HAES Supervision Group

HAES/FAT POSITIVE SUPERVISION GROUP FOR PROVIDERS WHO WORK WITH PEOPLE WITH EATING DISORDERS

Are you a fat positive HAES provider who works with people with eating disorders?

Would you find it helpful to talk with other fat positive HAES providers who work with this population?

If so, this supervision group may be for you!

In this group we will talk about:

  • Strategies for incorporating HAES even with our most severe clients
  • How HAES and fat positivity can support ongoing healing work of our clients
  • Ways that diet culture and weight stigma contribute to our client’s eating disorders and interfere with healing
  • How our own internalized weight stigma, body size, eating disorder history show up in the room with clients
  • And whatever you bring to the group

The Details:

Group format will include case consultation and discussion of relevant topics 

Groups are limited to 8 people

Meets requirements for supervision hours for CEDS

Cost: $450.00 ($75.00 per session)

Questions or to register: [email protected]

We are excited to be offering EMDR at our practice with Jessica Salatino, LSW. 

What is EMDR?

Eye movement desensitization & re-processing, or EMDR, is a treatment modality that helps people heal from trauma, painful life events, negative self-beliefs as well as post-traumatic stress disorder, anxiety, panic attacks, and many other mental health diagnosis. There have been hundreds of studies demonstrating EMDR's efficacy as a treatment modality. EMDR has become more widely known as a method for treating trauma due to the evidence base in support of it and personal narratives from those who have experienced EMDR as part of their healing process. 

EMDR has been approved as an effective treatment by the American Psychological Association, American Psychiatric Association, and the Department of Defense and the Veteran's Administration. 

What is an EMDR session like?

During EMDR, we will work together to identify what the focus of the session will be. I will support you in calling to mind the thoughts, feelings, and other memories about this event or belief system. Together we will discuss what to expect during the EMDR session and I will answer any questions you may have. After preparing together, I will facilitate the bilateral movement of the eyes or other dual attention stimulation of the brain, while asking you to notice what is coming up for you. 

Processing in EMDR is different than in traditional talk therapy. Unlike talk therapy that requires verbal communication and processing, EMDR relies on the ways the brain processes and re-processes information so that traumatic events and beliefs can be integrated and therefore no longer have the same distressing impact on your day to day life or on your future.  

Each person processes information differently based on their experiences. We will continue with processing the events through the set of eye movements until the memories become less disturbing.

Due to the nature of EMDR, I offer EMDR in 60, 90, and 120, and 180 minute sessions. Many people prefer doing a prolonged EMDR session as it gives us the chance to more fully process and have time to debrief and support you in centering before the session ends. Other people find a 60 minute EMDR session sufficient.

Some people seek care specifically to do EMDR, while others choose to do EMDR in addition to traditional talk therapy. For those who are wanting to do EMDR in addition to traditional talk therapy, we can integrate EMDR into your treatment and I am happy to collaborate with your other providers. 

The cost of EMDR sessions is as follows:

60 Minutes: $275

90 Minutes: $412

120 Minutes: $550

180 Minutes: $850

Questions/Scheduling?

If you have any questions about EMDR or about which session length would be appropriate for you, please reach out. I am happy to chat with you by phone to answer any questions and provide support with scheduling your EMDR session. 

I have been supervising and teaching since early in my career. Early on, I taught at several local colleges and universities. I quickly realized that teaching in a classroom setting was not for me, and that I much prefer working one on one with people. As an approved Certified Eating Disorder Specialist supervisor (through IAEDP), I supervisor providers who are working towards their CEDS. I also supervise people from a wide variety of disciplines who are either new to HAES and want to learn how to incorporate it into their work, or are experienced HAES clinicians who want a supervisor who understand s what they do.

My supervision style is warm, open and relational. I respect the work my supervisees do and view supervision as a collaborative process. I welcome discussion about clients, personal reactions, and feelings that come up in response to this work. We also frequently talk about the impact this work has on us as providers and how to best care for ourselves. As providers, we need a space to talk about all aspects of our work. If you are interested in working with me in supervision, please reach out.

We work with the queer, trans, non-binary, and gender-nonconforming communities and provide an accepting and validating space in which clients can show up as their whole, authentic selves. While we specialize in working with folx who identify as queer, trans or non-binary and are struggling with eating disorders or disordered eating, we also work with folx from these communities who need support. As with most marginalized groups, there has been little research looking at eating disorder rates in the queer and trans communities, however, recent research suggests that the trans community struggles with eating disorders and disordered eating at rates significantly higher than cis-gender folx. 

