Adolescent Series Weekly Topics and Speakers

Week 1

Introduction to Dietetic Treatment of Children and Adolescents with Eating Disorders using Family-Based Treatment (FBT) by Marcia Herrin, EdD, MPH, RDN, LD, FAED

This session will review how effective treatment for children and adolescents with eating disorders differs from strategies typically used to treat adults with eating disorders. Family-based Treatment (FBT) is recommended as the most effective evidence-based treatment for child and adolescent anorexia nervosa, yet limited access to FBT certified mental health providers hampers dissemination. Dietitians are an untapped resource for delivering evidence-based practice (EBP) based on FBT. During this session, dietitians will explore how they can expand delivery of FBT by serving as consultants to FBT mental health providers and to parents/carers who have a child engaged in FBT; by utilizing FBT techniques while serving as a member of a multidisciplinary team; and how the dietitian can lead phase 1 and 2 of FBT.

  1. Discuss the ways dietitians can use FBT in various practice settings.

Learning Objectives:

  1. Describe key issues associated with treating children and adolescents with eating disorders.
  2. Summarize the history, research and treatment resources associated with FBT.
  3. Delineate the difference between evidence-based treatment (EBT) and evidence-based practice (EBP) and the implications for dietitians using FBT.
  4. Discuss the ways dietitians can use FBT in various practice settings.

Dietitian Marcia Herrin, who has a doctorate in nutrition education and master’s in public health nutrition, is the founder of Dartmouth College’s nationally renowned eating disorder treatment program for college students. She is a Clinical Professor at Dartmouth’s Medical School with an appointment in the Adolescent Medicine Faculty and provides training to Pediatric Residents at Children’s Hospital at Dartmouth. Besides lecturing worldwide on nutrition counseling in the treatment of eating disorders, Dr. Herrin provides programmatic and clinical supervision for eating disorder providers in the US, United Arab Emirates, Britain, Mexico, Russia, and Venezuela.

Dr. Herrin has treated eating disorder patients for over 30 years. She is the author of Nutrition Counseling in the Treatment of Eating Disorders and The Parent’s Guide to Eating Disorders. Her Rule of Threes Food Plan is widely used in the treatment of eating disorders. Marcia received her doctorate in nutrition education from Columbia University. At the University of California-Berkeley, she received her masters degree and completed a dietetic internship. Marcia was honored as a fellow in the Academy of Eating Disorders in 2013. Marcia credits much of her success with patients with eating disorders and to her own struggles with and recovery from these conditions.

Week 2

Family Based Treatment In-Depth. Part 1 – Intro to FBT Tenets & Therapeutic Underpinnings by Bryan Lian, RDN, CEDRD-S and Anna Oliver, RDN

The second and third weeks of the series will train attendees on the individual phases and overall process of FBT. Designed to inform RDs on how they can explain what FBT is to families and healthcare providers, these talks will build a solid foundation and framework for how a dietitian can promote the FBT phases and tenets.

  • Part 1: Part 1 – Intro to FBT Tenets & Therapeutic Underpinnings

Learning Objectives:

  1. Summarize the FBT phases for RDs
  2. Be able to explain the process to families and healthcare providers
  3. Describe the role dietitians have in promoting FBT phases and tenets
  4. Discuss the ways dietitians can use FBT in various practice settings.

Bryan Lian is a registered dietitian nutritionist (RDN), specializing in eating & wellbeing through life’s transitions, namely adolescence into adulthood. He is a Certified Eating Disorders Registered Dietitian (CEDRD) and an Approved Supervisor, both through the International Association of Eating Disorder Professionals (IAEDP). Bryan’s professional experience spans a variety of levels of care, healthcare systems, and treatment modalities. He has presented internationally at eating disorder conferences/workshops on Family Based Treatment, published in the Journal of the Academy of Nutrition and Dietetics, and is a member of the board of editors for the Nutrition Care Manual for Eating Disorders.

