C H A R L O T T E C A P E R T O N - K I L B U R N , M S , R D N - - PowerPoint PPT Presentation
C H A R L O T T E C A P E R T O N - K I L B U R N , M S , R D N , L D N , C S S D , F A N D , C E D R D D I R E C T O R O F S P O R T S N U T R I T I O N , C O L L E G E O F C H A R L E S T O N - A T H L E T I C S N F L P E R F O R M
C H A R L O T T E C A P E R T O N - K I L B U R N , M S , R D N , L D N , C S S D , F A N D , C E D R D
D I R E C T O R O F S P O R T S N U T R I T I O N , C O L L E G E O F C H A R L E S T O N - A T H L E T I C S N F L P E R F O R M A N C E - P R I V A T E P R A C T I C E A U T H O R E M A I L : N F L P E R F O R M A N C E @ Y A H O O . C O M T W I T T E R : @ P E R 4 M A N C E F U E L
Coautho hor-
Winning T The W e War Wi Within: N : Nutrition T Ther erapy f for C Clien ents w with E Eating D Disorder ers
Ut Utili lize C CBT t techni hniques u useful t l to e eating ng d disorder c cli lient nts. . Create e effective s sessions ns f for c cli lient nts. . Und nderstand nd ho how t to i imple leme ment nt e effective C CBT d dialo logue.
COGNITIVE BEHAVIOR THERAPY (CBT) BRIEF REVIEW
Most e effective i in t n the he t treatme ment nt o
BN a and nd B BED D Structured t treatme ment nt f focuses o
n present nt a and nd f future t thr hrough s h ski kills lls t traini ning ng a and nd e education n The heory- i
nterconne nnected § Thoughts (cognitive) and § Actions (behavior) Cha halle lleng nge i irrationa nal b l beli liefs § New healthier thoughts and actions can occur by restructuring Heali ling ng b by u y und nderstand nding ng s self lf Work t k toward r rema maini ning ng c calm o lm or ne neutral i l in a n a d difficult lt s situation n
Self / Personal Growth Individual Clients Groups Marriage / relationships Family Workplace Varying Intellectual ability/learning impairments Caution: C n: Cogni nitive t the herapies d do no not a appear t to w work w k with c h cogni nitive i impairme ment nt
Event nt Attitudes, V , Valu lues, B , Beli liefs § Emotional Response § Behavioral Response
Over-evaluation of weight and shape Negative body image Core beliefs about self- worth Negative self-evaluation Perfectionism
Weight ht-c
ntrol b l beha haviors
§ dietary restraint § restriction § binge-eating § purging behaviors
Self lf-ha
m Body c y che hecki king ng Body a y avoidanc nce
nderstand nding ng o
the hems mselv lves a and nd t the heir e eating ng d disorder s so t tha hat he heali ling ng c can n
.
Nutrition T n The herapist R Role le § Listen
§ Encourage § Teach if needed § Help client determine goals
Cli lient nt R Role le
§ Express concern § Define goals § Implement learning
REQUIRES A COLLABORATIVE EFFORT BETWEEN NUTRITION THERAPIST AND CLIENT
Requires mo more t tha han ju n just he help lping ng w with h beh ehaviors o
bing ngeing ng a and nd purging ng. . Int Intervent ntions ns p prima mary f y focus o
n dietary r y restraint nt a and nd t the he dys ysfunc nctiona nal t l tho hought hts a about “ “bad” f foods, b , body w y weight ht a and nd sha hape. .
Winning The War Within: Nutrition Therapy for Clients with Eating Disorders, 3rd edition 2017
CBT he help lps t the he c cli lient nt § Moni nitor thinking and heighten awareness of thinking § Recogni nize the connection between certain thoughts and maladaptive behaviors § Exami mine ne the validity of particular beliefs § Try o y out more realistic and appropriate interpretations; and § Gr Gradual mo l modification n of the underlying assumptions that are fundamental determinants of beliefs, as well as self-defeating behaviors.
Winning The War Within: Nutrition Therapy for Clients with Eating Disorders, 3rd edition 2017
IRRATIONAL THINKING/COGNITIVE DISTORTIONS
Being convinced of an untrue reality (believing you’re overweight when you’re 85lbs.)
