Hi Alix and Maria (and all!),

Thanks for kindly offering to share your experience in running ACT
for BN groups. As you will see, we have heaps of questions to ask
you! (Sorry in advance!). I've sent this to everyone, in case they
are also interested in these issues. P.S If anyone else wants to
comment on their experiences, feel free!

Here they are:

* Do you have a mix of presentations in the one group? (ie. BN + BED
or AN). We were wondering whether there is a problem in putting both
BN and Binge Eating Disorder in the same group-ie. is there a
likelihood of BED clients learning purging as a new unhealthy
behaviours?
* We are wondering how behaviourally focused your groups are, in
terms of targetting and changing the binge purging behaviours?- ie.
do you focus on reducing binge eating and purging as the
predetermined, main goal of the group or do you have a general goal
of helping them to identify and accept their values and live a vital
life, with the idea that the ED behaviours will change in the process
of them taking active steps towards pursuing their values?
* Ambivalence is a feature of Bulimia and we often have EDNOS clients
with extremely restrictive food intakes and they are pre-
contemplative towards making changes in this area. Do you meet with
the group clients separately beforehand to do some pre-commitment
work with those who are ambivalent and to work on engagement before
the group commences?
* Do you target each session based on where the majority of the group
are at, or are the sessions structured in a predetermined order? ie.
We're wondering how early to bring in values...?
*  if you have come up with a content outline, are you willing to
share it with us?
* We are already familiar with ED measures, but were wondering
whether you are aware of other outcome measures that pick up on ACT
consistent outcomes, besides the AAQ?
* How many weeks did you run your groups for?
* What kinds of outcomes have you had?
* Are you doing any longer term follow ups?

Well I did warn you that there were a lot of questions here, didn't
I! We're hungry for answers, but don't feel obligued to answer
everything, anything you can share will be great food for thought
(pardon the pun!)
Thanks very much in advance,
Stella ;)


---------------------------------------------------------
Stella Dyer
Clinical Psychologist
Centre for Psychotherapy
James Fletcher Hospital
Watt Street, Newcastle NSW 2300
Ph.  (02) 49246820
Fax: (02) 49246801
---------------------------------------------------------

>>> "C. Alix Timko" <catimko@...> 9/07/2007 11:53 pm >>>
Hello Stella,
I use ACT with this group as well and had success with it.  I second
Maria - is there anything specific you were wondering about?
Alix

--
C. Alix Timko, Ph.D.
Department of Psychology
University of Pennsylvania
3720 Walnut St.
Philadelphia, PA 19104
Telephone:  215-746-4260
Fax:  215-898-7301
E-mail:  catimko@...

Hello Stella,
I use ACT with this group as well and had success with it.  I second
Maria - is there anything specific you were wondering about?
Alix

--
C. Alix Timko, Ph.D.
Department of Psychology
University of Pennsylvania
3720 Walnut St.
Philadelphia, PA 19104
Telephone:  215-746-4260
Fax:  215-898-7301
E-mail:  catimko@...

Dear Stella,
I have been using ACT with clients with Bulimia and Anorexia for a few years now
and I will be happy to share my experiences with you. Is there something
specific you would like help with? You can e-mail me back channel also if you
want.
Good luck
Maria

Maria Karekla, Ph.D.
Licensed Clinical Psychologist and Director of Clinical Practical Training,
Assistant Professor,
Intercollege and The Center for Therapy, Training, and Research (KESY),
Nicosia,
Cyprus
(357)22795100 or (357)22351274

________________________________

Áðü: eatingconcernsandcontextualpsychology@yahoogroups.com åê ìÝñïõò Stella Dyer
ÁðïóôïëÞ: Ðåì 5/7/2007 9:40 ðì
Ðñïò: eatingconcernsandcontextualpsychology@yahoogroups.com
ÈÝìá: [eatingconcernsandcontextualpsychology] ACT for bulimia Nervosa



Hi all,

Yay, this is my first post- I've finally overcome the fear! Better now than
never!!

I am an ACT therapist from the eating disorders service in Newcastle, Australia.
Both myself and Carla Walton attended the last conference in London (hi again if
we've already met!!!)

