Online Eating Disorder Treatment

Working in private practice for close to a couple of decades now, I've learned just how few general medical or allied health providers have a good understanding of how to safely, compassionately, and successfully help people recover from their eating disorder. But when you see your GP at one practice, dietitian at another practice, and psychologist somewhere else still, you're re-telling the same story over and over, getting different (sometimes conflicting) advice from each team member, and many clients or carers find themselves trying to do the job of co-ordinating their OWN care.

To be honest, the years of phone tag, disjointed email chains, and working with other clinicians who were not eating disorder specialists and didn't understand HOW to work with me, was one of the main reasons for forming our specialist group practice. Being a specialist team, our days are set up so that collaboration is easy- which is so important to us, because that means you get a better experience! Here's how we prioritise this:

• We have regular all-staff case discussion meetings as non-negotiables in our calendars. This gives us time to chat about treatment plans as a group, and means you have more brains thinking about how we can best support you!
• All our clinicians have shared admin time every day, so there's always a time we can check-in with each other and share important developments or changes to your plan.
• Shared client files mean that we can access each others' notes/ pick up where another team member left off/ provide holiday cover for each other (if you want this), and even leave notes for each other between your appointments

All of our team are committed to providing:

• Non-diet/ Health At Every Size/ Weight neutral health care. This alignment is such an important part of providing safe eating disorder treatment.
• LGBTQI+ affirming care. Trans and non-binary people have far higher rates of eating disorders than cis-gender people. Up to 6x, in fact. The negative impacts of diet culture that affect us all are amplified for those outside the gender binary, and ED professionals need to understand how to support you to improve your body image as you recover.
• Neuro-affirming care. This means that if you identify as Autistic, or have ADHD for example, we don't make assumptions and apply the same treatment goals to you as it might feel important for a neurotypical person to work towards. A quick example of this might be building ability to tolerate making spontaneous decisions about trying a new food (say, at a restaurant). This type of spontaneity might be totally unrealistic, or take all of an Autistic person's spoons to cope with, and really isn't necessary to be well nourished, so it wouldn't be a treatment goal unless it was important to that client.

As a specialist eating and feeding disorder practice, we see ALL of the variations of disordered eating challenges, as well as feeding challenges. Your/ your child's symptoms or behaviours don't need to fit neatly into a box, and you don't need to have been given a diagnosis by a doctor to see us. Some of the disorders we treat include:

• Anorexia Nervosa and Atypical Anorexia Nervosa (we believe these are one and the same)
• Bulimia Nervosa
• Binge Eating Disorder
• OSFED/ EDNOS
• Avoidant/ Restrictive Food Intake Disorder (ARFID)
• Paediatric Feeding Disorder (PFD)
• PICA/ Rumination Disorder/ Night Eating Syndrome, and other less frequent presentations.
• Body Dysmorphia and Body Dysphoria

Between us all, we're trained in all of the main evidence based treatment methods. These include:

• Motivational Interviewing
• Cognitive Behavioural Therapy- Enhanced
• Family Based Treatment (or the 'Maudsley Method')
• Dialectical Behaviour Therapy
• Acceptance and Commitment Therapy
• Schema Therapy
• Polyvagal approaches to restoring mind-body connection
• Responsive Feeding Therapy for kids with ARFID or other feeding challenges
• And so many more!

Being skilled in a number of treatment approaches is so important to our team, because it allows us to pick and choose from a wide variety of tools to find what will suit each client best. Some clinicians may disagree, but we don't love 'following the manual' at our practice. We believe that when choosing to start treatment at a private clinic, one of the benefits of this is that you should get to have more influence and control over what types of treatment you receive. Our team will of course give you our recommendations and explain these in your first meeting or two, and explain what to expect over the course of your recovery. But you are firmly in the drivers' seat, and if you want a particular approach (or something different to what you've tried before), we're on board with that.

I certainly remember that following lockdowns, a good number of our clients felt a bit burned out by the sudden transition of their whole lives to a screen. And certainly many parents worried about how their kids might engage with a new support person via video. I actually felt the same, and felt so relieved to be able to work from an office (away from my noisy kids!) and be with real humans again.