“Commit to loving yourself completely. It’s the most radical thing you will do in your lifetime.”

-Andrea Gibson

Dealing with the systemic and structural oppression that queer, trans, and non-binary folx encounter in our culture can cause trauma. We will work from a trauma-informed perspective to explore your experiences, thoughts, values, and any thing else you bring into session. Our work together is relational and while we are trained as therapists and will support you in your healing, you are the expert on your own life. 

"I will not have my life narrowed down. I will not bow down to somebody else's whim or to someone else's ignorance."

-Alice Walker

Anxiety is a regular part of life for most of us. We all feel some degree of anxiety, and given the current times, many people are feeling more anxious than they usually do. If you are visiting this page, it is likely because you are concerned that you have anxiety that goes beyond the kind of anxiety we all experience and that the level of anxiety you are experiencing is interfering with your life. 

For people struggling with anxiety disorders, the anxiety typically gets in the way of many things you want to do or you can’t enjoy things as much because of the anxiety. There are many different types of anxiety. Some people describe feeling anxious about everything, while others are anxious about one specific thing. Some people feel anxious only in social situations, while others feel anxious only when they are alone. People with anxiety may have panic attacks and then avoid doing things for fear of having another panic attack. 

Sometimes people with anxiety are embarrassed about their anxiety and try to hide it from others. This can leave people with anxiety feeling lonely and misunderstood. Many people with anxiety describe being anxious since childhood, while others may develop anxiety as an adult. Things like trauma or a significant life change can cause anxiety to develop as a response to these experiences. 

Anxiety can serve as a guide or warning system for many of us, but for people with anxiety disorders, the anxiety goes beyond what is protective in a particular situation and interferes with functioning. We will work with you to explore what type of anxiety you have and what is contributing to it. Depending on what we discover, there may be different approaches that will be most helpful for that particular type of anxiety. 

For some people with anxiety, medication can be helpful in managing it. If medication could be helpful in your particular situation, we want to discuss it with you and will make referrals to a prescriber if it is something you are open to.

If you have arrived on this page it is likely because you think you might be struggling with depression. Many people with depression describe feeling sad a good portion of the time and feel frustrated because even things they used to enjoy are now not enjoyable. Often times, people feel so down that they are hopeless about the possibility of ever feeling better. 

Depression is frequently used as a catch-all word to describe any kind of sadness that is ongoing. Things such as grief, trauma, dealing with oppression, stressful life events, etc., can contribute to feelings of sadness that continue over a period of time. For many people, these things can contribute to depression. As we work together, we will help you identify and feel all of the feelings associated with these things while also addressing the depression. 

People with depression often describe feeling lonely even when in a room full of people. This is usually because they don’t feel they can talk honestly about their depression for fear of being a burden or making other people feel sad too. We want to hear everything about your experiences including all about your depression. We want to understand what the contributing factors for your depression are and we want to know how it is impacting your life. 

For some people with depression, medication can be an important part of treatment. If medication is something you want to consider, we will assist in referring you to a psychiatrist or collaborating with your current psychiatrist if you already have one. While we may recommend medication as something that could be a helpful part of treatment, we respect your choice about whether to consider it or not.

Childhood and adolescence is a common time for eating disorders to develop. While children and adolescents are often diagnosed with the same eating disorders adults are diagnosed with, the way these eating disorders present and are treated is significantly different. Children and adolescents with eating disorders need treatment that is tailored specifically to them. In most situations we utilize Family Based Treatment (FBT) and work with the whole family to support healing from the eating disorder. There are times when FBT is not the best option in a particular situation, and then we typically turn to individual therapy that focuses on the specific needs of the child or adolescent. 

While we recognize that there is no one thing that causes eating disorders, there can be contributing factors. Things such as weight stigma, weight loss due to illness or increased activity, health classes, etc., can all be contributing factors for eating disorders. When we work with children and adolescents with eating disorders we not only focus on addressing the eating disorder, but building resilience for navigating difficult situations without the eating disorder. 

Diet culture impacts all of us and is everywhere. Living in diet culture makes recovering from an eating disorder harder and children and adolescents need tools for how to cope with all the triggering messages they will be exposed to. We work from a Health at Every Size(R) framework to help children, adolescents, and their families to develop the skills needed to recognize the harm in diet culture and learn ways to disengage from participating in it.  

