A Team Approach
Reposted from 08/03/17
When you've started to think about finding help for your challenging relationship with food and your body you may start that process by connecting with a wide variety of professionals. Eating disorders are incredibly challenging illnesses that touch on multiple domains of people's lives. Because of this, I've seen that people tend to do the best with their recovery when they have a team of outpatient supports who provide structure throughout that process. A lot of people ask about the types of providers you can see, so I hope this post can help clear up the types of providers I'd recommend people seeing regularly as they move through recovery. I will provide a quick disclaimer that everyone's treatment looks different for them, and some people will have significantly more providers than what I list, while others will feel comfortable and be successful with only one provider. Please consider the recommendations of any professionals you are currently working with as you decide what disciplines you believe could be helpful.
Primary Care Physician: I would recommend that everyone talk to their PCP about any medical concerns they have around their eating disorder. For children and adolescents this will be their pediatrician. These illnesses can cause a wide variety of medical concerns ranging from thinning hair to cardiac arrest. Unfortunately, some physicians struggle to recognize or treat the specific concerns associated with these illnesses, however, there are some wonderful physicians who are sensitives to the unique needs of those who have an eating disorder diagnosis.
Therapist: As a clinician, I'm a bit biased here. I believe that with few exceptions it's always helpful to have a therapist on your treatment team. You have options as far as the type of training/degree/license that your therapist holds. For the state that I work in, you can work with a psychologist who has a doctoral degree or a number of master's level therapists. In Massachusetts, you can work with a clinical social worker (LICSW), mental health counselor (LMHC), or marriage and family therapist (LMFT). Some psychiatrists will also offer talk therapy for their clients. Typically, your therapist is going to be the member of your team that you see the most frequently, so they will often have the most up-to-date data around your current challenges and successes.
Dietitian: Given that eating disorders deal with the relationship that people have food and nutrition, it's often imperative to have a member of your team who has had specific training in nutrition and dietetics. When I was first starting out in the field, I didn't understand the difference between a "dietitian" and a "nutritionist". One of my lovely dietitian coworkers explained that someone calling themselves a dietitian denotes their license/registration. Anyone can call themselves a nutritionist, but someone must be registered to call themselves a dietitian. Not all RDs (Registered Dietitians) specialize in working with clients with eating disorders, so it's important to ask any referrals how often they work with those diagnoses.
Psychopharmacologist: On an ongoing basis, only people who are taking psychiatric medication or considering taking medication need to follow-up with a psychopharmacologist. Most often, this provider is going to be a psychiatrist. Sometimes people will see psychiatric nurse practitioners for this as well.
Additional Providers: Like I said above, people can see a wide array of providers as they move through recovery. Sometimes people will work with specific family or couples therapists in addition to their individual clinician. Adolescents may see adolescent medicine physicians in addition to their pediatricians. Many individuals see additional medical specialists that can include providers such as gastroenterologists, cardiologists, neurologists, allergists, etc.
Once again, please carefully consider the recommendations of any professionals who you're currently working with when you're building your treatment team.