The treatment of eating disorders (EDs) presents many challenges. Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference may be partially due to the therapist's own vulnerabilities. Due to the personal connection to the work, countertransference towards ED clients may be pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists negotiate their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The present study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. The study was guided by the theoretical frameworks of social constructivism and symbolic interactionism, as well as the person-of-the-therapist clinical training philosophy. Using constructivist grounded theory methodology, semi-structured interviews (Mtime = 89 minutes) were conducted with 22 therapists with EDLE, who work with ED clients. Participants explored how they use and manage their EDLE during key tasks of treatment with their ED clients. Results revealed that therapists engaged in two, interconnected constellations of processes (systems) in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have implications for the EDLE literature, by providing novel ways therapists can use their EDLE. Findings also have implications for the POTT framework by exploring how POTT can be adapted for therapists who share lived experiences with their clients. A POTT-EDLE is proposed for training therapists with EDLE. / Doctor of Philosophy / The treatment of eating disorders (EDs) presents many challenges (e.g., frequent comorbidity, high rates of relapse, and the life-threatening nature of the disorder). Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference (e.g., worry, frustration, hopelessness) may be partially due to the therapist's own unresolved issues and vulnerabilities. Due to the personal and professional connections to the work, countertransference towards ED clients may be particularly pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists use and manage their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability and therapists with EDLE are working from a deficit. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. Interviews were conducted with 22 therapists with EDLE who work with ED clients. Results revealed that therapists engaged in two systems in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. The Central System and The Checks and Balances System work in tandem in order for the therapist to both use and manage their EDLE. Results describe the multiple processes informing these systems. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have clinical and training implications for how therapists with EDLE can use and manage their EDLE to inform their clinical work with ED clients.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/109608 |
| Date | 07 April 2022 |
| Creators | King, Ashley Ayn |
| Contributors | Adult Learning and Human Resource Development, Russon, Jody M., Bradburn, Isabel S., Dolbin-MacNab, Megan Leigh, Mensinger, Janell |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Language | English |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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