Working with children and adolescents with eating disorders requires teamwork. We view parents or caregivers as an important part of the team, which may also include a dietitian and physician. We will coordinate care with all members of the team and make sure that we all work together to support the adolescents recovery.

Learning to love your body in a capitalist society is like trying to dry yourself in the ocean. We need a socio-economic, political, societal change. So there will be a whole generation where no one learns that you have to be thin in order to deserve respect and happiness.
Sofie Hagen

The process of healing our relationship with food and body is one of unlearning and learning. We need to unlearn all of the lies we have been told about food, body size, dieting, and weight loss attempts. We need to unlearn the blame and shame we have been taught to put on our own bodies for not fitting what society has told us they need to fit. We learn about the possibility of freedom and liberation that we were never told about. We learn about the process of healing that recognizes that our bodies were never the problem. We learn about the power of community and about the hard and freeing path of walking away from diet culture. There is liberation waiting for us on the other side. 

It is important to name what you are buried in
Hilary Kinavey, MS, LPC

The paradigm shift from a weight focused approach to one focused on weight inclusivity and fat liberation is a significant one for most people. We have all been impacted by diet culture and have been taught that if we are not able to lose weight and keep it off we are to blame. Dana Sturtevant and Hilary Kinavey of Center for Body Trust point out that “most of us have been indoctrinated into a dieting culture before we could consent.” It is no surprise then, that most people who come to see us want to lose weight. Many have been dieting and weight cycling for years. Many have never heard that there is another path available. We turn to Health at Every Size(R), fat liberation, Body Trust(R), social justice, trauma informed care, non-dieting, and intuitive eating to introduce our clients to a different lens. 

In this practice we believe:

  • Weight is not an indicator of health
  • Pursuing health is not a moral obligation
  • Dismantling systems of oppression is part of our responsibility as therapists
  • Centering those most marginalized helps all of us
  • While weight stigma harms all of us, it harms the fattest bodies the most
  • Recognizing and naming our privilege is important
  • The relationship between therapist and client is central 
  • That all coping is rooted in wisdom
  • That therapy is a collaboration
  • That any focus on weight loss is harmful and unethical
  • You cannot tell if, or what kind, of eating disorder someone has by the size of their body

Whether you are new to this paradigm, or have been doing healing work within this paradigm for many years, we are honored to go on your journey with you. 

There has been a long-standing stereotype that only thin, white, heterosexual teenagers get eating disorders. This stereotype is untrue and harmful. The truth is that eating disorders don't discriminate, and some of the most marginalized communities are most impacted. Those who are furthest from the stereotype of who gets eating disorders, are often not diagnosed and suffer much longer before getting treatment.

Diagnosed eating disorders affect about 30 million Americans (ANAD) and disordered eating affects even more people. All eating disorders occur in people of every body size. It is important to remember that you cannot tell if or what eating disorder someone has based on the size or shape of their body. 

We treat people with all forms of eating disorders such as Binge Eating Disorder, Bulimia Nervosa, Anorexia Nervosa, Avoidant Restrictive Food Intake Disorder (ARFID), "Atypical" Anorexia, and Other Specified Feeding and Eating Disorders (OSFED). Many people struggling with food and body have never formally been diagnosed with an eating disorder or may feel that they don't meet the criteria for an eating disorder, and thus don't need help. Our clients have broad experiences and every story is different. Every single one of our clients is deserving of help. 

People of all ages get eating disorders, and we work with children, adolescents, and adults. When seeing clients with eating disorders, there is frequently a team that may include a dietitian and other healthcare providers. We believe that treatment is most helpful when all members of the treatment team and the client are working together. We collaborate with team members with the permission of our clients to make sure we can all offer the best support possible. Often times, decisions need to be made about whether clients need a higher level of care (HLOC) such as residential or inpatient treatment. While we may recommend that a HLOC would be beneficial, the decision about going to a HLOC is made collaboratively. 

We honor and value body diversity and work with people across the weight spectrum. We know that people in higher weight bodies can be weight suppressed and need to restore weight just as people in lower weight bodies may need to restore weight. We recognize that while diet culture and the fixation on thinness harms everyone, it harms people in the most marginalized bodies the most. 

Rachel Millner (she/her), PsyD, CEDS, CBTP
Healing Relationship with Food and Body
[email protected]   |    215-932-9885
Designed by Andrew Collings