ACT
What is the perspective of ACT?
Therapy that engages in values-driven behavioral change, keeps big picture in mind, and encourages mindful action. The goal is to create a meaningful life while accepting that pain exist and bad stuff happens.
Give a few examples of disordered eating
Food anxiety, guilt/shame associated with eating, rigid exercise rituals, distressing fixations on body shape/size, yo-yo dieting, procedures for "making up for" eating certain amounts or types of food, etc.
Treatment goals
Restore weight (if appropriate), address ED- related behaviors and thoughts, adopt flexibility with food, neutralize body image and heal relationship with food.
Overall goals
Disarm conflicting verbal communication.
Increase intimacy, respect, and affection.
"unstick" the perpetual conflict.
Goals
Expand and re-organize key emotional responses.
Create a positive shift in partners interactional patterns "the dance".
Foster the creation of a secure bond between partners.
What are the problems with cognitive fusion?
The problem solving mode of the mind can cause judgment, self-criticism, guilt/shame. As well as a lack of space between thoughts and a person’s experience of them.
Therapist/provider characteristics
Anyone providing treatment should be...
* using an inclusive, non- fat phobic approach
* building awareness around personal beliefs, implicit and explicit bias, and privilege
* using neutralizing language related to health & weight: Instead of "thin" or "obese" try "smaller" or "larger" bodies, avoid the term "obese", and "fat" ≠ "bad".
Treatment plan
(1) Assessment
(2) Identify and unpack cultural influences on body image
(3) Address food/body concerns through: health at every size, intuitive eating, CBT, and MI.
The Gottman philosophy
The majority of relationship problems are never resolved "perpetual problems/gridlock arguments", friendship quality predicts ability to resolve conflict, and the start up (harsh vs gentle) is important.
Primary vs Maladaptive Emotions
Primary emotions: adaptive, underneath defensive/overwhelmed emotions.
Maladaptive emotions: defensive responses, can come from the past, cause us to get "stuck".
What are the six core therapeutic processes of ACT?
Contact with the Present Moment, Values, Committed Action, Self as a Context, Cognitive Defusion, and Acceptance.
Describe how cultural messages can be confronted
Using the HAES reduces stigma, increases access to healthcare, improves quality of life for all bodies (not weight loss), goes beyond "body positivity" to help individuals accept their size, trust themselves, adopt healthy lifestyle habits, and embrace size diversity.
Describe why diets don't work
The human body is wired for survival
Restriction = body gets signals that you're starving.
Your body will promote survival: decreasing metabolic rate, decreasing thyroid activity, decreasing levels of fullness hormones, increased craving for calorie dense foods.
Describe the sound relationship house and its purpose in assessment
The sound relationship house is built on the pillars of trust and commitment and the foundation is knowing your partner "love maps". There are six more floors Share Fondness and Admiration, Turn Towards Instead of Away, The Positive Perspective, Manage Conflict, Make Life Dreams Come True, and Create Shared Meaning.
By evaluating problem areas, you can outline how the couple is doing overall, instilling hope and motivation in the relationship.
The types of attachment and a description of one
Secure
Insecure: Anxious (preoccupied), Avoidant (dismissive), Disorganized (disoriented)
A description of one
Describe an intervention of cognitive defusion
Reducing Meaning and Undermining Literality of Thought, Unwelcome Party Guest, Illusion of Control, or Open up a Different Perspective.
Name the levels of care and choose one to describe
Outpatient, Intensive Outpatient (IOP), Partial Hospitalization (PHP), Residential, and Inpatient.
A description of one.
Ways to maintain recovery
Recognizing the high propensity for relapse, encourage trauma healing, continually push back against diet culture through a supportive internal dialogue and boundaries, address comorbid diagnoses.
The four horseman and a description of each
Criticism: verbal attack on personality or character.
Contempt: attacking sense of self with an intent to insult or abuse.
Defensiveness: victimizing yourself to fend off attack and reverse blame.
Stonewalling: withdrawing to avoid conflict while conveying disapproval, distance, and separation.
The three stages and their processes
1) De-escalation: assessment, identifying attachment issues, access underlying emotions, frame problem
2) Restructuring the bond: expand the "dance" and express attachment needs
3) Consolidation: create new positions/cycles and new solutions to pragmatic issues
Explain one of the six therapeutic processes
Explanation of the use of Acceptance, Contact with the Present Moment, Values, Committed Action, Self as a Context, or Defusion?
Describe a treatment approach
A description of Intuitive eating principles, CBT approach, or MI.
Name the cultural influences on EDs and choose one to describe how it influences EDs
Narrowing definition of "health", "ideal body", and dieting.
A description of its influences.
Name the interventions of the Gottman method and choose one to describe.
The antidotes to the four horseman, rapport, island survival game, and love maps.
A description of one.
Name the interventions of EFT and choose one to describe.
Increase Emotional IQ, Build Attachment Security, Understand the "Dance", Create Corrective Emotional Experiences, Change the Dance, and Repair Attachment Injuries.
Description of one.