Pavel G. Somov, Ph.D., Licensed Psychologist
Author of "Eating the Moment: 141 Mindful Practices to Overcome Overeating, One
Meal at a Time"
www.drsomov.com
"7 Stars on a 5-Star Scale: an Excellent Continued Education Cross-Trainer!, October
9, 2008
As a psychologist in practice, in picking up this book on nutrition counseling
by a nutrition expert, I was expecting psychotherapy to be accorded its usual
short shrift and after-thought status that seems so common for the nutritional
literature on eating disordrs. I was pleasantly surprised. Not only is the book
calling for a non-nominal coordination of nutritional and psychological disciplines,
the nutritional angle itself is presented with an extraordinary degree of psychological
savvy.
Case in point: in addition to the coverage of various psychological treatment
paradigms, the book offers process suggestions for nutritional counselors on managing
self-disclosure, splitting, idealization, countertransference. The first two chapters
are smartly subdivided into basic nutritional counseling (more educational in
scope) and advanced nutrtional counseling that integrates nutritional counseling
and psychotherapy.
While empirically authoritative and technically comprehensive, the book is also
highly pragmatic. Dr. Herrin continuously offers direct speech suggestions of
how to pitch a certain educational theme or tid-bit to a prospective client. Throughout
the book, the reader keeps stumbling upon highly practical counseling gems that
begin with "explan this" or "you might want to say this." This pragmatic refrain
helps the reader to pause and translate the material into hypothetical counseling
exchanges.
I particularly appreciated the no-nonsense harm-reduction orientation of the book:
this is most evident in the discussion of normalizing the relationship with "fun
foods," as well as in the discussion of managing binge-eating through paradoxical
harm-reduction binge-schedulng alternatives.
The "intervention" core of the book, consisting of the following five chapters,
is impeccable: "Weight Management," "Managing Weight Restoration" (a euphemism
for "weight gain/weight normalization"), "Managing Binge Eating," "Managing Purging,"
and "Exercise Management."
Herrin's amazingly effective: page for page she offers tremendous informational
density - without (!) creating a sense of informational satiation. Her narrative
style feels light but never superficial. Her handling of the medical repercussions
of purging is a wonderful example of that: in the span of just a few pages, Herrin
manages to provide a panoramic overview of dental, electrolyte, cardiac, GI and
other types of medical complications that can result from purging.
She offers a similarly effective overview of misuse of veganism/vegetarianism
(as a socially sanctioned cover for restrictive eating), of eating pregnancy,
and of other "special issues." She offers an extensive Appendix with forms, tables
and handouts (check out Appendix E - "Recovery Plan" for binge-prevention and
post-binge damage control).
In sum, the book seems to round out the respective educational-professional fortes
of nutritional and psychological counselors. Nutritional counselors stand to learn
more about the counseling aspect of nutritional counseling and psychologists working
with eating disorders stand to learn more about the nutritional nuts and bolts
of the eating disorder presentations that might otherwise be left unattended in
the guilt-shame shade of client's ego-saving defenses.
Herrin's "Nutrition Counseling" is an excellent continued education cross-trainer!"
Dr. Marcia Herrin
(Brunner-Routledge, 2003, ISBN 1-58391-031-X, 284 pages)
Eating Disorders Review
Joel Yager, M.D.
Within a brief time, the eating disorders field has been gifted with several fine books by registered dieticians. Now Marcia Herrin, RD, founder and co-director of the Dartmouth Eating Disorders Center (and co-author of The Parents Guide to Childhood Eating Disorders: A Nutritional Approach to Solving Eating Disorders, previously reviewed in EDR) has written an excellent book that all nutritionists working with eating disordered patients will want to own and study. The book takes practitioners through the clinical processes necessary to establish and maintain friendly and effective clinical rapport and appropriate professional boundaries. Early chapter focus on relationship building, and offer nutritionists who may not be very familiar with psychiatric syndromes information about common developmental and psychopathological findings in these patients. Readers are provided with an informed introduction to the premises and conduct of the psychotherapeutic and psychosocial treatments, including counseling, cognitive behavior, diatical behavior, psychodynamic, and family therapies, they"re likely to encounter in the care of eating disorder patients. The major ģeducational themesī clinicians need to understand and to discuss to increase motivation and to have impact on gaining trust and adherence are laid out, including issues such as the impact of under-nutrition and purging on bones, brains, menses, and other physiological functions. Common myths held by eating disorder patients are also debunked.
