Finn Skårderud, MD, PhD is a Norwegian author, psychiatrist, psychotherapist and professor. He has produced numerous articles, essays, books and book chapters within the fields art, literature, film, psychiatry, psychology and culture, both fiction and non-fiction. As psychiatrist he is an internationally acknowledged expert in eating disorders.
Which specific competences should the MBT-ED therapist have? As stated numerous times, mentalizat... more Which specific competences should the MBT-ED therapist have? As stated numerous times, mentalization-based therapy (MBT) was originally developed for borderline personality disorders. The pivotal question is in what way should therapeutic approaches originally developed for borderline patients be modified to be optimal for persons with different subtypes of eating disorders? This chapter presents those additional therapist competences in detail. And, we stress the necessity of at the same time working with reduction of symptoms and promoting mentalizing. MBT-ED is a double-focused therapy: mind and bodily behaviour and symptoms.
In this chapter we describe how to integrate supervision within the structure of MBT-ED. The mode... more In this chapter we describe how to integrate supervision within the structure of MBT-ED. The model of mentalizing is not only about them but also about us. In the context of major therapeutic challenges, the therapists’ mentalizing may collapse. To ensure that we maintain our stance and to be able to recognize our own mentalizing lapses and difficulties, we will in this chapter set out how supervision and training has a role to play in supporting MBT practice.
In this chapter, we describe the main qualities and competences expected of an MBT-ED therapist. ... more In this chapter, we describe the main qualities and competences expected of an MBT-ED therapist. The competences for the therapist are the same as described in the original MBT model for borderline personality disorder. All these competences are highly relevant for psychotherapeutic enterprises with eating disorders. Such competences have further been developed to be used in the measurement of model adherence and therapy quality. We have provided clinical examples from eating disorders to illustrate. In the following chapter, we develop more specifically competences aimed at promoting mentalizing, symptom reduction and health in patients with eating disorders.
Eating and Weight Disorders-studies on Anorexia Bulimia and Obesity, Dec 1, 2011
Studies of attachment and eating disorders use different types of measures, including different c... more Studies of attachment and eating disorders use different types of measures, including different coding procedures for the Adult Attachment Interview (AAI). Generalizability of findings across studies is therefore uncertain. We compare the Main & Goldwyn procedure with the Dynamic Maturational Method, the two most common procedures for classifying AAI in eating disorder research. The sample consists of 20 female patients with a diagnosis of anorexia nervosa (mean age 22.9 (3.5) years). Attachment insecurity is by far most common, regardless of procedure. Within the insecure categories, there is little overlap between procedures in comparable categories. Both procedures discriminate between Anorexia subgroups (restricting vs bingeing), but do so differently. Findings suggest that comparing findings across methods, beyond the secure/insecure dichotomy, should be avoided.
BACKGROUND Eating disorders are severe mental disorders associated with notable impairments in qu... more BACKGROUND Eating disorders are severe mental disorders associated with notable impairments in quality of life. Despite the severity of the disorders and extensive research in the field, effective treatment for eating disorders is lacking. OBJECTIVE The aim of this study is to describe and evaluate the usability of Maze Out, a Serious Game co-produced by patients and therapists, and to explore the acceptability of Maze Out among patients suffering from eating disorders. METHODS The present study is a qualitative study, collecting data through focus groups and individual interviews, including user analytics collected through the game. Participants were recruited from Odense Mental Health Service of Region South Denmark. We used the mobile health evidence reporting and assessment (mERA) checklist to describe and evaluate the usability of the game, supplemented with user-analytics collected through the game. Eighteen patients and a therapist participated in the qualitative interviews t...
In this chapter, we will describe psychoeducational work with eating disorders. Introduction to M... more In this chapter, we will describe psychoeducational work with eating disorders. Introduction to MBT (MBT-I) is essentially an educational group in which people are told about mentalizing and its relevance to eating disorders, invited to share experiences, and do exercises that elicit its different aspects. The emphasis is on a pedagogical stance, with therapists taking an active role both in sharing ideas and involving all participants. The dual aim is that patients learn about but also practice mentalizing about themselves and others. The psychoeducational work should stimulate curiosity, playfulness and imagination.
