Readiness for Therapy – Part One
It is natural to feel apprehensive about beginning counseling, especially if you have never been in counseling before. You might think that your symptoms are not serious enough to warrant help, or you might feel that you are not ready for help. One common misperception is that counseling is only useful when you are ready to make changes in your life. However, many people begin eating disorder treatment when they are “on the fence” about their struggle, or when they have been pushed to seek help by others. While this might not feel like the most comfortable place to start, counseling can still be quite helpful in these instances. A skilled therapist can help you start your recovery journey from any starting point, and can also coordinate with your healthcare provider to ensure that you are assessed for medical stability. Medical stability is always the most critical part of treatment. Clients who are not medically stable must receive proper medical care before they can engage in treatment on an outpatient basis.
Although Prochaska and Diclemente’s (1982) stage model of behavioral change is often applied to recovery from substance abuse, and it can be helpful in understanding how people make and maintain any kind of behavioral change. Therapists can provide support or use interventions with clients at any stage.
In the first stage, which is referred to as “pre-contemplation”, people with eating disorders are often unaware that they have a problem. People in this stage are frequently introduced to therapy by a parent, friend or concerned family member. Body image distortion makes it difficult (if not impossible) for them to see their body size accurately. They might also feel that their actions are normal because their exercise and eating behaviors began with healthy intentions which have gradually changed into an obsession over time. In this stage, a therapist can emphasize the importance of medical treatment, help reevaluate the severity of their condition, and encourage them to explore their underlying issues. It is also helpful for clients to meet with a dietitian who is skilled in treating eating disorders so that they can learn about balanced nutrition. While most people with eating disorders believe that they have an extensive knowledge of food and nutrition, their knowledge is usually more focused on weight loss and calorie counting than it is on dietary needs and health.
In the second, or “contemplation” stage, people feel ambivalent about having an eating disorder, but are also considering change. Many people are in this stage when they enter treatment. They might have a sense that their eating is unhealthy, but they still feel unsure whether or not they are ready to change. At this point, it is helpful to explore the pros and cons in more depth with a therapist. This process can also reveal clients’ underlying emotional issues, as they discover what has caused them to value thinness and control over health. Clients can also discuss their fears about change and learn to include positive expectations as they move towards recovery.
In our next blog update, we will explore the remaining stages of change and what they look like in the context of eating disorder recovery.
This entry was authored by EDTC Therapist, Alayna Orozco, LMHC.