Bryan’s academic training includes studying nutrition and biology at Rutgers University in New Jersey, completing his dietetic internship at Beth Israel Deaconess Medical Center, the Leadership Educators in Adolescent Health (LEAH) fellowship at Harvard’s children’s teaching hospital, Boston Children’s Hospital, and his Masters degree in Health Administration at the University of California, San Francisco (UCSF). He has also completed a 200hr Yoga Teacher Training at Avalon Yoga Studio in Palo Alto, CA, and a 50 hour Yin Yoga specialty training.

He currently lectures at Stanford University and counsels students as a part of their student wellness and health promotions team. He also manages his group private practice, Nutrition Support Clinic.

Anna conducts a private practice in London and serves as the Chair of the London Eating Disorder Dietitians Group. She has primarily dedicated her career to nutritional counselling, supervising and teaching in the treatment for eating disorders across the lifespan (children, adolescents, and adults); and has been working in the eating disorder field since 2007 (including both inpatient and outpatient treatment within the public and private sector).

Anna has developed a special interest in working with children and adolescents, and has aligned her practice with FBT whilst working within multidisciplinary teams and in her private practice. She has completed a graduate certificate in ‘Systemic approaches to working with individuals, families and organisations’ (accredited by The Association of Family Therapy); and training in enhanced cognitive behavioural therapy (CBT-E).

Recently, Anna co-authored the ‘The clinical guidelines for dietitians treating young people with anorexia nervosa – family focused approach’ to support the UK’s National Eating Disorder Team Training (published January 2019); and will be starting a PhD focusing on evaluating the usefulness of Dietitians working with young people with anorexia nervosa using a family focused approach, and further developing the clinical guideline.

Week 3

Family Based Treatment In- Depth. Part 2 – Intro to FBT Phases & Registered Dietitian Advocacy by Bryan Lian, RDN, CEDRD-S and Anna Oliver, RDN

The second and third weeks of the series will train attendees on the individual phases and overall process of FBT. Designed to inform RDs on how they can explain what FBT is to families and healthcare providers, these talks will build a solid foundation and framework for how a dietitian can promote the FBT phases and tenets.

  • Part 2: Intro to FBT Phases & Registered Dietitian Advocacy

Learning Objectives:

  1. Summarize the FBT phases for RDs
  2. Be able to explain the process to families and healthcare providers
  3. Describe the role dietitians have in promoting FBT phases and tenets
  4. Discuss the ways dietitians can use FBT in various practice settings.

Bryan Lian is a registered dietitian nutritionist (RDN), specializing in eating & wellbeing through life’s transitions, namely adolescence into adulthood. He is a Certified Eating Disorders Registered Dietitian (CEDRD) and an Approved Supervisor, both through the International Association of Eating Disorder Professionals (IAEDP). Bryan’s professional experience spans a variety of levels of care, healthcare systems, and treatment modalities. He has presented internationally at eating disorder conferences/workshops on Family Based Treatment, published in the Journal of the Academy of Nutrition and Dietetics, and is a member of the board of editors for the Nutrition Care Manual for Eating Disorders.

Bryan’s academic training includes studying nutrition and biology at Rutgers University in New Jersey, completing his dietetic internship at Beth Israel Deaconess Medical Center, the Leadership Educators in Adolescent Health (LEAH) fellowship at Harvard’s children’s teaching hospital, Boston Children’s Hospital, and his Masters degree in Health Administration at the University of California, San Francisco (UCSF). He has also completed a 200hr Yoga Teacher Training at Avalon Yoga Studio in Palo Alto, CA, and a 50 hour Yin Yoga specialty training.

He currently lectures at Stanford University and counsels students as a part of their student wellness and health promotions team. He also manages his group private practice, Nutrition Support Clinic.

Anna conducts a private practice in London and serves as the Chair of the London Eating Disorder Dietitians Group. She has primarily dedicated her career to nutritional counselling, supervising and teaching in the treatment for eating disorders across the lifespan (children, adolescents, and adults); and has been working in the eating disorder field since 2007 (including both inpatient and outpatient treatment within the public and private sector).

Anna has developed a special interest in working with children and adolescents, and has aligned her practice with FBT whilst working within multidisciplinary teams and in her private practice. She has completed a graduate certificate in ‘Systemic approaches to working with individuals, families and organisations’ (accredited by The Association of Family Therapy); and training in enhanced cognitive behavioural therapy (CBT-E).

