- Therapists and licensed mental health practitioners have specialized training to help you examine the Why's of how you developed your eating disorder and to work through and treat underlying issues behind your eating disorder. They are also able to diagnose and treat other psychological issues which might be present such as depression, anxiety, a trauma history or substance abuse.
- As a Carolyn Costin Institute-trained coach I do not diagnose or treat conditions or have the training to delve into more underlying issues. Instead, I am trained to support the work and treatment goals you have with your therapist or treatment team should you be working with one, to focus on the “here and now” and the How's of recovery, and to help you in accomplishing day-to-day behaviour changes. However, if underlying issues do come up in a coaching session they will be empathized with and considered for how they are affecting you now, as well as how you might be able to bring them up with your therapist or most appropriate treatment team member.
- Therapists generally work from an office and sessions are generally an hour long. As a coach I can be an addition to the work you are doing with your therapist and work with you in areas where you might need support in your daily life and for variable lengths of time. For example support with eating at restaurants or grocery shopping.
- Having recovered from my own eating disorder, I can also act as a tangible role model for recovered living and I hope to provide you with a source of hope and inspiration that full recovery is possible. From my own experiences, I truly know the pain of an eating disorder and the challenges of recovery. Through my training I am conscious of how to use my personal experience in the best interest of each client.
- As a coach, I am trained to be a supportive addition to a treatment team and to help you implement the goals that you are working on with your team into your daily life.
- I am trained to deal with real-life situations that other team members might not want to or have the ability to perform due to time constraints or legal reasons. For example meal support sessions and between-session support by e-mail and text, as well as in-the-moment support with grocery shopping or other activities of daily life. Providing you with this type of "exposure and response prevention" work will allow your other team members to have more time to spend with you on underlying issues, larger psychological problems, or specific nutrition-related issues that are not in my scope of practice to address.
- I will work with you in the here and now, dealing with your current thoughts, feelings and behaviours and with helping you to build a skill base for daily living that will help your recovery become internalized and lasting in a complementary way to what you are working on with your therapist and other team members.
- As a recovered coach, I am also trained in how to use my personal experience in the best interest of each client, and can provide you with a tangible role model for recovered living and I hope to provide you with a source of hope and inspiration that full recovery is possible.
How is coaching different from and complementary to the work of a registered nutritionist or dietitian?
- A registered nutritionist or dietitian has specialized training that allows them to assess a person's nutritional status, create meal plans, and make professional recommendations regarding specific foods, supplements and eating changes.
- As a coach, I am trained to help you implement the work you are doing with your dietitian. I am also trained to help you challenge your food fears and eating rules and rituals in the moment to help you move towards where you would like your relationship with food to be. However, I cannot prescribe a specific meal plan or give guidance around what or how much to eat in a treatment-like way. Coaching support can look like:
- Supporting you by guiding you through a challenging meal or snack and eating the same food with you, as well as supporting you by text or e-mail throughout the rest of the day.
- Eating a specific fear food with you.
- Supporting you to purchase the food necessary to follow your meal plan.
- Supporting you to purchase new foods to expand the variety of your diet and challenge food fears.
- Supporting you to grocery shop without looking at nutrition labels.
- Supporting you to break entrenched eating patterns by preparing and then eating a new dish together at your home, whether in person or via videoconference, or
- Any type of practical support that will help you to implement the work you are doing with your dietitian and that will help you with your answers to the questions, "What would you like to do with food that you currently can’t do?" and "What behaviors would you like to stop doing with food, but currently can’t stop?" (questions from 8 Keys To Recovery From An Eating Disorder Workbook by Carolyn Costin and Gwen Schubert Grabb).
- For a more detailed description of how I can support you with food and eating challenges, please visit my Services page.
- Some situations where coaching may be ideal are:
- If you have a therapist and dietitian but feel like you need extra support to implement the work you are doing with them into your daily life and to help you set and follow through on goals. For example, completing meals according to your meal plan, completing meals without purging, challenging food fears and food rituals, or decreasing other eating disorder behaviours.
- If you need support outside of an office such as with grocery shopping, meal preparation, challenging yourself to eat at restaurants, buying new clothes after weight restoration, or having someone to text or e-mail throughout the week for extra support to not engage in eating disorder behaviours.