The middle chapters on food planning and establishing, maintaining and revising the food plan, and on the use of food plan templates are, pardon the pun, the bread and butter of the book. The sections on managing weight restoration, binge eating, purging, and exercise are all thoroughly and intelligently written. The large number of appendices include very helpful details on weight calculation (including BMI tables), energy need calculation, details on nutrition components of meals, several excellent patient handouts, and a number of professional tools, including food plan templates, self-monitoring diaries and other assessment tools.
This book will be an exceptionally helpful source of information for those entering the field, and will be a useful and an informed sensible review for veterans as well, including non nutritionist clinicians who wish to learn more about these essential aspects of our work.
J. Y.
Book Review Corner
Maureen Dymek, Ph.D.
Both the American Psychiatric Association and the American Dietetic Association consider nutrition counseling an essential component of eating disorder (ED) treatment. However, there has been a dearth of literature specifically addressing the practicalities of nutritional/dietary treatment of ED patients. Dr. Herrin"s book provides a comprehensive discussion of nutritional information and associated techniques for the effective treatment of this often challenging population.
Dr. Herrin defines the nutrition counselor as any professional who deliver nutritional information to a patient. As such, the book is an excellent resource for dietitians, physicians, nurses, psychotherapists, or any other health professional wishing to learn more about nutritionally- based treatment strategies for EDs, I consider it a ģmust readī for trainees or professionals beginning their work with this population. Dr. Herrin"s book is highly readable, and resents numerous brief case vignettes to help illustrate points.
The book is divided into three main sections: Methods, Food Management, and Interventions. The "Methods" sections reviews basic and advance nutritional counseling, and covers such topic as establishing a collaborative relationship, implementing nutritional interventions, and structuring sessions. This section provides brief descriptions of commonly used psychotherapeutic interventions for EDs (e.g., CBT, DBT, the Maudsley Method), and discusses the integration of nutritional counseling with psychotherapy. Relevant information on nutrition, physiology, and physical complications related to EDs is reviewed.
The "Food Management" section explains food planning and self-monitoring in great detail. The section discusses food planning goals and strategies, and provides food-plan templates appropriate for various classifications of ED patients. Included is a discussion of potentially sensitive topics particular to this population, such as counting calories, forbidden foods, ways to help incorporate "fun foods" into the diet, and a discussion of serving sizes and spacing of meals. Dr. Herrin does an excellent job relaying the many fears that ED patients experience, and presents insightful way for the counselor to manage these challenges in a firm, effective, and empathic manner.
The final section, "Interventions," reviews weight restoration and weight management, binge eating, purging, and exercise. This section presents numerous behavioral and psychoeducational techniques useful to correct beliefs and behaviors associated with dieting, weight control, binge eating and purging. Under each behavior, Dr. Herrin describes common treatment obstacles and sensible solutions. The book ends with helpful appendices, including DSM criteria, weight, calorie, and energy expenditure charts, as well as several patient checklists and monitoring forms.
In sum, Dr. Herrin"s book is the one of the first comprehensive, readable, and clinician-friendly books on nutritional counseling of EDs. In addition to basic information on eating and weight, she presents helpful vignettes, which illustrate the actual delivery of food-related treatment. I recommend it highly, particularly for those starting to work with this population.
Dr. Herrin,
I wanted to write and tell you how much I've appreciated your book--*Nutrition Counseling in the Treatment of Eating Disorders*. It's the best book I've read on this topic, the most thorough, and the most appropriate. I have been telling everyone about your book and would like to thank you for writing it.
Sincerely,
Milton Stokes
D. Milton Stokes, MPH RD CDN
Nutrition Counselor / Consultant / Writer