Recently, Anna co-authored the ‘The clinical guidelines for dietitians treating young people with anorexia nervosa – family focused approach’ to support the UK’s National Eating Disorder Team Training (published January 2019); and will be starting a PhD focusing on evaluating the usefulness of Dietitians working with young people with anorexia nervosa using a family focused approach, and further developing the clinical guideline.

Week 4

Building an Unbiased and Affirming Clinical Skill Set for Treating Adolescent Eating Disorders by Rebecca DeHamer, MS, RD

Build your clinical skill set for working with adolescents. This session will review setting Estimated Goal Weight Ranges (EGW) and Weight Restoration Energy Needs for adolescents with ED’s.

Learning Objectives:

  1. Summarize the history of adolescent growth charts
  2. Assess growth charts and create a recommended EGW for weight restoration for binary, non-binary, cis-and trans-gender adolescents
  3. Discuss EGW to families and other clinicians, within a HAES aligned framework
  4. Assess weight restoration energy needs for binary, non-binary, cis-and trans-gender adolescents

Rebecca DeHamer, MS, RD

Rebecca DeHamer is a registered dietitian, nutritionist in the fields of nutrition and movement therapy. Her background started in dance and education, quickly moving into adolescent physical education and athletics. Her graduate work focused on nutrition science, while continuing with teaching and work in health and wellness education. Before finishing graduate school, she trained as a board certified personal trainer and utilized this within public health nutrition. After completion of the UCSD Medical School’s Dietetic Internship, she took a position working in their Eating Disorders Treatment and Research Center.

Over the years she moved from adult eating disorders, focusing on Dialectical and Cognitive Behavioral Therapy (DBT, CBT) skills, into adolescent eating disorders. She is a primary adolescent milieu dietitian with UCSD, as well as the sports dietitian for their athlete track. Within the adolescent program, she continues to utilize DBT and CBT, along with Motivational Interviewing (MI) and Family Based Treatments (FBT) to appropriately work with parents and adolescents with eating disorders.

Her private outpatient practice supports her ability to continue care with discharged PHP/IOP patients and their families from these programs. This space is also an outpatient nutrition therapy practice for clients interested in making peace with food and their bodies through Intuitive Eating and Health At Every Size approaches.

Her passions remain in the specialties of Eating Disorders, Sports Dietetics, and Intuitive Eating with dual lenses of scientific evidence and the psychology of the human experience.

eatingdisorders.ucsd.edu

www.dehamerdietetics.com

Week 5

Strategies for Nutritional Rehabilitation in Child and Adolescent Patients with Eating Disorders: Helping families manage food issues at home by Wendy Sterling, MS, RD, CEDRD-S, CSSD; Casey Crosbie, RD, CSSD; and Marcia Herrin, EdD, MPH, RDN, LD, FAED

This session will describe strategies for nutritional rehabilitation in the treatment of eating disorders which ensures nutrient needs are met, food is consumed in an organized way, and food fears are addressed. Several food plan approaches developed for treating eating disorders will be explained, including approaches appropriate for use in FBT. These food plans are collaboratively developed with caregivers and are non-prescriptive. Participants will be provided with the specialized guidance necessary to empower parents to make food-related decisions in their own homes without engaging in unproductive worries and arguments and nutrition rules and details.

Learning Objectives:

  1. To explore methods of accomplishing nutritional rehabilitation in patients with eating disorders
  2. To understand how to implement the Plate-by-Plate Approach
  3. To understand how to implement the Rule of Threes Approach
  4. To understand how to implement a food plan in family based treatment that is collaborative with caregivers and non-prescriptive

Wendy Sterling, MS, RD, CSSD

Wendy Sterling, MS, RD, CSSD, CEDRD-S is a Certified Eating Disorder Registered Dietitian and Approved Supervisor through the International Eating Association of Eating Disorder Professionals, and a Board Certified Specialist in Sports Dietetics in the Bay Area in California. Wendy maintains a private practice in Menlo Park and Los Altos, California.

