FAQ

Psychotherapy, or talk therapy, is designed to help with a variety of mental and emotional challenges.  Through targeted questions and techniques, it can help eliminate or manage symptoms so that a person can improve well-being and function more optimally. Typical issues discussed might include difficulties with coping, the impact of trauma or loss, managing anxiety or depressive symptoms, and relational struggles.  It is important to know that therapy is a process. It is both science and art.  Change does not happen overnight and involves a complex interplay of factors.  

Research shows that most people who receive therapy experience symptom relief and improvement in function. About 75% of people show some benefit, according to the American Psychological Association.  Psychotherapy has been shown to improve emotions, thoughts, and behaviors.  It is linked with positive changes in the brain and body, which can lead to benefits in relationship, work, school functioning, and overall health.  Therapy is a collaborative process.  In order to get the most out of psychotherapy, it is recommended to be open and honest and to follow recommendations for treatment.  A trusting and connected relationship between a therapist and client is one of the most important treatment factors.  

Therapy is not the only route to healing.  Many people can work through issues with self-help books, support people, coaches, personal development workshops, and the like.  However, most people can benefit from therapy when the relationship and approach is the right fit. For certain problems, therapy and sometimes medication is essential. Given the progressive nature and fatality rate of eating disorders, it is vital to get early and adequate treatment.  Research indicates that the earlier eating disorders are diagnosed and treated, the better the outcomes, physically and mentally.  With treatment, full recovery is possible. 

Therapy is most often conducted in an individual, family, or couple setting. Sessions are typically held once a week for 50 minutes. Psychotherapy can be short term or long term, depending on an individual’s needs or a particular approach.  Generally, sessions begin with a check-in process, involve discussion of a topic or topics, and conclude with a brief summary and “check-out,” which can include at-home assignments. The initial session or two may feel more like an interview, focused on establishing connection, gathering history, and forming goals, as well as reviewing logistical matters. From time to time, progress will also be evaluated through objective tools or subjective reports. 

Length of treatment depends on the issue(s) presented, level of severity, and client’s motivation. There may be a concrete plan with a specific number of sessions, or a longer term plan.  An individual’s goals, progress, and barriers will constantly be evaluated by therapist and client to determine the appropriate length of treatment.  Once a client has made significant progress, session frequency may decrease.  For many people, there comes a time when therapy no longer feels necessary. There may be less to talk about; initial goals may have been accomplished; they may have plateaued with progress; or there may be logistical challenges. Either client or therapist may decide to end sessions, and ideally, ongoing recommendations or referrals will be provided.

At Olson Counseling Services, eating disorders are viewed through a biopsychosocial lens, taking consideration for the connection between biological, psychological, and socio-environmental factors.  The standard of care for treating eating disorders involves a multidisciplinary team, consisting of an eating disorders therapist, eating disorders dietitian, medical professional, and sometimes a psychiatrist.  Treatment is integrative, involving evidence-based approaches including Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and Acceptance and Commitment Therapy (ACT), aswell as trauma informed care. Treatment generally includes nutritional rehabilitation, weight restoration or stabilization, family education and coaching, skill building, and experientials. Relapse prevention is also a key component of recovery maintenance.

Some adolescents are not willing to do therapy.  They may have misperceptions about the process, believe they do not need help, or fear what will be shared with parents.  Individuals with eating disorders may also resist treatment, due to the very nature of eating disorders, often involving denial, control, and rigid beliefs. It is recommended that loved ones have honest conversations about observations and concerns and establish an agreement with the person to commit to therapy for a certain period of time before deciding whether or not to return.  In many cases, after the initial session or two, people feel heard and understood, become more comfortable with the idea and process of therapy, and choose to return to therapy. 

• Cognitive Behavioral Therapy (CBT): CBT involves efforts to recognize unhelpful ways of thinking and develop more helpful thinking patterns, which lead to improvements in behavior and emotion.  Strategies might include recognizing thinking “errors,” using problem-solving skills to cope, facing instead of avoiding fears, role playing, and relaxation techniques. Homework is frequently given outside of session to enhance development of coping skills.  CBT is commonly used for depression and anxiety.
• Dialectical Behavior Therapy (DBT): DBT is a modified type of cognitive behavioral therapy that is effective across diagnoses. It is especially helpful for individuals who struggle with emotional regulation or engage in self-destructive behaviors.  DBT consists of: 1) mindfulness skills to support present focus, 2) distress tolerance skills to manage intense emotions, 3) interpersonal effectiveness skills to improve communication and relationships, and 4) emotion regulation skills to identify, name, and navigate emotions effectively. 
• Acceptance and Commitment Therapy (ACT): ACT’s main focus is “mindful, values-congruent living.”  ACT includes mindfulness skills, values exploration, and actions aligned with values to improve quality of life. The 6 core processes of ACT include: 1) contacting the present moment, 2) defusion, or separation, from thoughts, 3) acceptance, in the sense of “sitting with” an uncomfortable emotion or experience, 4) understanding the “observer self,” 5) identifying values, and 6) committed action based on values. ACT can be used for a wide range of conditions.  
• Family Based Therapy (FBT): FBT is considered the leading treatment for children, adolescents, and some young adults with eating disorders.  While FBT may not be for every family, research shows that it is highly effective with quicker outcomes than many other treatment approaches.  Main principles of FBT include an agnostic view of the eating disorder, externalization of the eating disorder, and caregiver empowerment to aid in treatment.  Sessions are general family focused and include 3 phases, with initial focus on medical, nutritional, and behavioral stabilization.  
• Psychodynamic Therapy: Psychodynamic therapy focuses on exploring an individual’s needs, urges, and desires, rather than aiming to specifically reduce or eliminate symptoms. It focuses on understanding the influence of early life experiences and helping clients find patterns in emotions, thoughts, and beliefs in order to gain insight and form a positive sense of self. The style is open-ended and client directed.  
• Solution Focused Therapy (SFT): SFT is a short term approach, goal-directed, and focused on solutions rather than problems. This approach involves helping a client envision an improved or problem free life, using tools and strengths from previous times in which a client has successfully coped, and developing solutions for desired change.  
  
• Narrative Therapy: Narrative Therapy places emphasis on stories people develop through life experiences that influence how a person sees themselves and the world.  Techniques involve helping clients become an “observer” to their story, exploring the meaning placed on events, creating distance between themselves and their problems, and developing alternative stories.  This approach helps individuals gain clarity and become experts in their own lives.  

An individual’s privacy is of paramount importance in therapy and is a part of the professional code of ethics.  It is important that a client is able to be open and honest with private thoughts and behaviors in order for therapy to be as effective as possible.  However, there are some limits to confidentiality related to a client or other’s safety, court cases, or insurance purposes.  It may also be necessary, with an individual’s written permission, to share treatment information with other providers, teachers, or parents, for the purpose of care coordination.  Confidentiality will be discussed at the outset of therapy and in Intake forms.