The journey towards recovery can take many forms, but every person has to follow their own path towards health and make choices along the way. Some of these choices may come in the form of different treatment centers or levels of care to address the difficulties someone is having at that stage of their recovery. Every person’s process is different.

Eating disorders are very complex illnesses that require specialists to treat not only the emotional and behavioral facets of an illness, but the medical one as well. For these reasons, the American Psychological Association (APA) established guidelines for appropriate levels of care with eating disorders.

Chrysalis Center is an outpatient program and will soon be adding intensive outpatient (IOP) services. The other levels include partial hospital (PHP), residential, and inpatient levels; these last two are sometimes combined into an “IP-Res” format. To see the full APA criteria for eating disorders, click here. There are some other resources for eating disorder treatment in North Carolina, including Veritas Collaborative, Carolina House, and UNC’s Center for Eating Disorders.  Other treatment centers around the country specialize in eating disorders as well, and sometimes these other programs are a better fit for clients in terms of their individual needs and experiences.  Though not for eating disorders, there are several other levels of care in the Wilmington area for adolescents and adults in general psychiatry.

Usually, these difficult conversations start when we as clinicians recommend a higher level of care for someone who we do not think is appropriate for outpatient or IOP treatment. To be appropriate for outpatient or IOP, a person must be:

  • Medically and psychologically stable to the point that they are not a danger to themselves or others
  • Motivated to recover
  • Cooperative
  • Self-sufficient
  • Able to control their thoughts and behaviors using appropriate social support


When someone needs a higher level of care, they are usually:

  • Medically compromised (by weight, bloodwork, EKG, etc.)
  • Unable to manage their behavior
  • Un- or under-motivated
  • Not functioning in their lives in some significant way (work, family, relationships, etc.)
  • Unable to manage a co-morbid condition (psychological or medical) because of their eating disorder

Levels of care indicate how much structure, support, and observation a client requires at that stage in their recovery.

When someone needs a higher level of care, it can be a very difficult discussion between provider and client. Sometimes, we all know it is coming and have been trying to avoid it but it just is not working. Other times, clients may take a sudden turn. This could be for many reasons, but the important thing is that clients get the help that they need to recover from their eating disorder and co-occurring disorders. Our goal is always to help our clients and keep them focused on living healthy and productive lives, and we try to balance all their individual needs while keeping the goal of a full recovery foremost in our minds.

It is important to use the right tool to complete a task, and sometimes that tool needs to be a higher level of care in order for someone to truly recover. Often, IP-Res levels of care can get clients back on track faster than outpatient could and sometimes that is necessary for someone’s well being or even survival. PHP and IOP levels can provide support to keep someone out of the hospital or they can provide support as a step-down program. The transition between inpatient and home can be very stressful and there are a lot of facets to consider including social, family, academic, or work stressors. All of these are affected by or contribute to eating disorder behavior. A person cannot live in a vacuum so all of these need to be managed before someone goes back to their regularly scheduled lives.

By adding IOP services, Chrysalis hopes to provide a bridge for clients on their journey in recovery. It is an important stage or facet in that process. If you need us, we will be honored to work with you on that journey.


Kendra is a Senior Staff Therapist and soon to be Clinical Director of Chrysalis’s new Intensive Outpatient (IOP) program with 13 years of experience working with eating disorders in various settings, including inpatient, PHP, IOP, and outpatient treatment facilities.

Rachel Hendricks


Do you ever feel like you don’t have relationships, like you are alone or isolated, or that you are often misunderstood, overlooked, or unable to connect with others?

Does it ever seem that everyone else your age is doing other things while you feel “stuck” or left behind?

Have you ever seen someone look at you or heard someone say something to you, and your mind was suddenly flooded with eating disorder thoughts?

Or, maybe you experienced a loss, and seemingly the only solution was to turn to your eating disorder to manage your grief.

For many with eating disorders, you already know how interactions with others can impact you. In fact, there is a fair amount of research that shows that people with eating disorders have a vulnerability to over-assessing the verbal and nonverbal feedback from others as a way of checking to see if they are okay.

Research also shows that eating disorders can start or re-occur in the context of major life transitions such as during the grieving process, in mid-life, or starting middle school, high school, or college. One of the reasons these transition periods can be so fraught is because of how our roles and identities change, creating space for an eating disorder to slip in if one is struggling with the transition.

While many people have heard of using CBT (cognitive behavior therapy) or DBT (dialectical behavior therapy) for treating eating disorders, there is another treatment that can be just as helpful but is often not as well known. This therapy is IPT (interpersonal psychotherapy). IPT is a therapy that focuses on relationships and how relationships can affect one’s eating disorder or life, in general.