- If you have been recently discharged from an eating disorder treatment program and feel like you need extra support for your initial time at home, especially if you live in a small community where specialized eating disorder services are limited or not available.
- Some other instances where coaching may be a good fit should it seem safe and appropriate are:
- If you have tried therapy, dietitians and a treatment team or even a few and nothing has worked, and you want to explore coaching as an alternative.
- If you are far along in recovery but it feels like you could now go further with a coach who can support you in real-life situations and with goal setting and behaviour change rather than continuing with your previous team.
- If you are very early in your eating disorder or have disordered eating and you want to try a coach first before exploring other options because your symptoms are not too limiting and you think that coaching might be enough or will provide information about your real degree of symptoms and functioning.
- Important Note: In any case where you want to try coaching without also working with professional treatment team members such as a therapist or dietitian, I will use my best judgment to determine if I think this is a good idea and if I think I might be able to help you in this situation. In most cases, if you have a diagnosed eating disorder I will require that you are also working with a therapist and/or dietitian as eating disorders are complex illnesses and coaching is not a substitute for psychotherapy or nutritional advice.
I am a therapist, dietitian or other licensed mental health professional. Can you explain how your work differs from therapy and how it could complement my work and provide additional support to my clients?
- As a Carolyn Costin Institute Certified Eating Disorder Coach I am trained to be an adjunct to an overall treatment team and to work with clients to help them implement the goals that they are working on with their treatment team into their daily lives.
- I am trained to deal with real-life situations that other team members might not want to or have the ability to perform due to time constraints or legal reasons. For example, navigating shopping at the grocery store, eating at a restaurant, cooking meals at the client’s home, buying clothes after weight restoration, or even going to a social event to support the client in their day-to-day life where their eating disorder has been in control. These are all things that can be difficult or impossible for therapists, doctors or other licensed professionals to do, but are things that sober coaches have been doing with substance abuse clients for a long time and which can be powerful for those with eating disorders.
- My doing this exposure and response prevention work with your client will allow yourself and other team members to have more time to spend with the client on their underlying issues, larger psychological problems, or specific nutrition-related issues that are not in my scope of practice or training to address.
- I will work with the client in the here and now, dealing only with their current thoughts, feelings and behaviours and with helping the client to build a skill base for daily living that will help their recovery become internalized and lasting in a complementary way to what they are working on with their therapist and other team members.
- I am also able to provide on-call support for the client through texting and e-mail to help take some of this time commitment off of other team members, or to provide this for the client if other team members do not provide it.
- As a recovered coach I am also trained in how to use my personal experience in the best interest of each client and can provide the client with a tangible role model for recovered living and provide a source of hope and inspiration that full recovery is possible.
- From my eating disorder coach training, as well as my previous work as a registered dietitian working with eating disorders, I have a true appreciation for the importance of clear communication with you and the client's treatment team in whichever way each team member prefers. My goal is to help the client implement the work that they are doing with you and other team members more fully into their daily lives.
- I work with individuals 19 years and older diagnosed with anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding or eating disorders (OSFED) and unspecified feeding or eating disorders (UFED). I also work with individuals suffering from orthorexia (an unhealthy obsession with healthful or right eating), compulsive exercise, and any disordered eating or body image issues that are causing distress for which an individual would like help and support in overcoming, whether diagnosed as an eating disorder or not.
- In many cases, especially with a diagnosed eating disorder, I will require that you are also working with a therapist and/or a dietitian. This can be discussed further during our initial consultation or in initial sessions.
- I provide in-person sessions in Vancouver, BC Canada, logistics permitting. I also provide virtual services by phone or videoconferencing anywhere in the world.
- Unfortunately as a coach I am not covered by any insurance plans that I am aware of. However, if your benefits do cover any coaching services I will gladly provide you with a receipt to submit to your insurance company for reimbursement.
How frequently do you typically meet with clients? And how long does the overall coaching work last?
- I typically meet with clients on a weekly basis as I’ve found this to be the most effective for clients in achieving coaching goals and experiencing positive changes from the coaching work. If more support is needed or desired I am able to see clients more often, and towards the end of the coaching work sessions may become less frequent as the client becomes more advanced in their recovery. However, all of this is flexible and tailored to what is most beneficial for each client.
