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Friday 3 February 2012

What makes a good Eating Disorder clinician?

There's Julie O Toole's list of questions

Or the Strober/Johnson perspective.

So from the clinical perspective, the message that modern neuroscience underscores is: (1) that an invigorated focus on therapy skill is warranted, addressing not only the individual’s belief structure, but also the social context in which they live; and (2) applying technique, whether in manual form or instructed, can be valuable, but more is needed, especially when it comes to work with difficult cases. In our view, the further needed element is not easily measured, but patients and families feel its presence and they speak of it often. It is not one single thing, but rather a set of skills with different facets: the uniquely refined ability of the therapist to sit long hours sifting patiently and thoughtfully through strains and secrets the human psyche can easily cloak; insight into what this messy tangle of conflicting tensions, puzzling emotions, and disparaging self-beliefs reveals about a patient’s (and family’s) misery; the ability to translate this understanding into prose eloquent enough, and delivered with the strength of conviction needed, for our patient (and family) to ‘‘feel’’ they best give it deeper thought; and then to steer the treatment in the direction needed and escalate its intensity should progress lag. To appreciate science is one thing, but in the clinical realm there is no substitute for well-honed skills, intuitiveness, and decisiveness when facing AN’s challenge.

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