A Guide to Starting Eating Disorder Therapy: Beginning with Hope

An experienced, compassionate clinician needs to consider hope from the first minute of a consultation. Yes, understanding the person’s complete history and background is important, but from the introduction to treatment, the tone is set for how therapy progresses, and no treatment will make progress without hope.

The myths about eating disorders are in the background of any therapy. A patient will most likely think how can this new treatment help me? Is there any chance of really getting better? Will this person truly understand the nature of my eating disorder and what I struggle with every day? Why will this time be any different?

A therapist must realize these thoughts dominate the mind of the person you are just meeting. Even if they don’t state a word about the future, their expectation is the confirmation of the hopelessness they have likely felt throughout much of their clinical experiences.

But the sense of hope can’t be forced or unsubstantiated. There are some people for whom hope is not recovery but stabilization of the eating disorder to build a future, and that’s a very real accomplishment. The hope needs to be borne out of true beliefs the clinician has about this person, their eating disorder and realistic goals for the future.

At first, the hope stems from the therapist listening with an open mind, learning in detail about their eating disorder and asking questions that imply how things might change. Typically, one can reinforce positive experiences in the past, note treatment not considered yet or emphasize strong elements of motivation. The therapist’s initial approach to the session will communicate the direction therapy can take right away.

These immediate actions and initial plans need to be proactive so the person knows the treatment will be collaborative. They can’t feel alone anymore.

Communicating hope from the start is remarkably helpful and effective in laying the groundwork for successful treatment. This path needs to be integrated immediately into any new therapy.