Wendy is a co-author of “How to Nourish Your Child Through an Eating Disorder: A Simple, Plate-by-Plate Approach to Reestablishing a Healthy Relationship with Food.” She and her colleague Casey Crosbie created the innovative approach to refeeding called the “Plate-by-Plate Approach,”a no-numbers, visual approach, which has been featured in the Journal of Nutrition and Dietetics in an article entitled , “The Use of the Plate-by-Plate Approach for Adolescents Undergoing Family-Based Treatment.” For tips, support and encouragement on building good plates for nutrition rehabilitation for the treatment of eating disorders, follow on instagram: @platebyplateapproach.

She is also the co-author of, “No Weigh! A Teen’s Guide to Body Image, Food, and Emotional Wisdom,” a book co-written by an adolescent doctor, therapist, and herself as the dietitian for teens about their changing bodies, hormones, emotions, and tips for improving sleep, body image, and their relationship with food.

Wendy has been the Team Nutritionist of the Oakland Athletics since 2016. She has consulted for the Golden State Warriors, New York Jets (2006-2013), NY Islanders, and Hofstra University’s Women’s Lacrosse and Volleyball teams, where she worked directly with players to improve endurance, speed and explosiveness. Wendy has worked closely with the Menlo School since 2014, where she has developed a sports nutrition curriculum for the Athletics program and has consulted for the Santa Clara Aquamaids synchronized swim team. She is a Sports Performance Nutrition Consultant for a variety of Sports Agencies, where she helps athletes achieve peak performance prior to the NBA draft and NFL Combine. Wendy is part of the United States Olympic Committee Sports Dietitian Registry. She works closely with competitive athletes in order to enhance sports performance and gain a competitive edge.

Casey Crosbie RD, CSSD is a Registered Dietitian and Board Certified Specialist in Sports Dietetics. She currently serves as Director of Nutrition Services at The Healthy Teen Project, where she has played an integral role in the development and leadership of the program since its inception in 2013. Casey also holds a small a private practice in Los Altos, CA. Casey previously served as the lead dietitian for the Lucile Packard Children’s Hospital Comprehensive Eating Disorders Program at Stanford from 2008-2013. It was there that she trained with leading experts in Family-Based Treatment for adolescents with eating disorders.

Casey is a co-author of “How to Nourish Your Child Through an Eating Disorder: A Simple, Plate-by-Plate Approach to Reestablishing a Healthy Relationship with Food.” The “Plate-by-Plate Approach,” covered in great detail in this book, is a visual tool that has been featured in the Journal of Nutrition and Dietetics in an article entitled, “The Use of the Plate-by-Plate Approach for Adolescents Undergoing Family-Based Treatment.”

Casey received her B.S. in food science and nutrition from California Polytechnic State University, San Luis Obispo and completed her dietetic internship at UC Davis Medical Center to earn her RD. She is passionate about working with adolescents and their families to break free from diet rules and establish a positive relationship with food.

Marcia Herrin, EdD, MPH, RDN, LD, FAED

Dietitian Marcia Herrin, who has a doctorate in nutrition education and master’s in public health nutrition, is the founder of Dartmouth College’s nationally renowned eating disorder treatment program for college students. She is a Clinical Professor at Dartmouth’s Medical School with an appointment in the Adolescent Medicine Faculty and provides training to Pediatric Residents at Children’s Hospital at Dartmouth. Besides lecturing worldwide on nutrition counseling in the treatment of eating disorders, Dr. Herrin provides programmatic and clinical supervision for eating disorder providers in the US, United Arab Emirates, Britain, Mexico, Russia, and Venezuela.

Dr. Herrin has treated eating disorder patients for over 30 years. She is the author of Nutrition Counseling in the Treatment of Eating Disorders and The Parent’s Guide to Eating Disorders. Her Rule of Threes Food Plan is widely used in the treatment of eating disorders. Marcia received her doctorate in nutrition education from Columbia University. At the University of California-Berkeley, she received her masters degree and completed a dietetic internship. Marcia was honored as a fellow in the Academy of Eating Disorders in 2013. Marcia credits much of her success with patients with eating disorders and to her own struggles with and recovery from these conditions.

