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Eating Disorders Specialization/Apprenticeship

GOAL:
AN INTERN WHO DOES THIS SPECIALIZATION WILL DEVELOP ADVANCED SKILLS AND KNOWLEDGE ABOUT BULIMIA AND ANOREXIA IN THE AREAS OF INDIVIDUAL AND GROUP THERAPY, OUTREACH PROGRAMMING, CONSULTATION TO OTHER STAFF AND TRAINEES AND TO UNIVERSITY STAFF OUTSIDE THE CENTER. INTERNS WILL BE SEEN AS DEVELOPING EXPERTS IN THE AREA.

OBJECTIVES:
  • Objective 1: Interns will have a broad and in-depth knowledge of the literature and research concerning eating disorders. In particular, they will have awareness of the biopsychosocial model and the debate concerning eating disorders as an addiction.
  • Objective 2: Interns will have appropriate awareness of medical complications of eating disorders and will learn to develop successful working relationships with medical professionals.
  • Objective 3: Interns will develop knowledge of healthy nutrition. In particular, they will develop skills in analyzing eating records and giving feedback to clients. Interns also will learn to develop successful working relationships with dietitians.
  • Objective 4: Interns will develop skill in interpreting results of the Eating Disorders Inventory (EDI) and in giving feedback about it to clients.
  • Objective 5: Interns will develop and deepen skills in providing individual and group counseling to bulimic and possibly to mildly anorexic individuals.
  • Objective 6: Interns will develop and deepen skills in doing an effective intake with eating disordered individuals. They will also develop the skill to assess for anorexia and refer such individuals out of the Center to appropriate community or state resources.
  • Objective 7: Interns will competently deliver outreach and consultation concerning eating disorders to the university community.
  • Objective 8: Interns will develop awareness of the impact of sociocultural issues on the development of eating disorders.
  • Objective 9: Interns will develop an awareness of healthy weight loss possibilities and the dangers of unhealthy weight loss processes.
  • Objective 10: Interns will be sensitive to diversity issues among eating disordered individuals. This will include sensitivity to weightism as a diversity issue.
  • Objective 11: Interns will develop awareness of the stages of treatment of eating disordered individuals and the need to change the therapeutic intervention accordingly.
  • Objective 12: Interns will develop awareness of the importance of networking with other professionals in the local area and state in order to have a referral base and to continue to stimulate their own development and knowledge.
  • Objective 13: Interns will develop their own outreach program on eating disorders and present it.
  • Objective 14: Interns will be knowledgeable about ethical issues and integrate this into their work with individuals with eating disorders.
  • Objective 15: Interns will become aware of the impact of their work with this population on their own attitudes toward their bodies and dieting as well as their feelings, biases, and development and will be able to discuss these issues openly with their supervisors.
  • Objective 16: One of the interns' clinical case presentations will be on an eating disordered client.
  • Objective 17: Staff and supervisors working with interns in this area will be role models and mentors, supporting, encouraging, and stimulating the interns' development. They will assist interns in becoming developing experts and also assist interns in integrating into the profession of psychology.
PROCESS:
Interns specializing in this area will be assigned a staff supervisor who will be responsible for coordinating interns' professional and intellectual development in this area. The staff member will supervise interns' clinical work with eating disordered clients. The staff member will also help interns develop an outreach presentation. In addition, the staff supervisor will guide the interns reading of the literature and will promote discussions of the sociocultural pressures women face that lead them to become focused so intensely on the size of their bodies. One of the two senior staff supervisors will supervise the specialization during the first semester. When the second semester begins, the second senior staff supervisor will supervise.

CLINICAL WORK:
Interns will carry a caseload of 3-5 individual clients who are eating disordered. Most of these clients will be bulimic. A few may either be early anorexic (beginning restricting, weight focused) or binge-eating disordered (likely overweight, bingeing but not vomiting). The intern will also co-lead the Bulimia Group first and second semester. During the summer, if enough eating disordered clients remain for the summer, the intern will run the Bulimia Group alone. Interns also will be part of the rotation with the two coordinators to do intakes on individuals who present to the Center reporting concerns with eating. Interns will receive one hour of supervision per week from their specialization supervisor as well as group supervision from the staff group co-leader. If the intern leads the Bulimia Group alone during the summer, the former co-leader of the Bulimia Group will supervise the group work.

OUTREACH/CONSULTATION:
Interns will initially attend outreach presentations given by the senior staff coordinators. Gradually, as interns are ready, they will be assigned increasing responsibility in the outreach presentations. By the second semester, interns will be expected to do the outreach programs alone. Interns will also be asked to develop a program of their own. Second semester interns will be asked to provide answers to questions on eating disorders submitted to "Concerned Charlie", a computer based service that allows students to submit personal and informational questions to the Center. Staff and interns in the Center respond to these questions in their areas of expertise. The responses are reviewed by a committee before being put out over the network. In the case of questions on eating disorders, interns will be asked to submit questions and answers to the supervisor for review before sending it on to the committee. Interns will also be available to other staff and trainees for consultation about eating issues that their clients have.

INVOLVEMENT IN THE PROFESSION:
Interns will be encouraged to attend state and national conferences on eating disorders. When the Center schedule allows it, interns may attend the Eating Disorders Task Force of Indiana meetings in Indianapolis.

IMMERSION:
Center policy precludes seeing anorexics because the number of sessions necessary to successfully treat their disorder goes far beyond the twelve session limit. Therefore, interns will be asked to develop their awareness of severe anorexia by watching a variety of videotapes that have been assembled of nationally televised programs that focus on anorexia or treatment of it. Interns will also be asked to do extensive reading on eating disorders and to bring in any current media information relevant to the topic. There are also numerous audiotapes available on specialized topics in the area of eating disorders that the intern can utilize.

OPTION:
During the summer interns could do directed readings in an area of their choice to further deepen their knowledge. Possible topics could include eating disorders in males or athletes, body image issues and treatment, nutrition, obesity and weight loss.

EVALUATION:
Interns will be evaluated in a variety of ways by the coordinators of the Eating Disorders Specialization. The goal of evaluation is to insure that interns have the advanced knowledge and skill necessary to function competently in this area and to do no harm. Since the interns are making this an area of specialization, the coordinators will do everything possible to assist and mentor them in the development of expertise in this area. If, for any reason, the coordinators/supervisors/mentors believe that interns should not specialize in this area, this will be discussed in depth with the Training Director.

  1. The intern supervisor in the Eating Disorders Specialization will fill out a clinical supervisor's evaluation form with an addendum attached that reflects assessment of competence in clinical issues specific to eating disordered clients (Addendum to Clinical Supervisor's Evaluation of Intern for Eating Disordered Clients).
  2. The intern supervisor will fill out a Special Projects Evaluation form at the end of each semester that reflects evaluation of the intern's competence in providing programming and outreach and consultation.
  3. Group co-leaders will fill out the Group Evaluation Form at the end of each semester they co-lead with the intern with the additional addendum to the Clinical Supervisor's Evaluation of Intern attached.
  4. Supervisors will also provide ongoing informal feedback to the intern.
  5. Supervisors will provide oral feedback to the Training Director through meetings with the Supervisor's Committee.
  6. Interns will evaluate their supervisors, project coordinators, and group co-leaders as well on designated forms.
  7. An overall assessment of interns' level of expertise in the specialization will be done at the end of the internship year. It will be a part of the Attainment of Training Goals Evaluation.
  8. Evaluation is to be seen as reciprocal and shared openly between interns and their supervisors and the Training Director.