We're interested in commencing an ACT group for clients with Bulimia Nervosa and
we're keen to contact those of you who already have experience in this area. Can
you please share any contacts or resources/experiences that you have found
helpful so far with this population?

We also work with the restrictive folk using individual ACT and we find this
group much tougher, paticularly when they are in the pre-contemplative stage. I
am hoping that we could post a few discussions around these issues and how
others have dealt with it sometime soon too....

Please reinforce my 'bold' move with a response!!

Thanks very much,
Stella

---------------------------------------------------------
Stella Dyer
Clinical Psychologist
Centre for Psychotherapy
James Fletcher Hospital
Watt Street, Newcastle NSW 2300
Ph. (02) 49246820
Fax: (02) 49246801
---------------------------------------------------------

Hi all,

Yay, this is my first post- I've finally overcome the fear! Better now than
never!!

I am an ACT therapist from the eating disorders service in Newcastle, Australia.
Both myself and Carla Walton attended the last conference in London (hi again if
we've already met!!!)

We're interested in commencing an ACT group for clients with Bulimia Nervosa and
we're keen to contact those of you who already have experience in this area. Can
you please share any contacts or resources/experiences that you have found
helpful so far with this population?

We also work with the restrictive folk using individual ACT and we find this
group much tougher, paticularly when they are in the pre-contemplative stage.  I
am hoping that we could post a few discussions around these issues and how
others have dealt with it sometime soon too....

Please reinforce my 'bold' move with a response!!

Thanks very much,
Stella

---------------------------------------------------------
Stella Dyer
Clinical Psychologist
Centre for Psychotherapy
James Fletcher Hospital
Watt Street, Newcastle NSW 2300
Ph.  (02) 49246820
Fax: (02) 49246801
---------------------------------------------------------

Heh. I might have known you would have some ideas! I should have
called you first. I know several folks over at the Emily Program
(several of them go to the Eating Disorders Journal Club hosted I
think at the moment through the Department of Epidemiology), but not
Doug; I will give him a try. Thanks!

--- In
eatingconcernsandcontextualpsychology@yahoogroups.com, "Billig, John"
<john.billig@...> wrote:
>
> Hi Margit!
>
>
>
> I recently gave a talk at the Emily Program on ACT.  There is at
least
> one therapist there, Doug Perry, who is very interested in ACT, has
had
> a little training, and I think is planning to attend the ACT Summer
> Institute 3 in Houston.  You could try calling him @ (651) 645-5323.
>
>
>
> John
>
>
>
> John P. Billig, PhD, ABPP
>
> Supervisor/Program Manager, Mental Health-Primary Care Integration
Team
>
> Minneapolis VA Medical Center
>
> One Veterans Drive (116B)
>
> Minneapolis, MN 55417
>
> Ph: 612-725-2073
>
> ________________________________
>
> From: eatingconcernsandcontextualpsychology@yahoogroups.com
> [mailto:eatingconcernsandcontextualpsychology@yahoogroups.com] On
Behalf
> Of margitberman
> Sent: Tuesday, June 19, 2007 10:03 AM
> To: eatingconcernsandcontextualpsychology@yahoogroups.com
> Subject: [eatingconcernsandcontextualpsychology] New Member and
Question
> about a Therapy Referral
>
>
>
> Hi!
>
> I'm Margit Berman, and I'm a visiting assistant professor of
> counseling psychology at the University of Minnesota (until the end
> of the summer, at which point I will be at the University of
> Maryland). I got some training in ACT at the Minneapolis VA Medical
> Center, from John Billig and his colleagues, while I was on
> internship, and was intrigued enough to want to do some research on
> it. Currently I'm doing a small (N < 10)process and outcome pilot
> study using ACT for AN (with a protocol I adapted from the Heffner
&
> Eifert self-help book), with the aid of some terrific eating
> disorders researchers here in the departments of Pediatrics and
> Psychiatry. I wish I'd realized this listserv existed when we were
> putting together the study, but I'm delighted to have discovered it
> now!
>
> My main question for the list is on behalf of one of my
participants.
> She's done very well with the ACT approach in treating her AN, and
> she would like to continue with ACT therapy if possible. Do any of
> you know if there is anyone in the Twin Cities area who does ACT
for
> patients struggling with eating disorders? This patient has
struggled
> with her anorexia for many years, and needs a therapist who is
> experienced with eating disorders as well as ACT.
>
> Thanks so much for any advice/referrals you may have. Cheers!
>

Hi!