- The overall length of the coaching work varies greatly based on a variety of factors specific to each client, as well as ongoing evaluation on both of our parts in terms of recovery progress and goals.
- Although I have a solo private practice, I believe that a collaborative and comprehensive approach to care is the most beneficial and is often necessary given the complex nature of eating disorders. If you have an existing treatment team, with your consent I believe in working with them so that everyone is on the same page and so I can best support the work you are doing with them.
- If you do not already have a treatment team such as a therapist or dietitian and at the start of or during the course of our work I believe that this would be beneficial or necessary for you, then I will gladly provide referrals and help you to coordinate this.
- I do require that you are 19 years of age or older.
- After our initial session, if you are not working with treatment professionals such as a therapist, dietitian or psychiatrist then I may require that you send me a doctor’s note verifying that you are safe to participate in coaching and to engage in meal support. I also require that you agree to continue with any recommended medical follow-ups that they suggest.
- If you are actively struggling with an eating disorder or significant mental health concerns, I will likely require that you are meeting with a therapist and/or dietitian. If you are not already, then we can discuss this during our initial sessions or as our work together progresses and as I feel it is appropriate, and I will gladly make referrals and help you to coordinate this.
About Eating Disorders and Disordered Eating:
- Eating disorders, disordered eating and body image issues can affect people of any age, ethnicity, gender or background. They also affect people of any body shape or weight.
- The term "eating disorder" refers to having been given a formal diagnosis by a licensed professional based on meeting specific criteria of the DSM-V (Diagnostic and Statistical Manual of Mental Health Disorders). The term "disordered eating" refers to a relationship with food that is not "normal" or healthy - mentally, emotionally or physically - even if it does not meet the specific criteria for a diagnosed eating disorder.
- Both diagnosed eating disorders and disordered eating of any kind involve an unnatural relationship with food that takes away from your overall wellbeing and quality of life. The main differences between them lie in the frequency and severity of the behaviours and the impairment in functioning and distress they cause. However, even if someone does not meet all of the criteria for a diagnosed eating disorder their disordered eating may still be extremely problematic for their health and quality of life and deserves and needs to be taken seriously.
- If you are dissatisfied in any way with how your relationship with food or your body is negatively affecting your life you are deserving of concern and support to work on these issues and pursue a life of greater peace.
For further information on eating disorders and disordered eating, please explore:
- Yes, absolutely. I align with the belief of The Carolyn Costin Institute and many other experts in the eating disorders field that full recovery from an eating disorder is possible, where full recovery means more than being in remission or knowing how to manage your illness but rather that the eating disorder is truly gone and out of your life forever.
- However, while I believe that full recovery is possible for everyone, this does not mean that everyone will fully recover. Full recovery is up to each individual as it is believed that those "who don’t get better are the ones who, for whatever reason, stop trying" (Costin & Grabb, 2012, p. 35). However, there is no shame in this. Recovery is a long, difficult and very non-linear path, and maintaining hope and motivation can be extremely challenging. However, individuals of all lengths and severities of illness have recovered and can recover. Ambivalence and waxing and waning of hope and motivation is so normal, and part of my coaching work focuses on helping you to find the Why's for your recovery and exploring your motivation, patience and hope which will wax and wane but which are so necessary for the long, challenging but ultimately rewarding journey of recovery.
For more information on this topic, please explore:
- While the definition of "recovered" varies from source to source, the definition I align with is that of therapist Carolyn Costin from her book 8 Keys To Recovery From An Eating Disorder.
- This definition defines recovery as being beyond simply cessation of symptoms, weight gain or no longer meeting diagnostic criteria, and can be applied to eating disorders, disordered eating or body image issues at any point along the continuum of an unnatural relationship with food and body:
Being recovered is when a person can accept his or her natural body size and shape and no longer has a self-destructive or unnatural relationship with food or exercise.
When you are recovered, food and weight take a proper perspective in your life and what you weigh is not more important than who you are. In fact, actual numbers are of little or no importance at all.
When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size or reach a certain number on a scale.
When you are recovered, you do not use eating disorder behaviors to deal with, distract from, or cope with other problems.