Whether or not you feel comfortable taking on a case that involves treating an eating disorder, your evaluation/assessment of the patient and/or early interaction with the eating disordered child and family could provide the first, and perhaps the only, opportunity for the individuals in that family to avail themselves of professional care at a point where the disease could be easily ameliorated. Your role is pivotal. Respect that. Respect the disease, the role of the parents and your own responsibility to launch a successful recovery effort. As the entry point into the disease system and the family system, and as the stimulus to the creation and development of a patient support system, you could potentially be saving a life.

Education at this juncture is crucial. First, you need to become educated so that you know what you are looking at. Second, the patient needs to be educated to the fact that recovery is possible. Third, the family needs to be taught to understand that though they are not to blame for having caused this disease, there is a great deal they can do to insure that their child undergoes a successful process and timely recovery.

Be prepared to respond proactively, with insight and initiative. Share what you know, help the patient recognize, own, and gather in his or her resources, insuring that he or she be in touch with a medical doctor, and situated in the proper care milieu. Establish yourself or another knowledgeable professional in the role of case manager. Get the ball rolling. If you are the patient’s point of entry into the health care system, you may need to become the force behind pulling together the treatment team and you may become the key liaison between the various disciplines and personalities involved in the case. Now your role as educator extends beyond yourself, the patient and the family to other treatment team members.

Once your patient has become engaged in treatment, your role is pivotal in keeping that person on track throughout a recovery process that can be lengthy, convoluted, and discouraging. You are responsible for providing the patient and family information, reassurance, and a firm grasp on reality. The patient needs to recognize what point he or she is at in the long journey to recovery, how far he has come, the distance left to go, and what direction he or she will need to take to recover effectively. You and the patient need to anticipate, integrate and accommodate to frustrations, regressions and ambivalence strong enough to derail even the most committed recovery at any point along the way.

The circuitous and complex recovery process may sometimes appear to be elusive, and typically feels overwhelming. As a practitioner, your encouragement for patient and family needs to be knowledge-based, educative, and consistent; at the same time, it needs to be reality-based and limit setting, while nurturing. Your input is the lifeline that keeps the challenges and quality of the effort in the realm of “can do.” It is easy to forget or lose sight of the extent of the challenges that recovery presents when you are as close to the process as is the patient and family. Typically, you as the practitioner will need to function as the collective memory for the patient and the family.

In the end, the skill of the practitioner is measured in how clearly the patient grasps his or her OWN pivotal role in bringing about his or her own recovery. It is for the practitioner to empower the patient to recognize success as a function of his or her internal resourcefulness and commitment to health and to understand that personal triumphs can be perpetuated, attained and/or recreated.

Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 34years. She is the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers, Jossey-Bass, 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at www.empoweredparents.com and www.empoweredkidZ.com.