I'm Margit Berman, and I'm a visiting assistant professor of
counseling psychology at the University of Minnesota (until the end
of the summer, at which point I will be at the University of
Maryland). I got some training in ACT at the Minneapolis VA Medical
Center, from John Billig and his colleagues, while I was on
internship, and was intrigued enough to want to do some research on
it. Currently I'm doing a small (N < 10)process and outcome pilot
study using ACT for AN (with a protocol I adapted from the Heffner &
Eifert self-help book), with the aid of some terrific eating
disorders researchers here in the departments of Pediatrics and
Psychiatry. I wish I'd realized this listserv existed when we were
putting together the study, but I'm delighted to have discovered it
now!

My main question for the list is on behalf of one of my participants.
She's done very well with the ACT approach in treating her AN, and
she would like to continue with ACT therapy if possible. Do any of
you know if there is anyone in the Twin Cities area who does ACT for
patients struggling with eating disorders? This patient has struggled
with her anorexia for many years, and needs a therapist who is
experienced with eating disorders as well as ACT.

Thanks so much for any advice/referrals you may have. Cheers!

Okay,
So here are some thoughts -- sorry if they are not relevant.  I would recommend
using some sort of pre-screen a la Yalom for the first set of groups until you
get some of the bugs out in terms of how you approaching certain things.
Getting participants who are on the same page with the same level of motivation
will reduce drop outs and will provide a slightly more homogeneous group at
first.
I would try to make sure that if you have really symptomatic women (sorry for
the more sx specific language -- it is what I am more familiar with for
brainstorming) -- than try to make sure they are more or less in the same place
-- that is, I wouldn't have bulimics who really want to be anorectic in a group
with a number of low-weight restrictors. Though you could get at a lot of
really good clinical/values stuff with that - it is also really easy for
contagion to occur. That being said, I would make sure that you have good
confidentiality in effect - including no contact outside the group (for those
that meet weekly).  I have seen some groups turn into "how to be better at
having an eating disorder" or "how do I get one, 'cause i like the way you
look" groups.  I think an ACT perspective would really discourage this in
general – but best to alleviate it as much as possible.  If you have a number
of student and non-student members in the group together, you could get some
interesting dynamics – but college students do have different issues than
non-students – so you would have to move them rather quickly through the
forming and storming phases so that they could see past some of the superficial
aspects to the control issues – again, I don’t really have experience with ACT
in a group so this may work a bit differently than I am used to.
I think that if you make data collection part and parcel of the program it won’t
be devaluing at all.  In my experience we used a battery for the group screen
and then a short series of questionnaires at the beginning of each group and
then finally the battery at the end of the group series. If it is included in
the consent process and explained during the screen it usually goes over pretty
well.  Esp. if it is made clear that they will be helping others as well.
Wait list – where I worked this was pretty common on an outpatient basis just
because there weren’t enough groups running at any given time.  With
sub-clinical issues it shouldn’t be too much of a problem – with clinical EDs I
would think it would get trickier.  If they were medically stable and if the
wait list wasn’t too long than it might be okay ethically – but you may want to
compare to group tx as usual (so a standard Yalom type group) or do
psycho-education or biblio therapy.  Just some thoughts.

2) Questions - What questions would the group be interested in asking of this
project?
Are there assessments, activities, organizational factors etc... that you would
like to see
included/implemented?

Hmm.  Let me think and I am sure I will have lots of good stuff later!

