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During the course of eating disorder treatment, a variety of long-lasting life skills are taught that can help a person remain recovered. To help them learn and embrace these skills, there is often a skills workbook provided by the eating disorder treatment center. Progressing through the workbook, clients can learn how to manage stress and repair their relationships with food and eating.

These workbooks teach coping skills and provide other information that both the client and their support system can learn from. This can allow parents to provide better support for their teens during the aftercare period after they return from residential treatment. Outlined below are some of the skills and life-enhancing techniques an adolescent might encounter in the workbooks.

Therapy Sessions at a Typical Anorexia Nervosa Treatment Center

Residential care normally starts at 30 days and will include medical, psychological, and emotional therapy. While receiving care at anorexia nervosa treatment centers, adolescents usually engage in several therapy types, most prominently:

  • Dialectical Behavior Therapy
  • Cognitive Behavioral Therapy
  • Acceptance and Commitment Therapy

These therapies focus on cognitive retraining and mindful thinking practices that help clients identify their disordered thoughts and behaviors and begin to correct them. They are usually done in a dialogue with a therapist but can be practiced alone once the client is familiar with the process.

With therapy sessions and by using their workbook assignments,adolescents can improve self-awareness and learn to address their discomfort with healthy coping skills. These coping skills help both the initial recovery from anorexia nervosa and also avoid relapse in the face of intense stressors. The skills learned from CBT, DBT, and ACT can last a lifetime and foster a full recovery.

Recovery and Coping Skills Learned in Anorexia Nervosa Treatment

Increasing Self-Awareness

To truly cope with how they feel and avoid relapse, people in eating disorder recovery often need to develop a strong sense of self-awareness. Many practices taught in anorexia nervosa treatment focus on self-awareness and self-acceptance. This is often codified in the workbooks and other assignments the treatment center provides.

With that information, adolescents can come to understand their thought process and feelings with more clarity and more objectively. They can then understand what their mind and body need at that moment and use healthy coping skills to get through daily stressors.

This self-awareness is one of the most important aspects of anorexia nervosa treatment because disorders like anorexia nervosa cause clouded judgment and flawed self-assessment. Working on mindfulness and self-awareness provides a baseline for recovery whose importance can’t be overstated.

Teamwork and Cooperation

By working with anorexia nervosa treatment professionals and their fellow clients in treatment, adolescents can learn how to incorporate teamwork into their recovery. These skills can be furthered after treatment is over, by working with aftercare providers, the client’s family, and even willing friends.

When individuals openly collaborate with their care team, they gain the support they need, which eases the recovery process. Their care team can help them overcome common roadblocks to recovery, such as:

  • Ambivalence about treatment
  • Co-occurring disorders
  • Dysfunctional relationships
  • Low self-esteem
  • Body dysmorphia

Learning how to bypass or overcome these roadblocks is fundamental to maintaining recovery in the long term. Upon returning home, former clients can continue to work closely with their family or chosen caregivers taking the place of the care team (to a lesser extent, of course).

Improving Motivation to Recover

A feeling of ambivalence or outright rejection of the recovery process is very common in both teenagers and adults entering residential care. As anorexia nervosa and other eating disorders progress, they provide the individual with a false sense of control over their lives and can become a central part of their self-perceived identity. These feelings can make the client resistant or hostile to the idea of treatment.

One of the skills taught at eating disorder recovery centers is separating the disordered self from the true self – training and workbooks can help untangle this complicated pairing between eating disorders and identity. Understanding that the thoughts prompted by anorexia nervosa are distorted and flawed can help an individual understand the need to get better.

Rebuilding Relationships

Social isolation and self-removal from social situations is a common result of untreated anorexia nervosa. Disordered eating behaviors often cause feelings of guilt or shame, which might lead individuals to avoid other people, hurting their relationships. Sometimes people struggling with anorexia nervosa might lash out or build barriers between themselves and others as a way to stay in control of their lives.

