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.