Alix,

First on the target population - I desribed them vaguely as "individuals with
eating
concerns" because that is how we are recruiting participants.  In other words,
the
description of potential participants' target behaviors will be functional
rather than
topographical. (Off the top pf my head, something like, " for people whose
concerns about
their bodies or eating patterns have gotten in the way of the life they want to
live.") The
clinic through which we will be providing the workshops and groups is located on
the
university campus, but serves a large number of clients from the community.  I
am not
sure what kind of pre-screening we will have, but it will probably allow the
groups to be
populated with a range of behavioral topographies, including whether food or
body stuff is
more salient for them.  We are not limiting the group to females, but imagine
that it may
end up that way.

emily

--- In eatingconcernsandcontextualpsychology@yahoogroups.com, "C. Alix Timko"
<catimko@...> wrote:
>
> Hi Emily,
> A few questions about the group first -- then I am sure I'll have some
> thoughts.  You mention it is for those with eating concerns --
> specifically what will your group look like (I assume you are doing
> pre-group screening)... college students?  Adults in the community?
> Those with disordered eating or eating disorders?  So are you talking
> solely sub-clinical or solely clinical level eating problems or a mix?
> Body image -- will you let those in who have more body image issues per
> say (that is, the body stuff is more salient for them than the food
> stuff).  Will it be heterogeneous in terms of gender or homogeneous?
>
> Or are these all things you are still figuring out?  :)
> Alix
>
>
>
>
> --
> C. Alix Timko, Ph.D.
> Assistant Director of Undergraduate
>  and Graduate Studies
> Department of Psychology
> University of Pennsylvania
> 3720 Walnut St.
> Philadelphia, PA 19104
> Telephone:  215-746-4260
> Fax:  215-898-7301
> E-mail:  catimko@...
>

Hi Emily,
A few questions about the group first -- then I am sure I'll have some
thoughts.  You mention it is for those with eating concerns --
specifically what will your group look like (I assume you are doing
pre-group screening)... college students?  Adults in the community?
Those with disordered eating or eating disorders?  So are you talking
solely sub-clinical or solely clinical level eating problems or a mix?
Body image -- will you let those in who have more body image issues per
say (that is, the body stuff is more salient for them than the food
stuff).  Will it be heterogeneous in terms of gender or homogeneous?

Or are these all things you are still figuring out?  :)
Alix




--
C. Alix Timko, Ph.D.
Assistant Director of Undergraduate
	 and Graduate Studies
Department of Psychology
University of Pennsylvania
3720 Walnut St.
Philadelphia, PA 19104
Telephone:  215-746-4260
Fax:  215-898-7301
E-mail:  catimko@...

Hi all.

I am working on a protocol for a project I am mounting here at Ole Miss using
ACT with
individuals with eating concerns.  We hope to start with a half day workshop and
follow up
with those interested using weekly group sessions.  I'm looking for 2 things
from this
group:
1) Answers - If you have experiences that you think might help to guide this
project, by all
means, please share them.  I have questions about your experience a) using a
group
format with this population, b) having individuals with drastically different
presentations
participating, c) how to collect data in a way that doesn't devalue the
participants'
experience, d) how to handle ethical and research design issues with a wait list
control, e)
many other things I haven't thought of yet.

2) Questions - What questions would the group be interested in asking of this
project?
Are there assessments, activities, organizational factors etc... that you would
like to see
included/implemented?

Please, if you have Answers or Questions, take a minute to send them my way.

I will, of course, keep you guys updated on the project as it takes shape and
make the
protocol and any data available once we are done.

Thanks,

emily

Emily Sandoz, M.S.
Graduate Student
University of Mississippi
eksandoz@...

Susan,

The purpose of this list is to provide a forum for people who are interested in
the
application of Relational Frame Theory and/or Acceptance and Commitment Therapy
to
the understanding and treatment of all kinds of eating concerns.  While intended
to be
mainly of use to clinicians and researchers, we keep this list open to allow
anyone to
participate and share ideas.

This list is not meant to provide specific professional advice.  However, people
may be
willing to share their experiences in using ACT to help individuals suffering
with
overweight and related concerns.  I know that there are many of us out there
working in
this area...  Guys?  Any general experiences you'd be willing to share?