What we learned from researching the sudden transition of most healthcare to videoconference though, is that the measurable outcomes of video based therapy were found to be at least equal, but often better in some studies. This was most frequently put down to the improved accessibility, and ability to stay in your familiar surroundings during appointments.

What I've learned from looking at our own clinic's data, is that even when clinicians are working from our offices, now that there is a choice about whether to attend in person or via video, a bit over half of our clients continue to prefer videoconference (even when they’re locals and able to attend in person). Even our local clients love telehealth and many switch!

Our clients say that they love telehealth for its convenience, the familiarity of home/ work/ school surroundings, and to avoid spending time travelling. It also gives family members more options to support each other, for example, carers can join the chat from work, while their young person is at home! So while video based therapy might not be right for every client or every family, we’re so happy to be able to offer high quality services to everyone who needs our support, all over Australia.

As above, this is certainly the top concern that carers have about booking telehealth support for their young person!

Our team are all very experienced clinicians, with many years of practice at engaging clients in online therapy from diverse backgrounds, neurotypes, ages and developmental stages. It's our opinion that engagement with clients is based on the skill and experience of the clinician. This is something that is highly prioritised in our practice, due to the often difficult nature of opening up about sensitive food and body image concerns. This is all that our team do, and we've got the tools and tricks 😉

Our team use Zoom, which integrates with our practice management software.

When you make a booking, you'll receive a link unique to you via email (and reminder SMS if you want that). Because the link never changes, you can save it somewhere and won't need to worry about digging through your inbox for lost emails or accidentally using last week's 

We have a tech-troubleshooting page for telehealth clients, and our reception team are on-call to help if you get stuck, or find a work-around if your local internet is just having one of those days.

For many of our clients, yes. For clients who meet diagnostic criteria for an eating disorder, there are brilliant (and still quite new) Eating Disorder Plans offering rebates for 20 dietetics appointments and up to 40 psychology appointments.

More details about referral types can be found on our FAQs page here. Or, just give our reception team a call and they're happy to walk you through referral options. We can even send the referral criteria and forms to your GP to support them in providing the referral to you.

You don't need a referral to get started working with our team. 

If you're not sure whether you meet criteria, or don't feel ready to talk about your eating challenges with your GP yet, we can help you! We recommend booking in to see one of our dietetics team first, who can help you break the ice with your GP if this feels supportive. After your first or second meeting, any of our clinicians can write a letter to your GP explaining how you meet diagnostic criteria. However, our dietetics team can also assess physical health indicators, and make recommendations to your GP about what type of medical monitoring you might need (if any), and how frequently.

Details of our policies are on our FAQs page here.

Our fees differ by clinician, qualifications and experience level, but as per the FAQ on fees at the link above, we are proud to keep them below the recommended fees set by the top psychology associations in Australia.

Our short answer here is to book in with whichever profession you feel most ready to see, and whoever on the team you most like the profile of! This is something we can advise on when you have your 15min support call 🙂

But if we're looking at our ideal process for getting started, we recommend:

• See one of our dietitians first where possible, as they are able to do a physical health assessment.
• Then book in with one of our psychology team.
• Whether you make a booking with dietetics, psychology or both, we recommend booking two appointments with each provider upfront, and one week apart if possible. That way we're able to complete more of our assessment processes, and give you a better idea of what we recommend for your individual path forward.

Eating disorders are mental illnesses, with myriad physical health consequences, that impact a person's ability to relate in a comfortable and safe way to food and their body.

Role of the Dietitian:

You might think 'I know what I should be eating' so what could a dietitian teach you? But a Credentialed Eating Disorder Dietitian's role is so much broader than that! We don't throw a meal plan at you and call it a day (unless you want one). We focus on the when, how, why of eating, and over time we'll unpack all the (often conflicting) diet rules to help you find a new eating philosophy that aligns with your values, not the ED's. We're also trained in many of the same therapeutic techniques and counselling modalities that your psychologist is. Not so that we can provide psychological therapy- we can't- but so that we're speaking the same language, and can help you apply the new skills you're learning to meal times and managing triggers. Our Dietetics team are also usually the team members who run meal support and general support groups.

Read more about the role of an ED Dietitian here. Or meet the Dietetics Team here