Week 6

Counseling the Developing Client: Building Body Confidence and Resilience in Teens by Anna Lutz, MPH, RD/LDN, CEDRD-S

Disordered eating and eating disturbances present in different ways and oftentimes don’t fit into the diagnostic criteria boxes. There are many times when an adolescent client presents for outpatient nutrition therapy and an FBT model is not indicated. The outpatient RD has an important and often difficult job of assessing for appropriate treatment model, connecting with the teen client, and working with their family. In this session, we will present counseling strategies and tools for working directly with the adolescent client. We will discuss the unique challenges of working with this age group, how to involve parents, and resources available for this age client.

Learning Objectives:

  1. List 3 developmental characteristics of adolescents to understand when working with the adolescent client.
  2. Explain the reasons for and importance of involving parents and loved ones in all treatment with an adolescent client.
  3. List 3-4 counseling tools to use in session with an adolescent client.
  4. List 3-4 resources to use with adolescent clients in nutrition therapy.

Anna Lutz, MPH, RD/LDN, CEDRD-S

Anna is a nutrition therapist with Lutz, Alexander & Associates Nutrition Therapy in Raleigh, NC. Anna specializes in eating disorders and pediatric/family nutrition. Anna received her Bachelor of Science degree in Psychology from Duke University and Master of Public Health in Nutrition from The University of North Carolina at Chapel Hill. She is a Certified Eating Disorders Registered Dietitian (CEDRD) and an Approved Supervisor both through the International Association of Eating Disorder Professionals (iaedp). Anna previously worked at Duke Student Health on their eating disorders treatment team and at Children’s National Medical Center, providing outpatient care for people with eating disorders. Anna enjoys providing training, workshops, and supervision for dietitians and other health professionals about eating disorders and weight-inclusive care. She also writes about simple cooking and nutrition, free of weight and diet-talk, at Sunny Side Up Nutrition.

Week 7

When the Going Gets Rough : Concepts and knowledge to help you navigate working with separated or divorced parents, substance abuse issues, an “older than 18” child, and more by Therese Waterhous, PhD, RDN, CEDRD-S and FAED

The final part of this series will provide practical information and resources for RDNs using FBT informed treatment. This part will go into details about how to handle special situations, including families that are “not typical”, divorced parents, blended families, families with “an older than 18 child”. Impacts of substance abuse on recovery will be discussed. Language to use with families will be highlighted and cases will be presented to illustrate concepts and knowledge needed to work with difficult situations. Finally, situations where FBT may not be considered appropriate and situations where one professional has an FBT informed approach but other professionals on the team are not FBT informed will be discussed.

Learning Objectives

  1. Attendees will gain useful and practical language to use when treating adolescents and their families
  2. Attendees will be able to describe certain situations where FBT may not be appropriate as a first line form of treatment.
  3. Attendees will be able to describe how to work with blended and non-traditional family situations
  4. Attendees will be able to gain knowledge about how to work with a team where all members may not be FBT informed.

Therese Waterhous, RDN

Therese S. Waterhous PhD, RDN, CEDRD-S is an eating disorder expert in private practice in Corvallis, Oregon. She has worked with families and their children for over 25 years, having completed a pediatric fellowship at the University of Alabama at Birmingham during graduate school. Therese was one of the founding board members for the international non-profit advocacy group FEAST-ED (Families Empowered and Supporting Treatment for Eating Disorders) she has worked with the Eating Disorders Coalition during two of its the Washington DC lobbying days and she delivers many local talks to various groups, educating them about eating disorders.

Therese co authored the ADA Practice Paper on nutrition interventions in eating disorders, she served as Director of the Sports, Cardiovascular and Wellness nutrition practice group’s subunit on disordered eating and eating disorders. She has served on the Oregon IAEDP (International Assn. for Eating Disorders Professionals) chapter board and currently serves on the national IAEDP Excellence in Practice Committee., Therese served on the Academy for Eating Disorders (AED) special interest group on Family Based Treatment and currently is active on the Medical Care Standards Committee and the Experts by Experience Committee of AED. In 2016-2017, she received and has executed work on a grant from the local Coordinated Care Organization to train other health care professionals about eating disorder evaluation and treatment and extend eating disorder treatment to underserved Oregonians.