Increased Precautions We're Taking in Response to the Coronavirus
As updates on the impact of the coronavirus continue to be released, we want to take a moment to inform you of the heightened preventative measures we have put in place at McCallum Place Eating Disorder Center to keep our patients, their families, and our employees safe. All efforts are guided by and in adherence to the recommendations distributed by the CDC.

Please note that for the safety of our patients, their families, and our staff, on-site visitation is no longer allowed at McCallum Place Eating Disorder Center.

  • This restriction has been implemented in compliance with updated corporate and state regulations to further reduce the risks associated with COVID-19.
  • We are offering visitation through telehealth services so that our patients can remain connected to their loved ones.
  • Alternate methods of communication for other services are being vetted and may be offered when deemed clinically appropriate.

For specific information regarding these changes and limitations, please contact us directly.

CDC updates are consistently monitored to ensure that all guidance followed is based on the latest information released.

  • All staff has received infection prevention and control training.
  • Thorough disinfection and hygiene guidance has been provided.
  • Patient care supplies such as masks and hand sanitizer are being monitored and utilized.
  • Temperature and symptom screening protocols are in place for all patients and staff.
  • Social distancing strategies have been implemented to ensure that patients and staff maintain proper distance from one another at all times.
  • Cleaning service contracts have been reviewed for additional support.
  • Personal protective equipment items are routinely checked to ensure proper and secure storage.
  • CDC informational posters are on display to provide important reminders on proper infection prevention procedures.
  • We are in communication with our local health department to receive important community-specific updates.

The safety of our patients, their families, and our employees is our top priority, and we will remain steadfast in our efforts to reduce any risk associated with COVID-19.

The CDC has provided a list of easy tips that can help prevent the spread of the coronavirus.

  • Avoid close contact with people who are sick.
  • Cover your cough or sneeze with a tissue and then immediately dispose of the tissue.
  • Avoid touching your eyes, nose, and mouth.
  • Clean and disinfect objects and surfaces that are frequently touched.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Stay home when you are sick, except to get medical care.

For detailed information on COVID-19, please visit https://www.cdc.gov/coronavirus/2019-ncov/index.html

Blog

Cognitive-Behavior Therapy

Written by John Rapp, MSW, LCSW

Cognitive-behavior therapy (CBT) represents a collection of therapies with a unifying philosophy, capable of treating problems ranging from eating disorders to insomnia.  Cognitive-behavior theory posits that while we may not have much direct control distressing emotions, we at least have some control over our thoughts and, in particular, our behavior.  Cognitive-behavior therapies attempt to address problems by examining and changing thoughts and behaviors that interfere with wellbeing.

CBT has its roots in the treatment of depression.  At the time of its creation, the predominant theories of psychoanalysis suggested that depression stemmed from the “turning inward” of anger which patients could not otherwise tolerate consciously.  Aaron Beck, widely considered to be the creator of modern CBT, did not perceive his depressed patients to be angry.  Instead, he noticed that depressed individuals have characteristic styles of thinking (like black and white thinking) and relentless, self-critical thoughts which caused them distress.  He sought to treat depression by identifying and modifying depressogenic thoughts and behaviors.

Unlike other theories which suggest that emotional problems stem from unresolved issues in early development or unconscious conflict, cognitive-behavior therapies focus on the “here-and-now” and on observable thoughts/behaviors.  The hypothetical causes of the problem are deemphasized; factors keeping the problem going in the present are the focus.  The belief is that if whatever is maintaining a particular problem can be addressed, the problem will improve and may continue to do so even after therapy has concluded.  In order to demolish a house of cards, one need not remove every card, but rather the pillars and foundational pieces.  Thus, discovering the “cause” of a particular problem is viewed as largely irrelevant in CBT for treatment occur.  What if there are multiple causes for a mental health issues, representing an array of biological, social, and psychological factors?  Even if all of the “causes” could be identified in therapy, would this alone result in change?  Or would one still have to work on changing anyway?