I also would like to direct you the organization behind this work - the
Association for
Contextual Behavioral Science.  The association's website has a remarkable
amount of
content available, and is the home to other ACT forums that may be of use to you
as well.
You might start here http://www.contextualpsychology.org/
act_theory_and_weight_control with Jason Lillis' excellent conceptualization of
weight
control from an ACT perspective.

Finally, if this list is not quite what you are looking for, you may find the
ACT for the Public
listserv to better suit your interest, as a forum for non-professionals to
discuss ACT.
There are professionals on that list, as well, many of whom are willing to help
people
understand the ACT model, and how it might be applied with different
difficulties.  You
can check that list out at
http://health.groups.yahoo..com/group/ACT_for_the_Public/.

Hope this helps!


emily

Hi Jan, can you tell me what ACT is in helping people to eating
disorders?
Susan
--- In
eatingconcernsandcontextualpsychology@yahoogroups.com, "jan_martz"
<jan_martz@...> wrote:
>
> Hello
> I am a psychiatrist in Winterthur, Switzerland, and somewhat
> experienced in the treatment of eating disorders. Having read some
> books on ACT and having visited a workshop with Kelly Wilson, I am
very
> interested in using ACT for patients with ED. I find ACT elements
very
> useful in individual and group therapy settings. I look forward to
> participating in this group - my first such experience.
> Jan Martz
> Winterthur
>

Hi, want to introduce myself.  I have a group of women who want to lose
weight, but I'm not motivated enough to help them.  I was wondering if
some of you on here could help me and then in the long run, I could
help them.  I have a BS in Psychology and hope to get in a masters
program soon and to do something in order to help people lose weight.
Maybe this list is for me.........u let me know.
Anyway, I'm Susan, belong to quite a few lists, and will be active on
this one if I find it to be of help to me or vice versa.
So, can I be a member here?
Susan

Hello!  I'm so excited to join this group!  My name is Kathleen Young,
and I am a graduate student at Bowling Green State University in
Bowling Green, OH.  I am interested in obesity, weight loss, and
eating behaviors, and I'm looking forward to melding these interests
with ACT.

Kathleen Young, M.A.
Bowling Green State University
Bowling Green, OH 43402
youngkm@...

Hello
I am a psychiatrist in Winterthur, Switzerland, and somewhat
experienced in the treatment of eating disorders. Having read some
books on ACT and having visited a workshop with Kelly Wilson, I am very
interested in using ACT for patients with ED. I find ACT elements very
useful in individual and group therapy settings. I look forward to
participating in this group - my first such experience.
Jan Martz
Winterthur

Hello everybody,

I am a student at the University of Copenhagen currently finishing my
theoretical Master Thesis about CBT for obesity and the potential use
of ACT in this intervention.

I am very enthusiastic about ACT and cannot seem to come up with any
reasons why traditional CBT should be preferable. I still need to
produce a sound discussion though, so I was wondering if anyone could
help me with a reference to some articles that actually criticize ACT?

Best regards and Christmas greetings,

Rikke Kjelgaard

HI,

I have just started postgraduate studies in Galway, Ireland, under Dr.
Ian Stewart. I am interested in investigating implicit attitudes
towards weight/ body image. I hope to employ the Implicit Relational
Assessment Procedure and other implicit measurements to examine the
attitudes of people of a variety of different weights. I look forward
to hearing about and discussing similar projects being undertaken in
this area.

Sarah Roddy

Hi there!

I am a student at the University of Copenhagen currently writing my
master thesis about ACT and its potential utility in obesity treatment.
I am just now writing a chapter on traditional CBT and obesity. Does
anyone now some articles that provide evidence data on CBT for obesity?
The Fairburn book "CBT for obesity" has - to my knowledge - not been
evaluatet yet.

Yours sincerely,
Rikke Kjelgaard

Hey guys.  About a month ago, I posted a measure of body image
acceptance developed by Kelly Wilson and myself on the
contextualpsychology.org website.  While working on the manuscript, we
decided to change the name of the measure to the Body Image -
Acceptance and Action Questionnaire (BI-AAQ).  If you have downloaded
the measure or any of the associated documents, I would encourage you
to download the updated versions from the website in order to maintain
consistency.  If you have begun using the measure already, I assure
you that the content of the questionnaire is the same - only the name
has been changed.

