Communicating with Siblings about Eating Disorders
-Adrianne Altman, PhD.
Program Director, Menlo Park

When an individual has an eating disorder, it not only affects the person who is struggling but the entire family as well.  Traditionally, siblings have been less involved than parents in the recovery process and therefore, may not know or understand what is happening to the family member who is struggling.  Generally, parents are reluctant and unsure as to how to communicate with sibling(s) about the person with the eating disorder.  Parents sometimes worry whether their other children, particularly those who are younger, may develop similar symptoms as a result of observing dysfunctional eating behaviors.  They are often disinclined to discuss the eating disorder with the siblings because they want to protect them.  However, withholding information can be damaging to siblings as it can lead to misunderstandings, misinterpretation, exaggerated fears, helplessness, and isolation. For example, healthy siblings may feel that they caused their struggling sibling to become sick. They may also feel as though the illness is too terrible to discuss, which often leads to increased fear and anxiety. Siblings may attempt to increase their knowledge by seeking information from outside sources -- television or internet, which may be inaccurate and/or misleading.  Therefore, directly sharing information about the illness with siblings helps because it provides knowledge and understanding of what is happening.  Discussing the illness openly also provides an environment that allows siblings to ask questions and express their thoughts and feelings. It also allows parents and/or professionals to clarify any incorrect information that the sibling has received.

Whether you are a parent or professional, it is important when communicating with siblings, to use language that is direct, clear, and age appropriate. For example, preschoolers can sense when things are not right in the home. They often notice tension in the family. Young children may experience “magical thinking” which can lead to a false belief that they caused the illness.For young children, reassure them that there is nothing they did that prompted their brother or sister to become sick.  In addition, let children of this age know that they cannot “catch” the eating disorder. Providing less specific information and fewer details about the illness helps to minimize the likelihood of these children becoming overwhelmed.  For instance, it is appropriate to say, “Sam is having a hard time eating and doctors are working with her/him to help her/him learn how to do this again.” Allowing younger children to play with dolls and simple objects to recreate what is happening at home also helps children of this age express their thoughts and feelings.
School age children have basic knowledge of body parts and functions and understand simple explanations about illness and the effects on the body.  Providing simple explanations about the side effects of the illness, such as fatigue, irritability, hair loss, tummy aches, etc., can help school age children understand what is happening.  A conversation reminding this child, about the importance of eating for building strong bones, teeth, energy, and overall well-being as they grow is vital during this time.  Conversing with a school age child about their worries is also very important. Using their discretion, parents may choose to inform school personnel (nurses, teachers, or counselors) about what is happening at home so that can provide additional support and watch out for any behavioral or emotional changes that may occur at school.

During adolescence, teenagers are struggling to be “grown up” and are trying to be strong.  Often, they may fear being perceived as childish if they show their emotions or ask for help. During this time of their development, they may also have difficulty talking about the “illness.” As parents and professionals, reassuring teenagers that talking things through is positive, and the way in which adults work through their difficulties, is important.  At this age, parents and professionals can present their teen with more facts about diagnosis, course of treatment, and prognosis on their sibling.  Reminder – at this age, communicate using dialogue versus a lecturing style, this is the best approach.  Another recommendation is to encourage them to attend a support group or talk to someone close who can provide them with support they need. Finally, try not to over-burden the adolescent siblings with more responsibilities than they can handle or are comfortable taking on. 

In general, it is helpful to communicate the name of the illness and the way in which lives will be affected by this illness in the family.  For example, parents or professionals may say, “People with anorexia may need to take a break from school and need be careful about how much they exercise.” Parents and professionals can talk about how someone feels when they are sick and can emphasize the importance of patience and understanding while the person is seeking help. Reassure siblings that although the ill person may need special attention, it does not mean that that their own needs are less important.  Another helpful tip is to tell siblings about the changes that may occur in the family, changes such as increased family time and being together for meals.  Parents should NEVER talk about the family member with the eating disorder in a derogatory way. In addition, avoid sharing complicated medical details or financial issues, unless they may have a direct impact on the sibling(s). 

