Pepperdine University Pepperdine Digital Commons Theses and Dissertations 2010 Patients' perspectives on eating disorder treatment: a resource for practitioners Danielle L. Davis Follow this and additional works at: https://digitalcommons.pepperdine.edu/etd Recommended Citation Davis, Danielle L., "Patients' perspectives on eating disorder treatment: a resource for practitioners" (2010). Theses and Dissertations. 16. https://digitalcommons.pepperdine.edu/etd/16 This Dissertation is brought to you for free and open access by Pepperdine Digital Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Pepperdine Digital Commons. For more information, please contact [email protected], [email protected], [email protected]. Pepperdine University Graduate School of Education and Psychology PATIENTS‟ PERSPECTIVES ON EATING DISORDER TREATMENT: A RESOURCE FOR PRACTITIONERS A clinical dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Psychology by Danielle L. Davis July, 2010 Barbara Ingram, Ph.D. – Dissertation Chairperson This clinical dissertation, written by Danielle L. Davis under the guidance of a Faculty Committee and approved by its members, has been submitted to and accepted by the Graduate Faculty in partial fulfillment of the requirements for the degree of DOCTOR OF PSYCHOLOGY _____________________________ Barbara Ingram, Ph.D., Chairperson _____________________________ Anat Cohen, Ph.D. _____________________________ Gitu Bhatia, Psy.D. ______________________________ Robert A. deMayo, Ph.D., ABPP Associate Dean ______________________________ Margaret J. Weber, Ph.D. Dean © Danielle L. Davis (2010) All Rights Reserved TABLE OF CONTENTS Page TABLE OF CONTENTS ............................................................................................... iv DEDICATION ............................................................................................................... vii ACKNOWLEDGEMENTS ........................................................................................... viii VITA .............................................................................................................................. x ABSTRACT ................................................................................................................... xvi CHAPTER I: INTRODUCTION ................................................................................... 1 History of Eating Disorder Diagnoses ............................................................... 1 Cultural Diversity............................................................................................... 3 Etiological Theories ........................................................................................... 6 Biological Theory .................................................................................. 6 Sociocultural Theory .............................................................................. 7 Cognitive-Behavioral Theory ................................................................ 8 Psychodynamic Theory .......................................................................... 9 Family Systems Theory ......................................................................... 11 Treatment Options ............................................................................................. 13 Multidisciplinary Treatment .................................................................. 13 Nutritional Rehabilitation ...................................................................... 13 Cognitive-Behavioral Therapy............................................................... 13 Psychodynamic Therapy ........................................................................ 14 Family Therapy ...................................................................................... 15 Integrative Treatment ............................................................................. 16 Treatment Outcome ........................................................................................... 16 Purpose and Importance of this Project ............................................................. 17 CHAPTER II: LITERATURE REVIEW ...................................................................... 19 Introduction ........................................................................................................ 19 Treatment Satisfaction ....................................................................................... 20 Treatment Modalities ......................................................................................... 23 Ten Treatment Elements .................................................................................... 26 The Therapeutic Relationship ................................................................ 26 Provision of Social Support ................................................................... 30 Collaborative Treatment ........................................................................ 32 Focus on Emotions ................................................................................. 33 Focus on Underlying Issues ................................................................... 34 Inclusion of Psychoeducation ................................................................ 36 Therapist‟s Knowledge of Eating Disorders .......................................... 36 Behavioral Interventions ........................................................................ 38 Appropriate Use of Medication ............................................................. 40 Therapist‟s Competence in Family Dynamics ....................................... 41 Comparison to Therapists‟ Perspectives ............................................................ 43 Summary and Conclusions ................................................................................ 44 CHAPTER III: METHODOLOGY ............................................................................... 49 Introduction ........................................................................................................ 49 Identification of Relevant Literature and Existing Resources ........................... 49 Target Audience ................................................................................................. 51 Development of the Resource ............................................................................ 51 Format and Structure of Resource ......................................................... 52 Content of Resource ............................................................................... 53 CHAPTER IV: RESOURCE BOOKLET ..................................................................... 55 Cover Page ......................................................................................................... 56 Introduction ........................................................................................................ 57 Disclaimers ........................................................................................................ 58 Table of Contents ............................................................................................... 59 Part I: General Information ................................................................................ 60 Highlights in the Historical Review of Eating Disorders ...................... 61 Eating Disorder Diagnoses .................................................................... 62 DSM-V Eating Disorder Classifications ................................................ 65 Statistics on Eating and Body Image Problems ..................................... 66 Cultural Diversity................................................................................... 67 Etiological Theories ............................................................................... 70 Treatment Options ................................................................................. 79 Part II: Patients‟ Perspectives on Eating Disorder Treatment ........................... 86 Introduction ............................................................................................ 87 Overall Treatment Satisfaction .............................................................. 88 Treatment Modalities ............................................................................. 89 10 Treatment Elements .......................................................................... 90 Table: Research Studies on Patients‟ Perspectives ................................ 101 Limitations of the Research Literature .................................................. 103 Recommendations for Practitioners ....................................................... 104 Part III: Additional Resources ........................................................................... 105 Eating Disorder Organizations ............................................................... 106 Helpful Websites .................................................................................... 107 Books for Patients and Professionals ..................................................... 108 Books for Professionals ......................................................................... 109 References .............................................................................................. 110 v CHAPTER V: DISCUSSION .......................................................................................