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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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