IPT targets five major domains of functioning:

interpersonal deficits and/or lack of intimacy

interpersonal role disputes (conflict)

role transitions


life goals (like role transitions but for those who missed out on role transitions due to interference from their eating disorder or other barriers)

Like CBT and DBT, it is a time-limited intervention that has multiple phases. Usually, the treatment lasts 16-20 sessions and is broken into identifying the problem area on which to focus, understanding and addressing the interpersonal challenges that were identified, and reviewing the treatment and planning how to maintain the gains made with the treatment.

Generally, one area will be the focus of the treatment though at times 2 areas might be addressed, or an additional area might be addressed after focusing on another area (for example, working initially on grieving and adding life goals as you progress through treatment).

While IPT does not always have the same effect initially as CBT, research shows that the positive effect of IPT grows with time. That means the more you use the skills and strategies you learn with the sessions, the more effective the treatment is- even well after you stop getting additional IPT.

IPT is also a good option for people who struggle with the structure of CBT or DBT or who are unsure about addressing their eating disorder directly, and it has been shown to be helpful for depression, some personality disorders, and social anxiety, as well. Further, IPT is an excellent option for people who have completed CBT but still need supplementary work.

If you have questions about IPT and whether it might be a good fit for you, please don’t hesitate to reach out or consult with your treatment team about if IPT is the right option for you!

Rachel Hendricks, LCSW is a new addition to the clinical team at Chrysalis and loves providing IPT to clients when it is appropriate! She also specializes in working with clients who have had their eating disorder for ten or more years, clients with co-occurring substance use behaviors, as well as working with couples and families. She is excited to be making the transition to Wilmington from the Center for Eating Disorders in Baltimore, Maryland and looks forward to becoming more familiar with the area as well as continuing her reputation for providing excellent clinical care in the field of eating disorders.

For additional research, information, or references for this blog:

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What is traumatic stress?

Traumatic stress and posttraumatic stress disorder (PTSD) are unique mental health problems in that they have a known cause – a traumatic event. Life is filled with stressors. There are typical daily stressors such as a car breaking down or a large bill to pay. There are also bigger stressors such as getting divorced, losing your job, or the death of a grandparent. Even positive events can be stressful including buying a home or getting married. However, none of these positive or negative daily stressors are considered traumatic events.

Traumatic events are different in that they are events in which someone believes that their life or the life of others is being threatened. Traumatic events can be witnessed, such as watching a friend get mugged, or experienced directly, such as being sexually assaulted, fighting in a war, experiencing a serious accident or natural disaster, or being abused as a child. These are the types of traumatic events that can lead to PTSD.

How common are traumatic events?

Unfortunately, traumatic events are common. Statistics from the National Center for PTSD show that more than 60% of men and 50% of women have had at least one traumatic event in their lives. This means that most people have experienced a traumatic event at some point. However, among the people who have experienced a traumatic event, most do not develop PTSD. While about 7% of people develop PTSD in their lifetime, this is actually a substantial number, representing 1 out of every 15 people. So, it is likely that your or someone you know may have experienced PTSD at some point.

What happens after a traumatic event?

After people experience a traumatic event, it is useful to have a strong reaction. Remembering what was dangerous and staying away from that can help you stay safe after a traumatic event. However, once that threat has been removed, it is healthiest for our brains and bodies, if our strong reactions decrease to pre-trauma levels. For most people, this happens within about a month after a traumatic event. But, for people with traumatic stress and PTSD, these strong reactions do not disappear and they start negatively impacting daily life. In fact, if the traumatic stress or PTSD symptoms do not return to pre-trauma levels within a year, it is highly unlikely that they will go away without evidence-based treatment from a professional.

How do I know if I have PTSD?

If you have experienced a traumatic event and are having difficulty in areas of your life or find that you are coping with behaviors that are unhealthy, such has drinking heavily or drug use, self-injury, significant changes in eating or sleeping, or other high-risk activities, you may have PTSD.

To diagnose PTSD, individuals need to consult with a licensed mental health professional who specializes in PTSD. Symptoms of PTSD include experiencing a traumatic event and having specific symptoms that cause significant distress or impairment for more than one month including:

1) intrusion of traumatic memories or uncontrollable reminders of traumatic events

2) avoidance of safe people, places, activities, or behaviors that are in some way associated with the traumatic event

3) negative changes in thinking or mood

4) alterations in arousal or reactivity, which include feeling numb, also called dissociation, or feeling on edge, also called hyperarousal

What should I do if I think I have traumatic stress or PTSD?

It is not a good idea to “self-diagnose” if you think you have PTSD. Self-diagnosis can lead to increase in trauma symptoms and other problematic behaviors. The best course of action if you think you may have PTSD is to seek an evaluation from a licensed mental health professional who specializes in treating traumatic stress and PTSD.

How can I get help for traumatic stress or PTSD?