Self-monitoring is common in cognitive-behavior therapy.  Self-monitoring involves noticing and tracking thoughts, feelings, or behaviors which the therapy is attempting to modifying.  Tracking moods over time, keeping a food diary, and counting episodes of self-injury are all examples of self-monitoring.  Self-monitoring increases mindful awareness of the problem at hand, generates a record against which the effectiveness of the treatment can be measured, and can also result in behavior change if the self-monitoring is conducted real-time.  Individuals attempting to quit smoking who count the number of cigarettes they smoke as they smoke typically decrease their cigarette consumption by approximately 10%, even if they employ no other strategies for change.

Cognitive-behavior therapies generally employ four major strategies for change.  These including skills training, cognitive restructuring, exposure, and contingency management.  Skills training is appropriate when a problem exists because of skill deficit.  For example, some individuals may not have learned how to tolerate distress or regulate their emotions; therapy can directly teach such skills.  Cognitive restructuring involves identifying, testing out, and challenging thoughts and beliefs that might impede healthy functioning.  In cognitive restructuring, the role of the therapist is not to tell the patient that his or her beliefs are “irrational”, but rather to foster an attitude of empiricism on the part of the patient.  Unhelpful or irrational thoughts and beliefs are viewed as hypotheses to be tested via behavioral experiments.  For example, individuals with generalized anxiety disorder often have positive beliefs about worrying, such as, “Worrying prevents bad things from happening to me”.  Such a belief could be put to the test by freely worrying one week and limiting worry the next, while tracking the number of negative events that actually occur.  In exposure, patients act opposite of unjustified emotions, emotional that do not “fit the facts” of a given situation.  Gradual exposure to avoided situations, places, people, etc. changes problematic emotions that interfere with healthy behavior by promoting desensization and habituation.  Someone who knows how to relax but avoids it due to feelings of guilt or fears of “being unproductive” could practice attempting to relax in spite of these feelings, eventually quieting them.  In contingency management, problems in the environment are addressed, to ensure that the environmental rewards and punishments support healthier behavior.  Individuals in therapy can also learn how use positive reinforcement on themselves to become better at self-management.  A patient is openly taught to use these change strategies by practicing in session and via homework assignments in order to nudge the patient toward functioning ‘as their own therapist’, rather than fostering dependency on long-term therapy with the therapist.

CBT is intended to be efficient, short-term, and goal-oriented.  Sessions tend to be directed by the therapist and the mutually agreed upon goals for treatment.  CBT therapists encourage patients to form clear, behaviorally-defined goals for treatment.  Goals such as “I want to stop self-injuring” or “I want to be happier” are not considered to be optimal goals. The former does not suggest what the patient will be doing instead of self-injuring.  The latter does not define what happiness is, how the patient would know if she or she were happy, nor what thoughts and behaviors will become present/absent if the patient were to be happier. CBT sessions are structured. The CBT therapist and patient typically review homework, set a agenda for the remainder of the session, and then agree upon tasks for the patient to try in between sessions in order to hasten progress. CBT therapists are also transparent; they share their hypotheses openly with the patient, rather than analyzing in secret.

While different cognitive-behavior therapies share a common foundation, treatments for different disorders emphasize different techniques. CBT for depression emphasizes the restructuring of depressogenic thoughts/beliefs and scheduling positive activities. Treatments for anxiety disorders emphasize exposure. CBT for eating disorders emphasizes establishing regular eating and a meal plan, restoring weight (if necessary), exposure to feared foods, reducing body/weight checking and avoidance behaviors, and modifying self-esteem so as to decrease the over-evaluation of weight, shape, and the control of eating.

To learn more about McCallum Place, please visit our website or call 800-828-8158.

John received a Bachelor of Science degree in Microbiology from the University of Wisconsin-Madison and a Master of Social Work degree from the George Warren Brown School of Social Work at Washington University in St. Louis.  His approach to treatment draws from cognitive-behavior therapies, such as dialectical behavior therapy and exposure and response prevention.  John attempts to help patients solve their problems with living and create a life with joy and meaning.  John believes that recovery involves purifying one’s motivation, learning more effective coping strategies, challenging unhelpful beliefs, facing one’s fears, and coaching loved ones to be more effectively supportive.