Co-occurring Treatment

AT OLIVER-PYATT CENTERS, we know that eating disorder treatment involves more than treating the specific eating disorder. As part of any comprehensive treatment plan, each individual we treat is assessed for co-occurring disorders as well – adjunct programming for co-occurring disorders being a cornerstone of our successful treatment model. Commonly co-occurring disorder include depression, anxiety, PTSD, substance abuse disorder, and others. We understand the damaging impact of these disorders and choose the most effective treatments and therapies for each client based on their personal history and needs. 

CO-OCCURRING PRESENTATIONS such as depression, anxiety, OCD, substance use disorder, and trauma reactions such as PTSD share common causal and maintaining factors with eating disorders.  As such, they exert great influence on an individual’s treatment and recovery.  Our psychiatrists and therapists are experienced in treating co-occurring disorders and are prepared to address such conditions as: 

• Depression – The most common mental health condition, up to 9.5% of adults over age 18 experience a depressive disorder such as major depression, bipolar disorder, or dysthymia each year. Affecting mood, motivation, and energy levels, depressive disorders can have drastic effects on a person’s eating habits and exacerbate an eating disorder. Depression can trigger disordered eating behaviors as well as result from them. Treatment for depression can include various therapies and sometimes medication.
• Anxiety – There are several kinds of anxiety disorders, which combined may affect even more people than depression. These include Generalized Anxiety Disorder, Obsessive-Compulsive Disorder (OCD), Panic Disorder, Post-Traumatic Stress Disorder (PTSD), and Social Phobia (or Social Anxiety Disorder). Each of these can be interrelated with eating disorders and body dysmorphia, especially PTSD. Anxiety disorders are treated differently depending on the specific type, but generally also require a combination of therapy and medication.
• Substance Use Disorder – According to the National Eating Disorders Association (NEDA), substance use disorder may present in people with eating disorders at a rate five times higher than in the general population. Abuse of alcohol and illicit drugs can have an effect on appetite and eating habits, directly affecting a person’s physical health as well as worsening disordered eating patterns. Simultaneous treatment for substance abuse disorder in an eating disorder recovery context is a must – specialized therapy is made available at Oliver-Pyatt Centers for those who need it.

 SENSITIVELY TREATING co-occurring presentations requires great clinical skill and an environment of enhanced trust, warmth and safety.  At Oliver-Pyatt Centers, we integrate specialized programming to address co-occurring presentations as a core part of our eating disorder treatment programs. These can include:

• Utilization of the “stages of change” model and motivational interviewing to address triggers, post-acute withdrawal syndrome and the relevance of family / relationship dynamics to the client’s substance use and risky behaviors
• Employing evidence-based treatments like Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and interpersonal therapy to address substance use and support behavior change
• Emphasis on trans-diagnostic etiological and maintaining factors and setting treatment goals such as safety, decisiveness, building and rebuilding relationships, and self-directedness
• Family education and family therapy programs
• Opportunities for continual progress with therapy including journaling, challenges, self-guidance, explorations of spirituality, personal values, and self-comprehension 
• Psychoeducation, grounding techniques, specialized mindfulness training, narrative work and skills training integrated into individual and group therapies
• Specially designed exposure therapy and challenges in a supportive environment, including exposures to trauma-related food

The association of traumatic events and posttraumatic stress disorder with greater eating disorder and comorbid symptom severity in residential eating disorder treatment centers

Eating disorder onset during childhood is associated with higher trauma dose, provisional PTSD, and severity of illness in residential treatment

Headache, eating disorders, PTSD, and comorbidity: implications for assessment and treatment

Provisional posttraumatic stress disorder is associated with greater severity of eating disorder and comorbid symptoms in adolescents treated in residential care

Sexual and gender minority individuals report higher rates of lifetime traumas and current PTSD than cisgender heterosexual individuals admitted to residential eating disorder treatment

Core interventions such as Cognitive Processing Therapy (CPT) is offered to clients that present with trauma reactions such as PTSD. CPT is an evidence-based model for addressing PTSD. It helps clients identify and process traumatic experience and the post-trauma reactions and adaptations that may be contributing to their eating disorders. Central aspects of CPT include careful assessment, continual observation of trauma reaction symptoms and building a foundation for managing feelings, ideas and beliefs surrounding traumatic experiences and their aftermath.

THE ABILITY TO ADDRESS co-occurring disorders is an integral part of the eating disorder recovery process at Oliver-Pyatt Centers. Each of our clients undergoes a full physical and psychological assessment before admission. Through this process, each treatment plan can address any co-occurring disorders as well as the eating disorder.

If you or a loved one is struggling with an eating disorder with a cooccurring presentation, please reach out to us at 866.511.4325 or go to our Steps to Admission page.