... Such an increased intensity is connected to changes in time. When looking more closely at the... more ... Such an increased intensity is connected to changes in time. When looking more closely at the significant moments, there is also an inner ebb and flow during the selected excerpts of music. ... This implies that: "A regular pulsation in time is matched" (Stern, 1985/2000, p. 146). ...
This study describes the range of service provision and explores differences in treatment approac... more This study describes the range of service provision and explores differences in treatment approaches and therapeutic aims, in the 12 countries participating in the European Union collaborative COST B6 Adolescent Project into the treatment of adolescent anorexia nervosa (AN). Following a number of group meetings, two questionnaires were administered, completed and returned by e‐mail. The first questionnaire examined features of the services provided, including details of the numbers of patients seen, inpatient admission criteria and aspects of patient management. The second questionnaire contained a list of 13 therapeutic aims, asking respondents to rank in order the six they considered most important in the first weeks of treatment. There was broad agreement between services concerning the need to offer a full spectrum of services in a range of settings. Nevertheless, there were significant differences in approaches, chiefly concerning the readiness to admit to hospital, the use of ...
In this article, we aim to explore patient perspectives regarding the etiology of anorexia nervos... more In this article, we aim to explore patient perspectives regarding the etiology of anorexia nervosa (AN) in the context of participating in brain research for AN. This is a qualitative study using semistructured interviews with 12 young AN patients. Data were analyzed according to thematic analysis method. This study shows that patients’ language used to express their understanding of the etiology of AN was characterized by psychological terms such as personality, self-esteem, control, and coping rather than neuroscientific terms.Participants held a complex understanding of the causes of AN, acknowledging a brain–mind relationship. However, participants expressed the hope that brain sciences could contribute to identify an objective, physical proof for AN, that would validate their illness, increase understanding, and reduce blame. The study suggests that prevailing biological explanations promoted by brain research did not encourage simplistic perspectives on causation among patient...
Which specific competences should the MBT-ED therapist have? As stated numerous times, mentalizat... more Which specific competences should the MBT-ED therapist have? As stated numerous times, mentalization-based therapy (MBT) was originally developed for borderline personality disorders. The pivotal question is in what way should therapeutic approaches originally developed for borderline patients be modified to be optimal for persons with different subtypes of eating disorders? This chapter presents those additional therapist competences in detail. And, we stress the necessity of at the same time working with reduction of symptoms and promoting mentalizing. MBT-ED is a double-focused therapy: mind and bodily behaviour and symptoms.
In this chapter we describe how to integrate supervision within the structure of MBT-ED. The mode... more In this chapter we describe how to integrate supervision within the structure of MBT-ED. The model of mentalizing is not only about them but also about us. In the context of major therapeutic challenges, the therapists’ mentalizing may collapse. To ensure that we maintain our stance and to be able to recognize our own mentalizing lapses and difficulties, we will in this chapter set out how supervision and training has a role to play in supporting MBT practice.
In this chapter, we describe the main qualities and competences expected of an MBT-ED therapist. ... more In this chapter, we describe the main qualities and competences expected of an MBT-ED therapist. The competences for the therapist are the same as described in the original MBT model for borderline personality disorder. All these competences are highly relevant for psychotherapeutic enterprises with eating disorders. Such competences have further been developed to be used in the measurement of model adherence and therapy quality. We have provided clinical examples from eating disorders to illustrate. In the following chapter, we develop more specifically competences aimed at promoting mentalizing, symptom reduction and health in patients with eating disorders.