Other examples of Cognitive Distortions
Filtering (“This food is so full of fat, it makes me feel bad the rest of the day.”) Black and White thinking/Polarized Thinking (“I didn’t eat what I should have or breakfast, so what does it matter if I eat or what I eat the rest of the day.”) Overgeneralization- (“The last time I ate dairy I had diarrhea, I have a dairy allergy) Jumping to Conclusions (“People think I am fat if they see me eating bread.”) Catastrophizing/Magnifying or Minimizing Personalization
Grohol, J. (2016)
IRRATIONAL THINKING/COGNITIVE DISTORTIONS
Other examples of Cognitive Distortions
Control Fallacies- Two ways external control (helpless, victim of fate; feeling this way keeps one stuck and feeling not able to affect their own life or unable to make a difference in the world) and internal control (feel responsible for everyone around and is left exhaustive from trying to fill all the needs of others and guilty when unable to do so) Fallacy of Fairness-(”She can eat anything she wants and doesn’t gain weight.”) Blaming Should’s- (“I really should exercise. I shouldn’t be so lazy.”) Emotional Reasoning- (“I feel it therefore it must be true.”) Fallacy of Change- Global Labeling/Mislabeling- (”I am such a failure- I can never stick to what I plan to eat.”) Always Being Right
Grohol, J. (2016)
Beha havioral P l Pha hase: p : pla lan f n for s stabili lizing ng e eating ng a and nd e eli limi mina nating ng s sym ymptoms ms. Int Intens nsified e emo motions ns Tools ls ( (coping ng s strategies) f for ma mana naging ng f feeli ling ngs a are d develo loped a and nd b become me a an i important nt p part o
the he w work. Psycho hoeducation CBT i inc nclu ludes i in-s n-session a n activities a as w well a ll as “ “ho home mework” k”. .
Winning The War Within: Nutrition Therapy for Clients with Eating Disorders, 3rd edition 2017
Journa nali ling ng Unr nraveli ling ng C Cogni nitive Di Distortions ns Cogni nitive R Restructuring ng Beha havior M Modification n Education n Rela laxed B Breathi hing ng Experient ntial A l Activities Int Intent ntiona nal R l Reframi ming ng Tho hought ht s stopping ng
IRRATIONAL BELIEFS ARE THE SELF-DEFEATING RULES
Core beliefs are underlying rules that guide how people react to the events and circumstances in their lives.
IRRATIONAL BELIEFS
whatever I do. Clean eating makes me a worthy person. (their definition of clean eating)
Only healthy foods.”
punished.
IRRATIONAL BELIEFS
there is nothing I can do to feel any better.
frightening – otherwise they might happen.
influence my feelings and behaviours now.
unhappy when they’re sad.
Fact no not a assumptions ns ( (Rationa nal) l) § What are the medical & physical consequences of your behaviors? § How effective are laxatives or vomiting? Structured a and nd d directive- H
does t the he b body u y use c calo lories? H How d does me metaboli lism m cha hang nge t thr hrough h refeeding ng p process? W Wha hat i is no norma mal e l eating ng? Listen a n and nd u use t techni hniques f for r restructured r rationa nal t l thi hinki nking ng
Cognitive Phase: strategies for change, Identifying a and c cha hanging c cues(triggers), Connecting behaviors to thoughts and emotional patterns that perpetuate the problems (“I will only
be happy if I can lose this weight”)
Restructuring thoughts perspectives and ideas (“my
self-worth doesn’t depend on my size or shape”).
Setting consequences of behaviors (setting goals) and experimenting with high risk.
Winning The War Within: Nutrition Therapy for Clients with Eating Disorders, 3rd edition 2017
If If “ “thi hink” nk” c can b n be s substituted f for “ “feel” l” i in a n a s sent ntenc nce, i , it i is no not a a feeli ling ng. . If If “ “am” m” c can b n be s substituted f for “ “feel,” l,” it i is a a f feeli ling ng. . Wha hat i is t the he c cue t tha hat t triggers/cues t the he b beha havior?
S Social, s l, situationa nal, nu l, nutritiona nal a l and nd me ment ntal c l cues
Id Ident ntify, c , che heck, a , and nd c cha halle lleng nge a and nd r repeat
Winning The War Within: Nutrition Therapy for Clients with Eating Disorders, 3rd edition 2017
Wha hat i is t the he e evidenc nce t to s support o
refute t the he t tho hought ht? Wha hat a are t the he f func nctions ns o
my t y tho hought hts?- g
n, purpose Wha hat a are t the he i impli lications ns? Wha hat a are t the he a alt lterna native e expla lana nations ns?
