Table Of ContentTemperament Based Therapy
with Support
for Anorexia Nervosa
Temperament Based
Therapy with Support
for Anorexia Nervosa
A Novel Treatment
Laura L. Hill
TheOhioStateUniversity
UniversityofCalifornia,SanDiego
Stephanie Knatz Peck
UniversityofCalifornia,SanDiego
Christina E. Wierenga
UniversityofCalifornia,SanDiego
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DOI:10.1017/9781009032063
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Names:Hill,Laura(Psychiatry)author.|Knatz,StephaniePeck,author.|Wierenga,Christina,author.
Title:Temperamentbasedtherapywithsupportforanorexianervosa/LauraHill,OhioStateUniversity,
StephaniePeckKnatz,UniversityofCalifornia,SanDiego,ChristinaWierenga,UniversityofCalifornia,
SanDiego.
Description:Cambridge,UnitedKingdom;NewYork,NY:CambridgeUniversityPress,2022.|Includes
bibliographicalreferencesandindex.
Identifiers:LCCN2021024720(print)|LCCN2021024721(ebook)|ISBN9781009016803(paperback)|
ISBN9781009032063(ebook)
Subjects:LCSH:Anorexianervosa–Treatment.|Eatingdisorders.|Brain–Diseases–Treatment.|
Therapistandpatient.|BISAC:MEDICAL/MentalHealth
Classification:LCCRC552.A5H552022 (print)|LCCRC552.A5 (ebook)|DDC616.85/262–dc23
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Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateandup-to-dateinformationthat
isinaccordwithacceptedstandardsandpracticeatthetimeofpublication.Althoughcasehistoriesare
drawnfromactualcases,everyefforthasbeenmadetodisguisetheidentitiesoftheindividualsinvolved.
Nevertheless,theauthors,editors,andpublisherscanmakenowarrantiesthattheinformation
containedhereinistotallyfreefromerror,notleastbecauseclinicalstandardsareconstantlychanging
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stronglyadvisedtopaycarefulattentiontoinformationprovidedbythemanufacturerofanydrugsor
equipmentthattheyplantouse.
Wededicatethisbookto
WalterH.Kaye,MD
“Walt”
Thevisionarybehindthis
novelandemergingtreatment:
TemperamentBasedTherapywithSupport
(TBT-S)
Contents
ListofFigures xi
ListofTables xiii
ListofContributors xiv
Foreword:WalterH.Kaye,MD xvii
Preface xix
Acknowledgments xxi
Introduction 1 3 OverviewofTBT-SIntervention
Strategies 19
Neurobiological
Section 1 Temperament Based
Psychoeducation 19
Therapy with Support (TBT-S) ExperientialLearning 20
ExperientialActivities 20
Overview
Multi-FamilyTherapy(forYoung
AdultVersion) 20
1 WhatIsTemperamentBased
ClientandSupportSkills
TherapywithSupport(TBT-S)? 3
Training 21
WhyTBT-SBeganbyFocusingon
MealCoachingandDietary
AnorexiaNervosa 3
Activities 21
TBT-SDescription 3
FrameworkforAction
WhatIsTemperament,andWhyIsIt
viatheBehavioral
Important? 4
Agreement 22
WhoAretheIntended
Participants? 7 4 StateoftheEvidenceBasefor
WhereCanTBT-SBeApplied? 8 TBT-S 23
TBT-SModularStructure 9 Multi-SiteOpenTrialinYAandSE-AN
TwoTBT-SVersions:YoungAdult(YA) Adults 23
andSevere-and-EnduringAnorexia Single-SiteOpenTrialin
Nervosa(SE-AN) 9 YAAN 23
2 TBT-SCorePrinciples 12 5 HowtoUseThisManual 25
EatingDisordersAreBrainand
BiologicallyBasedDisorders 12
Section 2 Setting Up
TreattotheTrait:Targeting
TemperamentinTreatment 13 Treatment
FoodIsMedicine 16
SupportsAreaNecessaryPartof 6 HowtoIntroducethe
Treatment 17 BiologicalBasesofEating
Movementand/orActionsAre DisordersatInitial
FundamentaltoChange 17 Engagement 27
vii
viii Contents
7 HowtoEngageSupportsin 13 TBT-SNeurobiologyPsychoeducation
Treatment 29 Module:Decision-Makingand
IntroducingSupportsatthe InhibitoryControl 64
BeginningofTreatment 29 Objective 64
IncludingSupportsinTreatment Content 64
Segments 30
14 IntroductiontoTBT-SforYoung
HowtoAskSupportstoJoin