Most eating disorder treatment professionals agree that a strong support system and family relationships are key to anorexia nervosa recovery in the long term. For that reason, rebuilding relationships is a huge part of the anorexia nervosa treatment process. During family therapy sessions and workbook assignments centered on family cooperation, adolescents in treatment and their parents can learn more about:

  • Setting healthy boundaries
  • Having patience for their loved ones
  • Leaving behind codependency
  • Building strong communication skills
  • Integrating back into family life

May treatment centers offer family sessions that include both the client and their families, and the families by themselves as well. That proved opportunities for bonding and mutual self-expression as well as giving the chance for the family to act as a support system. As everyone works together in therapy, teens gain the social support needed to avoid relapse and remain recovered outside of therapy.

Avoiding Unhealthy Relationships

To build a strong social support network, people coming out of eating disorder treatment also have to learn how to release unhealthy relationships. If repairing the relationship and establishing boundaries aren’t successful in maintaining the individual’s recovery, it might be necessary to sever those ties, even if only temporarily.

Anorexia nervosa treatment programs often specialize in helping clients identify which of their relationships are toxic or dysfunctional. They also learn how to let the relationships go if they cannot eliminate the toxic interactions and build a healthier connection with that individual.

Often the treatment centers will have a workbook or manual to navigating these situations, but teens may also attend interpersonal therapy groups to learn coping skills that help with these relationships. There might be play-acting sessions that provide practice in ending toxic relationships or group sessions where other clients can share their experiences. The workbook also assists in this process and prepares teens to build a network of supportive individuals they can rely on through recovery and beyond.

Increasing Self-Reliance and Autonomy

Anorexia nervosa is often a response to feelings of losing control over a person’s life and body. The food restriction ad other disordered behaviors are a way to regain control, but the payoff is often a dependence on the behaviors to cope with even minor difficulties.

As their fears and concerns overwhelm them, these attempts to regain control end up causing an even greater loss of control. This often turns into a vicious cycle that is difficult for them to break without support at anorexia nervosa treatment.

Anorexia nervosa treatment teaches skills to break this cycle and rely on their healthier selves to cope with stressors.

Stress Reduction

Reducing and managing stress is one of the most important parts of anorexia nervosa recovery since stress is one of the major triggers for coping behaviors. Activities such as yoga and other calming, mindful meditation practices are easily replicated outside of the treatment center, making them eternally useful.

To help decrease stress levels, anorexia nervosa treatment centers introduce a variety of coping skills, including:

  • Meditation
  • Journaling
  • Breathing exercises

By using techniques such as these, it’s easier for recovered people to moderate their stress levels and avoid the triggers for relapse into disordered behaviors. This process will help them gain the confidence they need to become recovered from anorexia nervosa and avoid relapse as stress levels rise.

Accepting and Processing Negative Emotions

Self-critical, depressive, and other negative emotions are almost always present in people who have anorexia nervosa. Even after residential or outpatient treatment, these feelings can overwhelm an adolescent,forcing them back into disordered eating behaviors in an attempt to cope. Learning how to tolerate and work through these negative emotions is key then in helping teens through eating disorder treatment.

Workbooks, aftercare groups, and mindfulness exercises can encourage teens to notice when their thoughts and emotions turn negative and employ newly-learned coping skills to counteract them. They learn how to accept how they are feeling in the moment and use positivity to move into a healthier headspace.

Reaching Out for Help

To prevent relapse, teens need to know just when to reach out for help and receive timely support from the right people. Part of this comes from mindfulness, as teens need to be able to assess when they are feeling poorly. But they also need to know that guilt, shame, and self-doubt can creep in and make it difficult to reach out for help when that happens.

Teens should never have to feel like they have to fight against relapse on their own.As is so many cases concerning relationships and mental health, open, non-judgmental communication is key. The workbook, mindfulness techniques, and self-awareness taught at anorexia nervosa treatment centers also help get the support they need by effectively communicating their challenges to friends, family, and their eating disorder treatment team. With open communication, anorexia nervosa can be effectively treated and recovery maintained.


Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.