with it even if it means trying something that you’ve never done before.
Be mindful. With all of the opportunities in college you have to pick and choose what is most important so you don’t spread yourself too thin. Be conscious around how you spend your time and what you commit to as that will shape your experience.
Engage in self-care. Make sure to schedule time in each day to relax and take care of yourself, even if it’s just for a short time. Having rest, sleep, and time to decompress regularly will help to keep your stress in check.
Stay connected. Not only will you be forming new relationships in school, you still have your family and friends at home. Use your resources to stay connected with old and new.
Ask for help. It’s OK to ask for help from family, friends, and professionals if you need it. There are those on campus that can help you with your mental health, medical health, academics, financial issues, social needs, career planning, et cetera. Reach out and ask for what you need. The counseling or health centers are usually good places to start.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To learn about summer programming at Clementine, please visit our website or reach out to an Admissions Specialist.


Finding Your Passion with Career Testing

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Associate Director of Clinical Research and Clinical Outcomes Dr. Jessica Genet, PhD explores the importance of finding a passion; whether that includes hobbies, extracurricular activities, a major in college, or a career path. Career assessments and further exploration in therapy allow clients to understand their preferences, values and interests, and offers guidance toward following a true passion. 

“Individuals working to break free from the tangle of eating disorders need to find their passions in life… By passions I mean something external that gives the individual enjoyment, positive structure, or a pathway to self-knowledge.”
– Ira M Sacker, M.D., Author of “Regaining Your Self”

We strive to help our patients explore their passions and live a more meaningful life. Unfortunately, the eating disorder is often so preoccupying and all-consuming that it interferes with the process of exploring interests and engaging in fun activities. Some of our clients struggle to find a job, a major in college, hobbies or extracurricular activities that bring them true enjoyment. Other clients have chosen paths and activities that “look good” externally (and bring them praise from family and friends) but are internally unrewarding. With these struggles in mind, all aspects of our treatment at Clementine, from therapy sessions and yoga classes to outings in the community, aim to help our patients find their passions, explore new activities, and find what brings them true happiness.

One particularly unique service we offer at Clementine is the opportunity to complete a career assessment. Career assessments are designed to help individuals understand their preferences, values and interests, and offers guidance towards selecting majors in school, jobs, career paths, and hobbies that are motivating and rewarding. Are you a person who tends to make decisions based on personal values or are you someone who tends to make decisions based on logic? Are you a person who prefers working on teams or prefers accomplishing tasks independently? Are you excited about activities that require self-expression and creativity? Are you interested in the helping professions such as teaching? These are just some of the questions a career assessment will explore. It is important to understand that a career assessment is not a magic eight ball and will not spit out an answer like “you must become a teacher.” Instead, it offers a springboard for discussion on these topics, leaving plenty of space for personal reflection and choice. Career assessments offer more than guidance on career or job choices; many of our clients describe the experience as an opportunity for self-discovery. We are delighted to provide this service to our clients.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To learn more about our newest location, Clementine Briarcliff Manor, please reach out to a Clementine Admissions Specialist at 855.900.2221.