It is important for parents to spend quality time with the siblings and include them as a topic of discussion when conversing with others. In many instances, siblings feel abandoned, rejected, and isolated when parents are away from home and when the focus of conversation is solely on the sibling struggling with an eating disorder. The sibling of an eating disorder person, also have a tendency to hold emotions in so they are not an additional burden on the family. They feel as they need to be the “good child.”  Sometimes, siblings feel resentment towards the ill sibling because of the increased time and attention the person with the eating disorder receives.  Siblings may also feel guilt and shame about the negative feelings they are experiencing. They can also feel frustrated, overwhelmed, and helpless in regards to the “sick” sibling and the recovery process.  They may feel sad for what their ill sibling is going through and miss the parent(s), brother, or sister they used to know. Parents and professionals need to encourage siblings to learn how to support the brother or sister who is struggling and identify their own need and means for support.

At Center for Discovery , we believe that the whole family needs to be involved in treatment when an adolescent suffers form an eating disorder. Therefore it is our goal to help and support the entire family, including siblings, in dealing with the eating disorder.  We include siblings during weekly family therapy sessions when appropriate and invite siblings and their parents to participate in one or more of our Family Therapeutic Meals.  These sessions demonstrate that each person has an important role in the recovery process and diminishes the feeling of powerlessness that family members often experience.  In addition, we offer a weekly family support group so that parents and siblings can express their thoughts and feelings as well as learn how to understand the family member who is struggling. 


Exciting News from the Pacific Northwest
Center for Discovery has been working diligently on providing more localized treatment for adolescents in the Pacific Northwest and we are closer than ever to reaching our goal. In order to ensure a successful launch and a smooth transition to Seattle , Discovery has added a Clinical Outreach Consultant to our team for the Northwest. Jennifer Scharf (“Jenni”) joins Center for Discovery with a background in marketing, public relations and sales. She graduated from Western Washington University with a degree in Journalism and Pubic Relations. After dabbling in the technology industry, she joined the Valley Medical Center as an integral part of their marketing team. Jenni worked at the Seattle-based hospital for almost five years and then went out on her own as a freelance marketing consultant with such clients as The American Lung Association, Valley Medical Center , Spektor Dental, Forrest Yoga and Gem Media . Jenni is married with 2 children and loves fitness, being outdoors and spending time with her family. She looks forward to being your Discovery Clinical Outreach contact for the Pacific Northwest .

Jennifer “Jenni” Scharf
Clinical Outreach Consultant
800.760.3934
Jennifer.scharf@centerfordiscovery.com
www.centerfordiscovery.com

Nor Cal Update
Elizabeth (“Liz”) Rock, who has been with Discovery for over two years and is very familiar with the needs of Northern California, will once again be returning as the Regional Manager of Clinical Outreach for Northern California . If you have any questions about our Menlo Park facility please contact:

Elizabeth “Liz” Rock, BA
Regional Manager of Clinical Outreach
Center for Discovery
(562) 298-2634
elizabeth.rock@centerfordiscovery.com
www.centerfordiscovery.com

Holiday Tips
As we know, holidays can be hard on our clients with the increase in stress, family dynamics and for those with eating disorders, the emphasis on food during the holiday season.  Some general tips to use with clients to deal with the holidays in a healthy way include:

• Plan ahead so you feel a certain amount of security and to help avoid the extra stress and anxiety created by the holidays.
• Only attend what you feel comfortable with. The holiday invitations can become overwhelming and it is important to choose activities where you feel safe and able to enjoy yourself.
• Set goals for the holidays that are NOT weight and food related.  Have the goals be something positive you want to accomplish, like providing a toy for a toy drive or visiting someone during the holiday season that you have not seen in awhile.
• Eat regularly. Do not restrict before the big meal of the day and then binge.  Avoid skipping meals and eat in a regular pattern.
• Be flexible. The holidays always bring surprises, like unexpected foods, pressures and family dynamics.  Staying flexible with your food, your expectations of yourself and others’ behaviors will help you remain less stressed.
• Find a support group. If you cannot attend your usual support group, find one where you are.  Be flexible in the type of support group you look for; 12 step groups, spiritual groups or an eating disorder group will offer you the support you need.
• Create an exit plan.  Plan ahead of time “safe” people you can talk to and how to exit when needed if you become overwhelmed.  Learn to trust your “gut” when you start feeling as if it is all too much and leave for a little while.