Feel free to email me if you have any questions!

emily

Emily Sandoz, M.S.
Graduate Student
University of Mississippi
eksandoz@...

Hi all.  I'm a psychology intern at the VA Palo Alto Healthcare
System. I trained with Steve Hayes at the University of Nevada, Reno.
  I am currently finishing up work on a RCT comparing ACT to TAU for
obesity-related stigma and weight loss for participants who have
received at least 6 months of a diet and excercise intervention.  We
will have all of the follow-up data by the end of October and I will
be sure to post results.  Glad to be on the list, looking foward to
discussions.

Jason Lillis, M.A.

HI,

I am looking forward to joining and adding to this group.


Melissa Morrissette, MSW

Melissa A. Morrissette

Hello everyone!

I am a Postdoctoral Fellow in Behavioral Medicine at Duke University
Medical Center. I work primarily in the Duke Eating Disorder Program--
conducting research and seeing clients. I was trained under Kelly
Wilson and believe that ACT/RFT can make a difference in the treatment
(and ultimately quality of life) of this population. We are starting
several ACT/RFT relevant projects and I am excited to have a place to
discuss ideas, build collaborative relationships, etc!

Rhonda

Hi colleagues,

My name is Carla and I'm a Clinical Psychologist in Newcastle, Australia. I work
at the Centre for Psychotherapy which is an outpatient public sector service
specialising in Eating Disorders and Borderline Personality Disorder (usually
separately and at times, together).

In the Eating Disorder arm of the service, we run a DBT group for Bulimia and a
couple of us use ACT in our individual work with clients with Anorexia. At a
theoretical level, ACT makes so much sense to me to use with folks with eating
difficulties. Having said that, I find Eating Disorders a very challenging area
to work in. It also seems to be one of the clinical areas that has been less
navigated by ACT researchers and clinicians than some other clinical areas, so I
am really pleased that this group is being set up so that we can support each
other.

I've been interested in ACT for about 3 years and find that the more I open
myself up to it, the richer my experience with it has become and the more I have
seen growth in my clinical work and in my personal life.

I have recently returned from World Con II. It was great to meet some of you
there who are also interested in the area of ACT / contextual psychology with
eating concerns and I look forward to 'meeting' the rest of you via this group.

Carla.

I wanted to take a moment to let you guys know who I am and what I am up to -

I'm a graduate student in the Clinical Psychology program at University of Mississippi where I
am engaged in a couple of lines of research and clinical work related to eating concerns and
contextual psychology. In general, most of my work so far has been involved with the
investigation of relational conditioning processes as they related to eating and eating-related
disturbances using the IRAP and a measure of body image acceptance of my own creation. I
hope to eventually link this work to the design of a solid line of clinical research applying
ACT to these disturbances, and am excited about the possibility of bouncing ideas off of this
little community as that becomes more of a reality.

Please feel free to email me backchannel anytime: eksandoz@olemiss.edu.

Emily K. Sandoz, M.S.
University of Mississippi

I wanted to take a moment to let you guys know who I am and what I am up to -

I'm a graduate student in the Clinical Psychology program at University of
Mississippi where I
am engaged in a couple of lines of research and clinical work related to eating
concerns and
contextual psychology.  In general, most of my work so far has been involved
with the
investigation of relational conditioning processes as they related to eating and
eating-related
disturbances using the IRAP and a measure of body image acceptance of my own
creation.  I
hope to eventually link this work to the design of a solid line of clinical
research applying
ACT to these disturbances, and am excited about the possibility of bouncing
ideas off of this
little community as that becomes more of a reality.

Please feel free to email me backchannel anytime:  eksandoz@....


Emily K. Sandoz, M.S.
University of Mississippi

Greetings all!  I just wanted to welcome you all to the group.  I am excited
about the
opportunities that this group affords and would like to encourage people to take
a moment
to introduce themselves and what they are up to with this work.  I, for one, am
extremely
curious.

Please let me know if you have any questions/concerns regarding the listserv.


Thanks again for your participation!

Emily K. Sandoz, M.S.
University of Mississippi