Did you know that an estimated 10 million men and 20 million women will experience living with an eating disorder at some point in their lives? And although eating disorders have the highest mortality rate of any mental health disorder, it
is estimated only 20% of people with eating disorders actually receive treatment. Eating disorders are a public health crisis. However, through increased awareness about early warning signs and symptoms of eating disorders, combined with improved technology making eating disorder treatment more readily accessible through online counseling, many providers hope to improve that 20% statistic on those who receive treatment and reduce suffering.
One of those ways is through online eating disorder therapy.
We are delighted to have been able to interview Marcella Cox — founder of the Kindful Body, a group counseling practice in California that specializes in online eating disorder treatment — about why she started a virtual group practice to treat eating disorders online, common misconceptions and issues, and key things to know if you’d like to explore online counseling.
Why did you decide to open an online eating disorder treatment program?
I saw a growing need for experienced eating disorder specialists in my area, and I was experiencing an overwhelming number of calls from people looking for help. Every time I found someone experienced who I could refer out to, they would get filled up to the brim as well, and none of us could keep up with the need. It was heartbreaking to turn people away and not be able to give them a solid resource. I kept increasing my caseload and seeing more clients and never could even remotely fill the need.
Finding other eating disorder experts isn’t easy, but expanding to online meant I could attract the very best employees from anywhere in the world who were licensed in California and were experts in the work. With increased rates of people willing to get mental health help through video conferencing, and by opening a virtual group practice that includes a team of experienced eating disorder clinicians, we are now able to serve more people with an immediate need for support on their recovery journey. Some of our clients were initially unsure about video counseling, but they found it just as effective as in-person and some clients ended up preferring it over in-person sessions for its convenience.
What are the biggest issues you see that clients with eating disorders are missing out on by getting treatment with someone not qualified, or getting no treatment at all?
One of the most common issues I see with clients being treated by an unqualified therapist is that the therapist unknowingly does harm by saying the wrong thing and triggering the client’s eating disorder or by colluding with the client’s eating disorder behaviors, which they mistake for healthy habits. Not being seen by a trained eating disorder professional can also lead to a prolonged recovery process, which means greater risk to both the client’s mental and physical health as they’re not receiving the tools and working on the underlying issues that will help them recover fully. As with most mental and physical health conditions a client’s prognosis improves the sooner they get treatment.
There are also issues with access to treatment because of insurance guidelines, particularly with weight biases in the diagnosis and treatment process. You can’t tell how much someone is struggling or the medical complications solely by a person’s weight. It’s important for providers and individuals to know that a person of any size can develop an eating disorder, and equal treatment opportunities must be made available to those of all sizes living with eating disorders.
What are the biggest misconceptions about online eating disorder treatment?
The two biggest misconceptions I see is the thought that they’ll receive better or more effective treatment from an in-person counselor, or that online counselors are less qualified.
I’m happy to say that both of these things couldn’t be further from the truth! In fact, research shows that online therapy can be just as effective as traditional therapy, if not more because you can be in the comfort of your own home. And whether in-person or online, it’s so important to do research on the therapist’s qualifications and ask the right questions to make sure your counselor is a good fit.
Who could benefit from online eating disorder treatment?
Anyone with a need for treatment and desire for recovery can benefit from online eating disorder treatment, and it’s especially beneficial to those who have time constraints, lack of care because of where they live, and/or financial restrictions that prevent them from getting the treatment they deserve.
For those with bustling schedules or who work at various hours, an online session that can be taken from anywhere and at flexible times can serve them well. For individuals living in areas where a qualified eating disorder therapist is located farther away, online therapy provides the opportunity to receive quality and specialized care regardless of location. And because of the nature of the business itself, online therapy tends to be a more affordable form of treatment than traditional in-person therapy.
As an online eating disorder treatment program, who can you currently work with?
Presently we work with adults and older adolescents located in California and are available to help individuals and families anywhere in the state.
What kind of training should clients look for when seeking online eating disorder treatment?
As with any mental illness, it’s crucial to work with someone who is thoroughly trained and licensed that specializes in the area you’re seeking treatment. Individuals should research what certifications their potential therapist has, what sort of continuing education they engage in, what types of disorders they’ve treated in the past, and if those experiences and qualifications line up with your needs.
For example, if you or a loved one is living with binge eating disorder — the most prevalent eating disorder — and sought treatment with an anxiety specialist, your treatment plan may not look the same as if you saw a binge eating disorder specialist or one of the clinicians at Kindful Body, who are all have experience treating the full range of disordered eating, from chronic dieting to full-blown eating disorders, along with body shame and dysmorphia as well as underlying issues, such as trauma.
What are the biggest risks of online eating disorder treatment?
While online and in-person treatment can yield the same results, if you’re not used to video calls, there can be an adjustment period when getting used to the differences with speaking with someone through a screen as opposed to face-to-face.
Another risk is connected to privacy, as an online session is secured differently than an in-person session. To protect your privacy, make sure the platform being used for sessions and notes are secure and HIPAA-compliant.
Even with these risks, there are so many more life-changing benefits to choosing online eating disorder counseling through an individual therapist or group practice like Kindful Body. Whether you or a loved one has time, location, or financial hindrances preventing them from doing in-person therapy, or simply wants to give it a try, the most important thing is to connect with a qualified and compassionate therapist as soon as possible to begin or continue your recovery journey.
Wow! Isn’t Marcella great? We hope this story of opening up a specialized group therapy practice inspired you to know that you can think outside the box to create a private practice that meets the needs of you and your clients. If you want support creating your Happy practice- check out other therapists like Marcella who learned the ins and outs of private practice in our Business School Bootcamp for Therapists.
About Marcella Cox
Marcella Cox is a Licensed Marriage and Family Therapist and Certified Eating Disorder Specialist in the San Francisco Bay Area specializing in treating eating disorders, body image issues, trauma, and anxiety. She founded Kindful Body, a collaboration of skilled eating disorder professionals dedicated to providing compassionate, trauma-informed care through in-person and online eating disorder counseling anywhere in California. Kindful Body’s mission is to help clients heal so they can make the changes they desire to live with more balance, authenticity, and ease. Our unique non-pathologizing approach is informed by Internal Family Systems (IFS), Mindful Self-Compassion, Brene´ Brown’s Shame Resilience Theory, Intuitive Eating and Health At Every Size®.