Eating and Weight Disorders-studies on Anorexia Bulimia and Obesity, Dec 1, 2011
Studies of attachment and eating disorders use different types of measures, including different c... more Studies of attachment and eating disorders use different types of measures, including different coding procedures for the Adult Attachment Interview (AAI). Generalizability of findings across studies is therefore uncertain. We compare the Main & Goldwyn procedure with the Dynamic Maturational Method, the two most common procedures for classifying AAI in eating disorder research. The sample consists of 20 female patients with a diagnosis of anorexia nervosa (mean age 22.9 (3.5) years). Attachment insecurity is by far most common, regardless of procedure. Within the insecure categories, there is little overlap between procedures in comparable categories. Both procedures discriminate between Anorexia subgroups (restricting vs bingeing), but do so differently. Findings suggest that comparing findings across methods, beyond the secure/insecure dichotomy, should be avoided.
BACKGROUND Eating disorders are severe mental disorders associated with notable impairments in qu... more BACKGROUND Eating disorders are severe mental disorders associated with notable impairments in quality of life. Despite the severity of the disorders and extensive research in the field, effective treatment for eating disorders is lacking. OBJECTIVE The aim of this study is to describe and evaluate the usability of Maze Out, a Serious Game co-produced by patients and therapists, and to explore the acceptability of Maze Out among patients suffering from eating disorders. METHODS The present study is a qualitative study, collecting data through focus groups and individual interviews, including user analytics collected through the game. Participants were recruited from Odense Mental Health Service of Region South Denmark. We used the mobile health evidence reporting and assessment (mERA) checklist to describe and evaluate the usability of the game, supplemented with user-analytics collected through the game. Eighteen patients and a therapist participated in the qualitative interviews t...
In this chapter, we will describe psychoeducational work with eating disorders. Introduction to M... more In this chapter, we will describe psychoeducational work with eating disorders. Introduction to MBT (MBT-I) is essentially an educational group in which people are told about mentalizing and its relevance to eating disorders, invited to share experiences, and do exercises that elicit its different aspects. The emphasis is on a pedagogical stance, with therapists taking an active role both in sharing ideas and involving all participants. The dual aim is that patients learn about but also practice mentalizing about themselves and others. The psychoeducational work should stimulate curiosity, playfulness and imagination.
... Such an increased intensity is connected to changes in time. When looking more closely at the... more ... Such an increased intensity is connected to changes in time. When looking more closely at the significant moments, there is also an inner ebb and flow during the selected excerpts of music. ... This implies that: "A regular pulsation in time is matched" (Stern, 1985/2000, p. 146). ...
This study describes the range of service provision and explores differences in treatment approac... more This study describes the range of service provision and explores differences in treatment approaches and therapeutic aims, in the 12 countries participating in the European Union collaborative COST B6 Adolescent Project into the treatment of adolescent anorexia nervosa (AN). Following a number of group meetings, two questionnaires were administered, completed and returned by e‐mail. The first questionnaire examined features of the services provided, including details of the numbers of patients seen, inpatient admission criteria and aspects of patient management. The second questionnaire contained a list of 13 therapeutic aims, asking respondents to rank in order the six they considered most important in the first weeks of treatment. There was broad agreement between services concerning the need to offer a full spectrum of services in a range of settings. Nevertheless, there were significant differences in approaches, chiefly concerning the readiness to admit to hospital, the use of ...
In this article, we aim to explore patient perspectives regarding the etiology of anorexia nervos... more In this article, we aim to explore patient perspectives regarding the etiology of anorexia nervosa (AN) in the context of participating in brain research for AN. This is a qualitative study using semistructured interviews with 12 young AN patients. Data were analyzed according to thematic analysis method. This study shows that patients’ language used to express their understanding of the etiology of AN was characterized by psychological terms such as personality, self-esteem, control, and coping rather than neuroscientific terms.Participants held a complex understanding of the causes of AN, acknowledging a brain–mind relationship. However, participants expressed the hope that brain sciences could contribute to identify an objective, physical proof for AN, that would validate their illness, increase understanding, and reduce blame. The study suggests that prevailing biological explanations promoted by brain research did not encourage simplistic perspectives on causation among patient...
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