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Doing What Works:
An Integrative System for
the Treatment of
Eating Disorders from
Diagnosis to Recovery
By Abigail Horvitz
Natenshon
Published by NASW Press
Abigail Natenshon's Doing
What Works: An Integrative
System for the Treatment of
Eating Disorders from Diagnosis
to Recovery is an excellent,
comprehensive guide for eating
disorder treatment.
Abigail Natenshon, MA, LCSW is a
psychotherapist who has over
forty years experience
specializing in the treatment of
eating disorders with
individuals and their families.
Ms. Natenshon has been featured
on television and other print
media. She is also the author of
When Your Child Has An Eating
Disorder: A Step-by-Step
Workbook for Parents and Other
Caregivers (Jossey Bass,
1999).
For professionals, treating an
individual with an eating
disorder can be meaningful, but
it also can be challenging. Ms.
Natenshon's new book, as the
title states, takes the
therapist through the steps of
diagnosis and treatment all the
way to solutions for recovery.
This book bridges evidence-based
approaches and research with
practical clinical approaches.
It begins with current
treatments in the field and
emphasizes a substantial
roadblock for many: the
misunderstood role of food in
the treatment process. Ms.
Natenshon writes, "eating and
weight issues can sometimes
distract and deter practioners
from the need for constant
vigilance of the deeper issues
and co morbidity that underlie
and drive these disorders."
Abigail's sense of energy and
delight from years of working
within the eating disorder
community shows on every page.
She provides a compelling
explanation of how the
therapist's sense of self is
integrated into his or her
treatment and gives useful
strategies for the therapist to
be self-aware and begin with
where the client is. The power
of the therapeutic relationship
is apparent throughout her book.
She interjects many useful tips
and recommendations for all
therapists who treat individuals
with eating disorders. Applying
Prochaska and DeClemente's
stages of change model to eating
disorders, Ms. Natenshon
explains that many clients come
to treatment in the
pre-contemplation stage. "Never
fight with an eating disorder,
as there will be no way to win,"
she says confidently, and
instead urges the use of the
change model to facilitate
different approaches depending
on where the client is in the
process of change. Resistance is
seen as a normal process instead
of willful opposition. This book
also details different treatment
approaches and methods with
specific case examples, and
shows how different methods can
be uniquely tailored to the
client to achieve healthy
recovery.
Ms. Natenshon ends the book on
the recovery process and its
uniqueness. She emphasizes that
recovery is not a number on the
scale but an overall sense of
well-being and capacity to eat
healthfully and without fears or
obsessional thinking about food.
Recovery is defined as self-
acceptance, sound judgment and
appropriate response to feelings
and needs.
For all members of the
multi-discipline clinical team
who work with clients struggling
with an eating disorder, this
integrative approach is a must
read. This book provides an
integrative, comprehensive, and
practical tool for clinicians
who are just beginning to see
clients with eating disorders or
for the experienced clinician to
refer back to year after year.
Parents who already have a
thorough understanding of eating
disorders may also find this
book an important reference as
it explains many models of
treatment along a continuum.
Laura Discipio, LCSW is the
Executive Director of ANAD,
The National Association of
Anorexia Nervosa and Associated
Disorders
February 2009
Description by author
Doing What Works is the
first book of its kind to offer
novice and veteran practitioners
a coherent and sequential system
for approaching, treating, and
effectively managing complex
eating disorder cases, from
start to finish. Highlighting
the unique qualities that set
eating disorder treatment apart
from generalist practice,
Natenshon synthesizes
evidence-based eating disorder
research and best-practice
treatment protocols into
innovative and practicable
clinical applications 'that
work,' offering a fully
integrative approach to eating
disorder care. Bringing the
field into the 21st century,
Natenshon cites recent
neurobiological research to
underscore the significance of a
unique and versatile use of the
therapist's self within the
treatment relationship. Her work
is also pioneering in
explicating the power and
significance of mindfulness in
psychotherapy practice, as well
as the role of interpersonal
neuropsychology and brain
plasticity in enhancing healing.
In the seasoned voice of an
expert who has specialized in
the treatment of eating
disorders for close to four
decades, Natenshon's book speaks
to the entire multidisciplinary
treatment team… including
nutritionists, physicians,
school personnel and families,
filling in extensive gaps in
professional education. The book
offers clarity, vision,
intention, and optimism to
practitioners striving to meet
the rigors and challenges of
managing diagnostic ambiguity,
complex transference issues,
persistent patient resistance,
and daunting co-occurring
conditions within a highly
counterintuitive recovery
process. Aside from honing
treatment skills, this
reader-friendly treatment guide
provides clinicians the
opportunity and confidence they
need to become self-starters
within a demanding treatment
process--while helping their
patients to do the same.
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