Prevalence & Features of Eating Disorders in Males – Part 7

Behavioral Activation Treatment for Eating Disorders – Part I

We’ve discussed Exposure Therapy for eating disorders. Now, let’s move to a second behavioral therapy intervention known as Behavioral Activation

Overview of Behavioral Activation Treatment

Behavioral Activation (BA) is a treatment approach that is, historically, very effective at addressing depression. As I mentioned before, there are significant common currents between depression and eating disorders.

Behavioral activation is effective because it encourages gradual increases in a variety of different life activities that, for the patient, are very personally meaningful and relevant.

These are things that are highly idiosyncratic because the types of behavioral activation tasks or activities that we encourage are very personally relevant and fulfilling to the individual.

One of the most crucial maintenance factors of depression, and why depression doesn’t just go away naturally with the passage of time, is avoidance. Avoidance of important life activities, of people, of things, of events that are really personally important to a person.

It follows that activating a good variety of different behaviors that are personally fulfilling and meaningful to a person, and doing this consistently, will bring about improvements with one’s mood by experiencing more consistent positive mood.

To understand the critical model underlying behavioral activation therapy, we first have to explore how individuals might typically respond to adverse life events. This is what’s known as the “TRAP TRAC Model.”

TR – Trigger

For the onset of experiencing a depressive episode, ex: a life event might serve as a trigger that elicits a response in the individual. This might be any type of intense negative emotion that a person might experience.

The “TR” in both TRAP and TRAC refer to this trigger and track that’s from where it comes. Now, an individual might respond behaviorally in one of two ways, and that is where “AP” or “AC” come into play.

AP – Avoidance Pattern

An individual might engage in an Avoidance Pattern when they encounter really significant life events, wherein they withdraw or pull back from life a little bit.

AC – Active Coping

An alternative way of behaving in response to a really significant life event that’s accompanied by negative emotions is active coping, and this is you know what. This is certainly the more helpful behavioral pattern and involves one doing something to try to stay actively engaged in coping in a way that is helpful in the long term. and

Based on this model, let’s consider the example of a negative life event being the trigger where an individual was up for a promotion at work but they, unfortunately, did not receive the promotion.

This, naturally, is going to lead to a response where one might experience a really intense negative emotion accompanied by fatigue and noticeable loss of interest in important life activities and people that are important to that person.

The individual may respond to that intense negative emotion by engaging in a more avoidant patterns of coping by showing up too late for work more often or using a lot of sick days. These are patterns called avoidance and disengagement.

This avoidance pattern may come back and contribute to further triggers such as increasing the likelihood that, in the future, that individual will not be up for promotion again.

So, let’s back up a bit and look at if we can encourage this individual to try to stay out of the the avoidant pattern and instead engage in a more active coping process such as taking the active step of meeting with the boss so that he or she could learn more about what factors contributed to not being chosen for the promotion that might, in turn, help the individual to block the future experience where they may encounter for similar triggers.

A lot of this comes down to active coping and problem-solving in a way that’s going to decrease the likelihood of re-experiencing those same negative life events repeatedly.

Eating Disorders in Males – Life Domains

Let’s talk about some of the specific nuts and bolts of behavioral activation.

What patients are encouraged to do is to gradually increase their overall engagement in a good variety of different life activities and then, at the same time, prevent avoidance or other unhelpful coping strategies.

The general aim of implementing this therapy is to help patients increase their overall activation across three different important life domains.

First is what we consider the Routine Activity Domain. These are the types of things that we all might take for granted from time to time but that, in the throes of depression, might become enormously difficult for a person to do consistently.

This might include things like routine grooming/bathing routines, dressing oneself, changing clothing, simple everyday cleaning, or other types of chores around the home.

The second major life activity domain that we look at is the Pleasurable Activity Domain. These are things that we really don’t have to be motivated to do by anything more than just the inherent enjoyment that we experience when we do the activity.

This consists of things that we consider to be our hobbies such as spending time with friends watching movies, listening to music, playing sports, anything that a person does just for the sheer enjoyment of the activity.

Finally, the third domain that we look at in behavioral activation is the Values-Driven Domain which are behaviors that one does in service of deeply held values that one has.

An example is that, if one places a high degree of value on being an active member in one’s community, it might be a very good behavioral activation task for that person to be more routinely involved in volunteer activity such as a community clothing drive or something of that nature.

Similarly, if one places a high value on educational endeavors, it might be a good behavioral activation activity for that individual to find opportunities to learn more or to take a new class that’s offered in the community.

Please See

Prevalence & Features of Eating Disorders in Males – Part 1
Prevalence & Features of Eating Disorders in Males – Part 2
Prevalence & Features of Eating Disorders in Males – Part 3
Prevalence & Features of Eating Disorders in Males – Part 4
Prevalence & Features of Eating Disorders in Males – Part 5
Prevalence & Features of Eating Disorders in Males – Part 6

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Source:

Virtual Presentation by Dr. Nicholas Farrell in the Dec. 7, 2017 Eating Disorder Hope Inaugural Online Conference & link to the press release at https://www.prnewswire.com/news-releases/eating-disorder-hope-offers-inaugural-online-conference-300550890.html

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About the Presenter: Dr. Nicholas R. Farrell, Ph.D. is a licensed clinical psychologist who directs and supervises the treatment of patients in eating disorder programs at Rogers Memorial Hospital. Dr. Farrell specializes in the use of empirically-supported cognitive behavioral therapy (CBT) treatment strategies that are used to help patients in our eating disorders programs.

Additionally, Dr. Farrell is a regular contributor to scientific research on the effectiveness and dissemination of CBT for eating, anxiety, and mood disorders and has published over 20 peer-reviewed journal articles and book chapters. Dr. Farrell has been the gracious recipient of federal grant funding to study the role of social stigma in the context of eating disorders.

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About the Transcript Editor: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on June 18, 2018.

Published on EatingDisorderHope.com