1. ©2011 National Association of Social Workers. All Rights Reserved. 1 Skinny Revisited: Rethinking Anorexia Nervosa and Its Treatment Maria Baratta, PhD, LCSW

2. Introduction Overview of Anorexia Multidimensional Model for the treatment of Anorexia Introduction to the “Language of the Anorexic” Case studies ©2011 National Association of Social Workers. All Rights Reserved. 2

3. ©2011 National Association of Social Workers. All Rights Reserved. 3 Photograph: Lucas Dolega/EPA W Magazine, Photographs by Alexis Dahan

4. ©2011 National Association of Social Workers. All Rights Reserved. 5

5. TWIGGY ©2011 National Association of Social Workers. All Rights Reserved. 4

6. A Multidimensional Model for the Treatment of Anorexia Nervosa Engagement Diagnosis, Evaluation, Assessment The “language of the anorexic” Integration of comorbid disorders Address of familial issues Address of “skinny” from a cultural/feminist perspective ©2011 National Association of Social Workers. All Rights Reserved. 6

7. DSM-IV Diagnostic Criteria for Anorexia Nervosa 307.1 A. Refusal to maintain body weight at or above a minimally normal weight for age and height B. Intense fear of gaining weight or becoming fat, even though underweight. C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self- evaluation, or denial of the seriousness of the current low body weight. D. In postmenarcheal females, amenorrhea,the absence of at least three consecutive menstrual cycles. ©2011 National Association of Social Workers. All Rights Reserved. 7

8. “The language of the anorexic” “The language of the anorexic,” simply stated, is a way obsessing with the patient--allowing them to obsess about every particle of food, and thus, on their own, begin to make better food choices. ©2011 National Association of Social Workers. All Rights Reserved. 9

9. Comorbidity Anorexia Nervosa is comorbid with the following: Obsessive–Compulsive Disorder Obsessive–Compulsive Personality Disorder Body Dysmorphic Disorder ©2011 National Association of Social Workers. All Rights Reserved. 8

10. Feminist literature ©2011 National Association of Social Workers. All Rights Reserved. 10

11. Review of Multidimensional Treatment Model Engagement – “unconditional positive regard” (Carl Rogers) Therapist is accepting and welcoming without judgment. Axis I Diagnosis of Anorexia Nervosa 307.1 (DSM-IV) Evaluate for suicidal risk Assess whether patient is treatment compliant Be sure patient is under the care of a physician Integrate comorbid disorders Address familial issues Address “skinny” from a cultural/feminist perspective – challenge patients’/cultural belief that thinness is a prerequisite to attractiveness and esteem ©2011 National Association of Social Workers. All Rights Reserved. 11

12. Questions & Answers ©2011 National Association of Social Workers. All Rights Reserved. 12

13. ©2011 National Association of Social Workers. All Rights Reserved. 13 SKINNY REVISITED: RETHINKING ANOREXIA NERVOSA AND ITS TREATMENT DISCOUNT Receive a 15% discount on the purchase of this title. Call 1-800-227-3590 and use promotional code WCSR11 to place your order (cannot be combined with any other offer) ISBN: 978-0-87101-407-8. 2011 Item# 4078 Offer valid through November 21, 2011