I’ve just returned from the first part of my training as a Master Practitioner in Eating Disorders.  Covering ‘Essential Obesity’, the three days intensive training was part re-attending to the core work of a psychotherapist and some timely reminders on certain techniques and models of therapy that can be useful, and part new information for me.  The new information was based around weight management, nutrition and aspects of food that I was previously unaware of.  We also looked at a model of therapy for clients who are significantly overweight but who might not have an eating disorder.  It was excellent training and very informative.

However, one issue that arose quite early on was that of how to work with clients.  We were a mix of attendees, some Counsellors/Psychotherapists like me, some Psychologists, some Nutritionists/Dieticians, even one Doctor.  Our Facilitator strongly recommends that we become ‘Coaches’, more than Therapists, when working with clients. Hmmm.

When I trained as a counsellor/psychotherapist, we were told over and over again that we should not be ‘directive’, or ‘prescriptive’.  We should never tell clients what to do.  We should support clients in their own decisions and choices.  We are not educators, but facilitators.  So when the Trainer suggested we become more like ‘Coaches’, there was quite a lot of squirming and murmuring from the attendees, because it goes against everything we are taught as Therapists.

The Trainer suggested that we could educate clients about nutrition, food labelling, even cooking and shopping.  We could even do this with some “in-vivo” work, actually accompanying clients to the supermarket and shopping with them, or arranging a cookery session (either ourselves if we were competent cooks, or elsewhere).  We could also offer a significant amount of education around the science of weight loss, and weight maintenance following weight loss (the same applies to weight gain and maintenance for clients in the other direction).

There was more.  For clients trying to lose weight, although we would not offer any weighing (in fact, weight was the one factor we should pay no attention to, as our clients are so much more than a number on a scale and I’ve always agreed with that), we could offer to track other things, such as blood pressure (via a qualified professional such as a Doctor or in our case our Nutritional Therapist), movement of the notches on a belt, or fitness levels (via the gym or exercise goals).

You might be reading this and thinking “so what?”, but this is actually quite radical for a Therapist in some respects.  I’m not the most hands-off  Therapist anyway, and I think I do offer a reasonable level of psycho-education and some guidance, but this level of coaching is far beyond my comfort zone as an ethical, professional Therapist.  So I’m asking, what do YOU think?  Would it be helpful?  Would you appreciate this sort of practical information and guidance, or would it be yet another person telling you what to do?

Feedback is very welcome on this post.