Family systems therapy draws on systems thinking to view the family as an emotional unit. When applied to families, systems thinking—evaluating the parts of a system in relation to the whole—suggests that an individual’s behavior is informed by and inseparable from the functioning of his or her family of origin.
Therapy sessions include:
- Family Therapy Sessions
- Couples Therapy
Cognitive-behavioral therapy, or CBT, is the leading evidence-based treatment for people with eating disorders. It is based on the theory that a person’s thoughts, emotions, and behaviors are interconnected and can be restructured to support new, healthier thoughts and actions. Cognitive behavior therapy provides the foundation for individual and group therapies throughout all levels of care at Madrone Mental Health.
The cognitive-behavioral model emphasizes the important role that both thoughts (cognitive) and actions (behavioral) can play in maintaining negative behavior patterns. CBT stresses education and skills training and consists of structured treatment that focuses on the present and the future. Three phases of CBT may unfold over the course of treatment:
- Behavioral Phase
- Cognitive Phase
- Maintenance & Relapse Prevention Phase
The primary goal of Dialectical Behavior Therapy (DBT) is to help individuals build a life that has meaning and worth, with a freedom from suffering. DBT was originally developed by Marsha Linehan, Ph.D., to treat individuals who engage in self-harm behavior, many of whom meet the diagnostic criteria for borderline personality disorder. In DBT eastern approaches and western therapies are combined to build skills and address emotional dysregulation.
DBT is composed of four modules, each with its own goals and skill sets:
- Distress Tolerance
- Emotion Regulation
- Interpersonal Effectiveness
MMH facilitates group therapy focusing on DBT skills every day of the week in the Day Treatment Program. Individual therapy is also utilized to address DBT skill development and practice.
Ambivalence and resistance towards recovery are common among those with eating disorders even when faced with the negative, and sometimes dangerous, consequences of their illness. Because of this, a key ingredient in the initial phase of treatment at Madrone Mental Health is developing motivation for change.
The Stages of Change
- Pre-contemplation (no intention to change)
- Contemplation (thinking about change, but not committed)
- Preparation (intending to take action, but have not done so)
- Action (modifying behavior)
- Maintenance (relapse prevention)
At Madrone Mental Health, therapists work to identify each patient’s readiness for change. Unless medical risks dictate otherwise, therapy begins with support, education, and other efforts to increase motivation. The overall goal is to move each patient toward acceptance and readiness for change.
Overcoming an eating disorder involves, among other things, learning to focus (and maintain that focus); control emotional impulses; and to redirect thoughts from negative to positive.
Meditation teaches us to observe and control our bodies and minds – sitting for extended periods without moving, and resisting the urge to fidget or give up is difficult. It is the process of learning mental control; first we gradually learn to observe thoughts and feelings, or shut them out entirely, and then to choose positive rather than negative thoughts or emotions.
Meditation/Mindfulness groups are facilitated two times per week in the Day Treatment Program at MMH.
We believe in the value of Experiential Therapies.
We want our clients to learn new skills, then have the opportunity to put them to use. One innovative way new skills are put to practice is on the Spencer Butte Challenge Course. The Challenge Course offers both low and high activities. Both involve an intricate network of ropes, cables and logs; the exclusive difference between the two courses is height. The high ropes course is 25 to 55 feet in the air, while the low ropes course is one to four feet off the ground. We also have a rock climbing wall.
Our goal is for every patient to visit the challenge course during their stay, provided they are deemed medically capable. They may go as part of a group, or in an individual session with their therapist. Patients must wear a helmet, safety harness and remain attached to a safety line while engaging in these activities.
All activities are designed to address specific therapeutic issues. Often these are areas clients are currently exploring in individual or group therapy. These include group communication, problem solving, trust, planning, teamwork, facing fear, cooperation, understanding self and self-esteem.
Specialized Treatment Tracks
Dual Diagnosis Substance Use Disorder
About half of all individuals with eating disorders also struggle with a substance use disorder. Part of the recovery process may involve a personal and individualized exploration of the factors that may be contributing to the person’s illnesses.
Madrone Mental Health’s Day Treatment Programs offer a specialty track for patients who struggle with substance abuse and addiction issues. Individuals utilizing this specialty treatment track receive one, 1.5-hour blocks of group therapy each week dedicated specifically to the management of the substance use. Each one and half-hour block consists of a 12-step component focused on the substance abuse.
In addition to helping patients learn how to manage their concurrent disorders, the Substance Abuse specialty track focuses on the relationship between the two disorders, understanding symptom substitution, and provides individuals the opportunity to develop an addiction recovery plan. This specialty track helps patients to identify coping skills to manage the co-occurring disorders, explores motivation to change and helps patients identify additional resources to aid in relapse prevention.
PTSD and Trauma Symptoms
It is not uncommon for individuals with PTSD to engage in dangerous eating disorder behaviors in an attempt to cope with painful memories. Our Trauma Specialty Track is a unique therapeutic opportunity to simultaneously address the eating disorder and the effects of trauma. At Madrone Mental Health, specialized Trauma treatment is based on methods with empirical support and following expert consensus guidelines. That is, similar to the treatment of eating disorders in general, trauma treatment is based on an approach that highlights the importance of biological, psychological, and social factors.
In addition to receiving individualized eating disorder interventions, MMH’s trauma specialty track offers the following therapeutic components:
- Specific CBT-based trauma work during individual psychotherapy
- Weekly participation in trauma group therapies including psycho-education, skills training and art therapy.
- Individualized nutritional counseling around trauma-related fear foods
- Psychiatric assessment and treatment of trauma symptomatology.
- Individualized trauma work during art therapy and other expressive therapies
- All individual and group trauma work is specially tailored to address the individual’s developmental needs.
Similar to all patients in our program, the therapy focus will be determined based on individual needs but within the context of the trauma. Additionally, it should be noted that for all patients, regardless of therapy track, the goal of individual therapy is to cultivate an understanding of the development, maintenance, and purpose of their eating disorder while reducing and eliminating eating disordered behaviors. Thus, the individual conceptualization of the eating disorder will therefore need to include an understanding of the personal meaning of the trauma. And, eating disorder symptom management occurs concurrently with trauma symptom management.