Adults(YATBT-S) 70
theAdultClientinDesignated
RationaleforaTBT-SModelfor
Sessions 31
YoungAdultswithAnorexia
8 NutsandBoltsofTBT-S 33 Nervosa 70
WhoIsInvolvedinthe WhatIstheConceptualFrameworkof
TBT-STreatmentTeam,andWhatAre YATBT-S? 72
TheirRoles? 33 HowIsTemperamentTargetedinYA
WhereTBT-STreatmentTakes TBT-S? 73
Place 35 RationaleforIncludingParentsas
FoodConsiderations 35 SupportsinYATBT-S 75
HowTBT-SMealsAreConductedatAll YATBT-SSessionFormat 75
LevelsofCare 35 15 YoungAdultTBT-SMulti-Family
GroupFormat 77
Section 3 TBT-S Treatment TBT-SGroupTherapyforParentsand
YoungAdultswithAN 77
Interventions
HowtoFacilitateCross-Group
Interactions 78
9 HowtoDeliverNeurobiology
PsychoeducationasaMotivational 16 YoungAdultTBT-SParentSkills
Strategy 38 Training 82
Objective 38 PurposeandDescriptionoftheParent
Content 39 SkillsTrainingModule 82
ParentSupportforYoungAdults
10 TBT-SNeurobiology
withAN 82
PsychoeducationModule:Overview
ParentingaYoungAdultActivity 83
oftheNeurobiologyofAnorexia
DialecticalParentalSupport
Nervosa 42
Module 84
Objective 42
ParentSkillsTraining 89
Content 43
17 YoungAdultTBT-SClientSkills
11 TBT-SNeurobiology
Training 94
PsychoeducationModule:Anxiety
PurposeandDescriptionofthe
andInteroception 50
YoungAdultClientSkillsTraining
Objective 50
Module 94
Content 50
ClinicianChecklistforYASkills 95
12 TBT-SNeurobiology TargetingAnxietyModule 95
PsychoeducationModule: TargetingInteroception
RewardandPunishment Module 102
Sensitivity 57 TargetingAlteredReward
Objective 57 Sensitivity/MotivationalDeficits
Content 57 Module 103
Contents ix
18 TBT-SToolstoManageandReduce 23 Severe-and-EnduringAnorexia
EDSymptoms 107 NervosaBehavioralAgreement
ToolsforSevere-and-Enduring (SE-ANBA) 137
AnorexiaNervosa(SE-AN)andYoung WhatIstheSE-ANBA? 137
Adult(YA)Clients 107 Stage1:BehavioralAgreement
TBT-SToolboxInstructions 110 Preparation 137
ToolDescriptions 111 Stage2:GoalsandObjectives 143
Stage3:SE-ANBehavioralAgreement
19 TBT-SExperientialActivities 115
Summary 148
WhatAreTBT-SExperiential
WhoIsInvolvedinCompletingthe
Activities? 115
SE-ANBA? 148
WheretoUsetheActivities? 115
WhenShouldtheSE-ANBABe
WhoAreParticipantsof
Completed? 148
TBT-SActivities? 115
WhereIstheSE-ANBA
WhenAreTBT-SExperientialActivities
Completed? 150
Implemented? 115
WhyUsetheSE-ANBA? 152
TBT-SNeurobiologicalExperiential
HowtoUsetheSE-ANBA 152
Activities 116
TBT-SProblem-SolvingExperiential
Section 4 TBT-S Augmenting
Activities 117
HowtoApplyTBT-SActivities 117 Eating Disorder Treatments
HowExperientialActivitiesAre
Organized 117 24 TailoringTBT-STreatmentModules
intoAllLevelsofCare 153
20 TBT-SStrategicDietary
ExamplesofTBT-SModule
Approach 118
Combinations 153
PurposeandDescriptionofthe
DietaryApproach 118
25 HowtoApplyTBT-SinDiverse
TemperamentBasedRoleofthe
Settings 159
Dietitian 119
The5-DayTBT-SProgram:YA
DietaryNomenclature 121
TBT-SandSE-ANTBT-S 159
Meal-PlanningStrategies 122
IntegratingTBT-SintoOutpatient
RoleofDietitianduringMeal
LevelsofCare 160
Sessions 124
HowOftenDoSupportsAttend
WhenMealsFallApart 127
OutpatientTreatmentSessions? 160
HowtoFlexiblyUse
21 FrameworkforActionvia
TBT-SModules 162
TBT-SBehavioralAgreement 129
22 YoungAdultTBT-SBehavioral 26 HowtoInterfaceTBT-STreatment
Agreement(YABA) 130 withOngoingProvidersandEating
WhatIstheYABA? 130 DisorderPrograms 164
HowtoUsetheYABA 130 HowtoInterfaceTBT-SModulesinto
YABAClinicianChecklist 132 OngoingEDTherapy 164
Stage1:BehavioralAgreement TBT-SPromotesSeamlessTransitions
Preparation 132 ofCare 165
Stage2:ConstructingtheFinal WhatMaterialsAreSenttoOngoing
BehavioralAgreement 135 Providers? 166
