With the latest mandates on the COVID-19 pandemic, many dietitians and eating disorder practices have moved their counseling services and intensive outpatient programs to telehealth and digital formats to continue to provide care for their patients. Even in these difficult, socially isolated times, recovery is still possible.
by: Sadie Grant
Although many things in the United States have taken a break due to the COVID-19 outbreak, eating disorders are not among them. In fact, these stressful, more solitary times can actually exacerbate eating disorder symptoms for many people. With fewer opportunities to get out of the house and enjoy typical day to day activities and social gatherings, individuals may experience less control and struggle to maintain their support systems. And it is certainly no help that diet culture is trying to capitalize on this difficult period of time by claiming that now is the perfect moment to “detox” or to “get back your life”. This is a crucial moment for available treatment for individuals struggling with anorexia nervosa, bulimia nervosa, binge eating disorder, compulsive overeating, and other eating disorders.
However, for many, in-person treatment is not accessible due to social distancing and safety concerns related to COVID-19. While residential treatment is still available for those who need it, many outpatient programs have switched to using online platforms such as Zoom for therapeutic visits, nutritional support, and group therapy. Today we are going to talk about telehealth (digitally delivered health services) for eating disorders. We will consider some of the benefits as well as some of the potential drawbacks of telehealth services and discuss opportunities for treatment from home.
What does telehealth typically look like for the treatment of eating disorders?
- Typical treatment services, such as therapy, meal support, group support, and nutritional sessions delivered through a HIPPA compliant telecommunication platform such as Zoom
- Live, direct telephone or video calls between the client(s) and the treatment team
- Necessary treatment delivered by licensed clinicians and nutritionists while the risk of exposure to COVID-19 (and other illnesses) is greatly reduced
What are some of the benefits of eating disorder telehealth?
- Efficacy: Numerous studies have found that telehealth programs for the treatment of eating disorders are highly successful. For example, Hildebrandt et al. found that a combination of Cognitive-behavioral therapy (CBT) delivered through telemedicine and CBT-guided self-help (CBT-GSH) was significantly more effective than standard care in treating symptoms of binge eating, purging, and other disordered eating behaviors (2020). Anderson et al. also found that family-based therapy (FBT) delivered through telehealth yielded significant improvements in eating disorder symptoms among adolescents with anorexia nervosa (2017).
- Treatment in the home environment: In traditional treatment, the client typically travels to a center to receive clinical services. Sometimes, the new skills and information that clients use during treatment are difficult to transfer to the home environment. By receiving treatment from home, clients may be able to develop coping mechanisms for the specific triggers that they encounter in their day to day environment.
- Convenience: Outpatient eating disorder treatment programs often require the client to spend many hours at a treatment center each day. Telemedicine enables the client to fully participate in a treatment program without the inconvenience of having to commute. Furthermore, if a client moves locations, they do not have to discontinue treatment.
- Safety: Telehealth for eating disorders allows clients to receive necessary support without risking exposure to COVID-19 and other contagious diseases. Beyond the physical dangers of COVID-19, the virus can also be mentally and emotionally taxing. Eliminating the risk of exposure during treatment can help mitigate anxiety, which is often closely associated with eating disorder behaviors.
What are some of the challenges that can arise from eating disorder telehealth?
- Changes in interpersonal communication: Communication can be altered by technology. For example, therapy sessions may look or sound different through a telehealth platform (such as Zoom) compared to face-to-face communication. Some research indicates that in-person communication may lead to greater feelings of closeness between individuals. However, technological communication has been shown to facilitate emotional understanding. Additionally, digitally delivered treatment may not be appropriate for clients with more severe eating disorders as behaviors and symptoms can be more closely monitored in-person.
- Difficulties with technology: Clients may need some assistance when learning new digital platforms and terminology (i.e., bandwidth, resolution). Furthermore, visual factors such as camera angle and lighting can impact treatment.
- Legal restrictions: Legal restrictions can determine whether or not clinical services can be provided across state lines. Clinicians may have to obtain licensure in certain states or direct clients to local treatment centers.
Are you interested in virtual eating disorder treatment for yourself or a loved one?
Here at BALANCE, we understand the importance of structured support in a time of social distancing and uncertainty. We have adapted to the current COVID-19 crisis by offering fully online, virtual programming and services.
Our Day Treatment Program is a full-time program that is running online Monday through Friday from 8:00am-2:15pm and Saturday from 8:30am-1:30pm. Our weeknight program meets online 3 times per week on Monday, Wednesday, and Thursday evenings from 6:00-9:00pm. We are also offering virtual groups, including our Intuitive Eating Group, Body Image Group, Men’s Group, Women’s Group, RO DBT Class, Food & Mood Group, and Supporting a Loved One Group. We are also continuing to offer individual nutrition counseling, therapy, and meal supports virtually.
BALANCE Admissions is following the COVID-19 screening process as outlined by the CDC. We are offering intake assessments by phone six days per week and have evening hours available upon request. To join a BALANCE program or group, we ask our prospective clients to complete a 90-minute intake assessment with one of our experienced Master’s level Admissions Therapists. After your intake is completed, we then consult with any outpatient providers and relevant family members to develop the best treatment plan for you. In a complimentary follow-up phone session we will discuss our recommendations.
Even in these difficult, socially isolated times, recovery is still possible. We are here to support you in the safest way possible. If you would like to reach out to our admissions team, book a free consultation call below or send an email inquiry to our team here.
This post was written by BALANCE Blog Intern, Sadie Grant.
Sadie is a recent graduate of Oberlin College with a B.A. in psychology. After recovering from disordered eating, Sadie became passionate about eating disorder awareness, body neutrality, and destabilizing beauty standards that are established by social and cultural norms. While earning her Bachelor’s degree, Sadie conducted quantitative research, worked with populations experiencing barriers to essential services, and studied Spanish. Sadie hopes to use her developing research and interpersonal skills to work in the field of eating disorders and address the way in which expectations around eating and beauty vary across different populations.
References
Anderson, K. E., Byrne, C. E., Crosby, R. D., & Grange, D. L. (2017). Utilizing Telehealth to deliver family-based treatment for adolescent anorexia nervosa. International Journal of Eating Disorders, 50(10), 1235-1238. doi:10.1002/eat.22759
Hildebrandt, T., Michaeledes, A., Mayhew, M., Greif, R., Sysko, R., . . . Grilo, C. (2020, February 01). Randomized Controlled Trial Comparing Health Coach-Delivered Smartphone-Guided Self-Help With Standard Care for Adults With Binge Eating. Retrieved July 20, 2020, from https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.19020184
Online Telehealth. (n.d.). Retrieved July 21, 2020, from https://centerfordiscovery.com/online-telehealth/
Shingleton, R. M., Richards, L. K., & Thompson-Brenner, H. (2013). Using technology within the treatment of eating disorders: A clinical practice review. Psychotherapy, 50(4), 576-582. doi:10.1037/a0031815