Thi his i is a a t time me t to c cha halle lleng nge a again t n the he u und nderlyi lying ng a assumptions ns
Winning The War Within: Nutrition Therapy for Clients with Eating Disorders, 3rd edition 2017
Concentrates on reducing triggers
Can b n be a appli lied t to a assist i in c n cha halle lleng nging ng a a c cli lient nt’s ’s d distorted a and nd irrationa nal t l tho hought hts a about f foods. . The he p process i involv lves § education § behavior modification § and cognitive restructuring
Winning The War Within: Nutrition Therapy for Clients with Eating Disorders, 3rd edition 2017
REFERENCES / RESOURCES / BIBLIOGRAPHY
And nderson, J n, J. ( . (2014, J , June ne 1 12). 5 . 5 g get-p
techni hniques f from C m Cogni nitive B Beha havioral T l The
. Everyd yday H y Healt lth. h. R Retrieved f from m ht http:/ ://www.e .everyd ydayhe yhealt lth.c h.com/ m/hs hs/ma majo jor-d
n-living ng-w
ll/cogni nitive-b
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hniques/ Bernard, M. E. (1986). Staying Rational In an Irrational World: Albert Ellis and Bond, F.W. & Dryden,
Bo Boyes, A , A. ( . (2012, De , Decemb mber 6 6). C . Cogni nitive b beha havioral t l the herapy t y techni hniques t tha hat w work: M k: Mix a and nd ma match C h Cogni nitive B Beha havioral T l The herapy t y techni hniques t to f fit y your p preferenc
. Psycho holo logy T y Today. R . Retrieved f from ht m https:/ :// www.p .psycho holo logyt ytoday.c .com/blo log/in-p n-practice/201212/cogni nitive-b
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Dryden, W. (1995). Brief Rational Emotive Behaviour Therapy. Chichester. John Wiley & Sons. Ellis, A. (1988). How To Stubbornly Refuse To Make Yourself Miserable About Anything. New York. Lyle Stuart. Ellis, A. & Harper, R. A. (1975). A New Guide to Rational Living. Hollywood. Wilshire Book Co. Ellis, A., Wolfe, J. & Moseley, S. (1980). How to Raise an Emotionally Healthy, Happy Child.
Ellis, A. & Dryden W. (1997). The Practice of REBT (Second edition). London. Free Association Books.
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Garner DM, Rockert W, Olmsted MP, Johnson C, Cosane DV. Psychoeducational Principles in the Treatment of Bulimia and Anorexia Nervosa. In: Garner DM, Garfinkel PE, eds. Handbook of Psychotherapy for Anorexia Nervosa and
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Kratina K, King N, Hayes D. Moving Away From Diets: New Ways to Heal Eating Problems and Exercise Resistance, 2nd
Martin, B. (2016). In-Depth: Cognitive Behavioral Therapy. Psych Central. Retrieved from https://psychcentral.com/lib/in-depth-cognitive-behavioraltherapy/ Megan, R. (2016, August 8). List of CBT techniques – cognitive behavioral therapy. Info Counselling. Retrieved from http://www.infocounselling.com/list-of-cbt-techniques/ National Association of Cognitive-Behavioral Therapists, http://www.nacbt.org/whatiscbt.htm Neuropsychiatric Research Institute and Eating Disorder Institute. Bulimia Nervosa Individual Treatment Manual. Fargo, ND; 1998.
http://www.infocounselling.com/list-of-cbt-techniques/ http://psychologytools.com http://www.therapistaid.com www.webmd.com - http://www.webmd.com/depression/guide/cognitive- behavioral-therapy-for-depression#1 Steinberg, D. & Dryden, W. (2003). How to Stick to a Diet. London. Sheldon Press Still, A. & Dryden, W. (2003). Ellis and Epictetus: Dialogue vs. method in
Viscott D. The Language of Feelings. 2nd ed. New York, NY: PocketBooks; 1990 Wilson GT. Cognitive Behavioral Therapy Treatment of Bulimia Nervosa. The Clinical Psychologist. 1997; 50(2). Ziegler, D.J. (2002). Freud, Rogers, and Ellis: A comparative theoretical
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