You can find more information on this and many other tips at National Eating Disorders Association’s website, www.nationaleatingdisorders.org.  

As always, Center for Discovery is here for your adolescent eating disorders and dual diagnosis clients that need a higher level of care during the difficult holiday season.  Please contact our intake department at (800) 760-3934, 24 hours, 7 days a week for immediate assistance or visit our website at www.centerfordiscovery.com. 

Join the Preferred Partner Network
It is important to us that our patients have a quality team to go to after treatment. We look for quality Psychiatrists, Psychologists, Medical Doctors, Therapists and Dieticians across the country to refer our patients to. Simply click here, complete the online form, and a representative from the Center for Discovery and Adolescent Change will contact you.

Alumni Groups
Eating Disorder Alumni
For more information please call
Lisa Arndt at 562-698-8888

Dual Diagnosis Alumni
Free Alumni Group for all former residents and their parents of La Habra , Long Beach , and Whittier 's Dual Diagnosis Programs.

Thursday evenings at 8:00 PM at the Long Beach Facility
For more information please call
562-981-0700

Meet Intake
Our Intake Department welcomes your calls!  Please feel free to contact them to discuss any questions and/or referrals you may have.  They can be reached at 800-760-3934, 24 hours a day, and seven days a week.

Jennifer Trajano, B.A.
Lead Intake Coordinator
jennifer.trajano@centerfordiscovery.com

Todd Hirata
Intake Coordinator
todd.hirata@centerfordiscovery.com

Lindsay Ferron, B.A.
Intake Coordinator
lindsay.ferron@centerfordiscovery.com

Ebony May, M.A.
Intake Coordinator
ebony.may@centerfordiscovery.com

Carolyn Halliburton, B.A.
Intake Coordinator
carolyn.halliburton@centerfordiscovery.com

Yusvi Salza, B.A.
Assistant to Intake & Marketing
yusvi.salza@centerfordiscovery.com

Discovery Intake Offers Free and Confidential Assessments

If you are currently working with or have been recently referred an adolescent who may be in need of a higher level of care, please contact our Intake department for a free assessment. This assessment will take approximately 60 minutes and includes physical, social, emotional and behavioral aspects, as well as a thorough history of the disordered eating or chemical dependency issues. Our Intake staff is also prepared with a substantial list of resources at all levels of care. If residential is not the appropriate level for your client we will be able to provide the suitable resources for his or her needs.

For more information please contact our Intake Department at 800.760.3934.

Discovery at a Glance
Center for Discovery is a residential treatment program dedicated exclusively to adolescents struggling with eating disorders and dual diagnosis issues. We believe that just as eating disorders and dual diagnosis disorders require specialized treatment, so do adolescents. Discovery offers professional, structured environments with the comfort and nurturing of serene home-like settings where adolescents can safely address their challenges. Our individualized treatment approach is provided by a multidisciplinary team and a low staff to resident ratio. At Center for Discovery , we assist hundreds of adolescents and their families annually across our six JCAHO accredited and California licensed campuses. Since 1997 we have been privately owned and operated. Discovery is contracted with most major healthcare insurance providers and will assist families in verifying their insurance benefits. Our Intake Department is available for both professionals and families 24 hours a day, 7 days a week.

EATING DISORDERS PROGRAM
• Helping males and females 10 to 19 years old
• Disorders treated:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating
- Other related complex disordered eating
• Weekly Family Involvement
• The Discovery Therapeutic Family Meal
• Four private therapy sessions per week
• Over 41 structured groups per week

DUAL DIAGNOSIS PROGRAM
• Helping males and females 12 to 17 years old
• Disorders treated:
- Addictive Disorders
- Anxiety Disorders
- Depressive Disorders
- Childhood/Adolescent Disorders
• Weekly Family Involvement
• 12-Step Focus
• Four private therapy sessions per week
• Over 41 structured groups per week

Our mission at Center for Discovery is to combine the finest traditional inpatient approaches with creative, innovative and individualized interventions that position our therapeutic experience at the forefront of adolescent treatment.