The Chrysalis Center for Counseling offers compressive treatment for traumatic stress, PTSD, and many co-occurring problems. At Chrysalis we have licensed professionals, who used evidence-based treatments to decrease trauma symptoms and help people live their best lives following trauma.

Future blog posts will describe the specific evidence-based traumatic stress and PTSD treatments offered at Chrysalis. However, you can call at any time to hear about these treatments and to schedule a time to talk with one of our licensed professionals.

You can also find out more about evidence-based treatment for PTSD at the National Center for PTSD: This site has useful posts and videos on PTSD treatment, including many of the treatments we offer at Chrysalis.

Dr. Kate Brody Nooner is a licensed clinical psychologist and associate professor of psychology at UNCW. She also holds an adjunct appointment at Duke University and is the principal investigator of NIH-funded grants aimed at reducing child and adolescent trauma and preventing alcoholism.

Lisa*, a 41-year-old woman, wakes up at 5:45am to the screeching sound of an alarm clock. She rolls over and slaps it furiously to silence the brain piercing sound. She sighs and says in a determined whisper, “Thirty-six days.” As she begins her daily routine, worries swirl around her mind…”Did I forget to wash my coffee cup before I went to bed last night? If I left it out again, I will get fined by the recovery house manager. What if the bus is running late this morning… they’ll fire me if I’m late again. How am I going to make it to my therapy appointment today? I think my roommate hates me. She’s always so mad that I have to be up before she wants to get up when I work a morning shift. Am I going to have enough money to pay my rent?” Her chest feels tight, and she is filled with dread before the day even begins. Lisa lives in a recovery house. A recovery house is a place where addicts live with other addicts who are working on recovery from addiction. The recovery house provides structure, accountability, and support to those who are willing to comply with the rules of that recovery house’s program and who are actively pursuing recovery. Lisa shares a room with another woman who is in recovery from heroin. She has been sober from heroin for 31 days, and Lisa has been sober from alcohol for 36 days. However, Lisa faces a challenge in her recovery that her roommate does not. Lisa has Generalized Anxiety Disorder in addition to her addiction.

The National Institute on Drug Abuse (NIDA) states that individuals diagnosed with a substance use disorder are twice as likely as a member of the general population to be diagnosed with a co-occurring mental health disorder. In addiction, when an individual stops using a substance such as alcohol or another drug, the body goes through a period of time, called withdrawal, where it is adjusting to the absence of the substance. During this time, it is particularly difficult for an individual to refrain from using since using is the easiest way to stop withdrawal symptoms. These symptoms vary depending on the substance(s) used by the individual and can include extraordinary pain, depression, sweats, goose flesh, vomiting, diarrhea, and seizures. This is considered “acute” withdrawal. Depending on the amount and duration of substance use, this can last for a few weeks. After these symptoms subside, a person will go through “post acute withdrawals” which can include forgetfulness, inability to focus, confusion, emotional disregulation, sleep disturbance, emotional numbness, depression, anxiety and more. This can last up to two years after completely ceasing use and generally lessens over time. During post acute withdrawal, the extreme experience of emotions, depression, anxiety, and feelings of boredom are major triggers to use.

So, as you think about Lisa’s story, imagine what it is like to have used alcohol to cope with anxiety, only to have become addicted to alcohol. Having realized that her life had become unmanageable, she sought help at a recovery house and at a clinic where they treat people who have co-occurring mental health and substance use disorders. She is motivated to “get her life back” and tries hard to follow the advice given by those who know more than she knows about the road to recovery, but she still struggles daily with overwhelming feelings of anxiety, all the while her brain is begging her to fix it the old way… with alcohol. She is also not immune to the emotional effects of post acute withdrawal symptoms that are common at this point in her recovery, and her anxiety can be exacerbated by these symptoms. She can seek medical attention for her anxiety but is afraid of becoming reliant on a pill to cope with anxiety. She only considers this as an option because the symptoms of her generalized anxiety are so severe that she is afraid she will relapse on alcohol if she doesn’t stabilize her mental health.

Individuals who suffer from co-occurring mental health and substance use disorders face the challenge of staying sober while not being able to lean on the substance that they have used for so long to medicate their mental health disorder. They also face the challenge of coping with mental health symptoms complicated by post acute withdrawal symptoms. Structure, accountability and support is often not enough to help them overcome this special challenge. Frequently, medication and psychotherapy are necessary to stabilize their mental health disorder symptoms while they build the skills for living a sober lifestyle. Programs that include this combination offer hope to those who are determined to make a change and willing to work hard to begin a new life.

*Lisa is a fictional character created to represent real circumstances and challenges faced by those who suffer from co-occurring mental health and substance use disorders.

Lillian Hood, LPA, LCAS
Psychologist and Clinical Addictions Specialist
At the Chrysalis Center, I specialize in treating individuals with co-occurring disorders. This includes working with individuals who have trauma, depression, bipolar, anxiety, and/or eating disorders along with an addiction. I use evidence-based practices to help patients develop skills for successfully facing this unique challenge.