For more information please call 800.760.3934 or visit us at www.centerfordiscovery.com 

Upcoming Events

Networking
IAEDP Arizona – Scottsdale , AZ. “Recovery and Hope Fundraiser” on Friday, November 14, 2008 at Pointe Hilton Squaw Peak . Cost $35/person or $60/couple. For more information, please contact Elizabeth Rock at 562-298-2634 or elizabeth.rock@centerfordiscovery.com

The OC Network – San Juan Capistrano , CA co-hosted by BHC Alhambra, Center
for Discovery, and Hope by the Sea. Meetings are held on the third Friday of every month at Hope by the Sea. Next meeting will be on Friday, November 21 featuring Dr. Headrick from Pacific Coast Recovery Center , “New Views on Chronic Pain and Addiction”, from 11:30 – 1:00pm. For more information, contact Alexia Mowry at 562-881-9886 or alexia.mowry@centerfordiscovery.com

IAEDP Los Angeles – Santa Monica , CA . Next meeting will be on Friday, November 21, 2008 from 11:30 – 1:30pm at A New Journey featuring Buck Runyan, MFT, LPC, CEDS, and COO Center for Discovery , as Panel Moderator “Family Dynamics and Resources”. For more information, contact IAEDP LA at562-457-7373 christina.weiss@centerfordiscovery.com

The SD Network – La Costa, CA co-hosted by BHC Alhambra, Center for Discovery , Hope by the Sea, and Miracle by the Bay. Meetings are held on the first Thursday of every month. Next meeting will be on Thursday, December 4 from 11:30 – 1:00pm featuring Martha Torkington from A Stable Place – Equine Demonstration!  For more information, contact Alexia Mowry at 562.881.9886 or alexia.mowry@centerfordiscovery.com

IAEDP San Diego – San Diego , CA . Next meeting will be on Friday, December 5 from 11:15 – 1:30pm at Bethel Seminary featuring Mary Bellafato, MA, LMHC, CEDS, NCC, TEP, Director/Owner Interactive Dynamics, “Action Methods: Techniques Designed for the Eating Disordered Client”. For more information, contact IAEDP San Diego at iaedpsd@gmail.com.

Adolescent Resource Network – Sherman Oaks, CA co-hosted by Center for Discovery , Clearview and Insight Treatment Centers featuring Susan Davies, LCSW “Working with Step Families” on  Friday, December 5 from 8:30 – 10am held at Insight Sherman Oaks For more information contact Christina Weiss at 562-457-7373 or  christina.weiss@centerfordiscovery.com

An Evening at Discovery Menlo – Menlo Park , CA. Thursday, December 11, 2008, 4-7pm. Drop by and see our Menlo Park facility, meet with Buck Runyan, COO Center for Discovery Eating Disorder program, and the staff at Menlo Park . For more information, please contact Elizabeth Rock at 562-298-2634 or elizabeth.rock@centerfordiscovery.com.

The OC Network – San Juan Capistrano, CA co-hosted by BHC Alhambra, Center for Discovery , and Hope by the Sea. Meetings are held on the third Friday of every month at Hope by the Sea. December 19, 2008 meeting will be a holiday celebration with more time to network. For more information, contact Alexia Mowry at 562-881-9886 or alexia.mowry@centerfordiscovery.com

Upcoming Conferences
Stop by Discovery’s booth!

TAMFT
January 29 – 31, 2009
Hilton Fort Worth

Featuring:
Buck Runyan, MA, LMFT, LPC, CEDS

IAEDP Symposium 2009
March 5 – 9, 2009
Long Beach , California
The Westin Hotel

Featuring:
March 4: Buck Runyan, MS, MFT, CEDS, LPC
“The Directive Use of Imagery and Art Expression to Motivate Complex Clients”

March 7: Rachel Liger, MS, RD
“The Use of Exposure – Based Nutrition Therapy for Adolescents with Eating Disorders”

Eliza Project Symposium
February 27, 2009
Dallas , Texas