National Institute on Drug Abuse
National Association for Alcoholism and Drug Abuse Counselors


With attempted suicide rates on the rise, it’s imperative to spotlight the transgender and gender nonconforming (TGNC) community. Prejudice against TGNC people often manifests in forms of denial (in health-care services), harassment, bullying and physical assault. TGNC people may be further marginalized by other microaggressions, such as racial and ethnic identity, socio-economic status, and age. Individuals’ external reactions towards TGNC people may be aggressive as the result of explicit and/or covert fears about what it means to deviate from gender norms. TGNC people are often perceived as “Other,” not “fitting” into a particular box. By challenging constructs, clinicians can provide and advocate for the TGNC population.

Challenging Constructs

Gender has been perceived as a binary construct with mutually exclusive groupings of male or female. Blue or pink. Trucks or dolls. These groupings create an assumption that gender identity is always in alignment with sex assigned at birth. However, for TGNC people, gender identity differs from sex assigned at birth to varying degrees. Gender identity is defined as “a person’s deeply felt, inherent sense of being a girl, woman, or female; a boy, a man, or male; a blend of male or female; or an alternative gender.” To provide the most affirmative care, a non-binary understanding of gender is essential. Whenever I am greeting a client, I always ask them, “How would you like to be addressed? Do you have preferred pronouns you’d like me to use?” Simple, but by using their preferred identification, their self-identity and sense of self-worth is validated.

Trans-Affirmative Care

I wanted to provide the following list that offers a very general overview of language used within the TGNC+ community, and it’s important to emphasis that these terms are constantly evolving. Language is powerful. Staying updated and informed as a clinician will nurture open and collaborative discussions around experience through the lens of the TGNC person. It will also support the TGNC person in the least confusing and dishonorable way. Modelling an “acceptance of ambiguity” may be helpful as TGNC people develop and discover aspects of their gender expression, especially in adolescence and early adulthood. TGNC identities include but are not limited to: transgender (TG), female-to-male (FTM), male-to-female (MTF), transgirl or transboy, they/them, bigender, gender fluid(ity), drag queen or king, gender queer, transqueer, queer, cross-dresser, androgynous.

Research in the Field

It’s important to highlight the progressive work being done by Dr. Diane Ehrensaft and her colleagues at the Child and Adolescent Gender Center in San Francisco, California. They are utilizing what is called the “Gender Affirmative Model” which encourages clinicians against labeling TGNC individuals as “dysphoric” and instead view their varying gender expressions as “fluid.” This deconstructs the concept of gender being binary and stagnant. The ability to respectfully interact in a trans-affirmative manner can help improve TGNC people’s quality of life and experience in therapy overall. By supporting TGNC people to articulate their authentic truth, clinicians can strengthen the therapeutic alliance and cultivate a safe environment to explore gender identity and  gender expression.



American Psychological Association. (2015). Guidelines for Psychological Practice with Transgender and Gender Nonconforming People. American Psychologist, 70(9), 832-864.


Cassy is a Licensed Clinical Social Worker-Associate who is passionate about transformative justice and advocacy for contemporary social issues. In addition to providing individual counseling, Cassy also enjoys facilitating groups. She currently provides group support for patients who have recently undergone bariatric and weight-loss surgery and a group for young women called SOAR (Staying Open about Recovery), who are making strides to positively stay on track in eating disorder recovery.



Throughout my years of practice I have heard too many individuals talk about exercise as something they hate, something they dread, or most commonly, as something they only do when they are dieting. To some, the mere thought of incorporating exercise brings along a dark cloud of self judgement, shame and fear. When exercise becomes a ‘have to’ instead of a ‘want to’ – Houston, we have a problem!

Strict and rigid exercise routines and exercise performed solely to change one’s body, weight, or dependent on food intake may bring one to dangerous grounds. Quite often this results in inadequate fueling for what is being asked of our bodies, leaving one feeling fatigued, irritable, having difficulty concentrating, and more prone to illness, injury or further medical complications. These side effects may lead one to eliminate exercise all together, often creating guilt which challenges mental, emotional, and physical health. Evelyn Tribole, MS, RD and Elyse Resch, MS, RD, FADA, CEDRD in their book Intuitive Eating use the analogy of comparing exercising for weight loss to a time card being punched by a bored assembly-line employee, emphasizing that weight loss will not motivate exercise for long and will become discouraging when the results are not happening quick enough or are not what was pictured or promised. These authors recommend “decoupling exercise from weight loss,” and I couldn’t agree more.

You may be asking, what does exercise look like if it is not weight, calorie, or food focused?

First off, the definition of exercise is: planned, structured, and repetitive bodily movements; while the definition of  physical activity is: body movement produced by contractions. Takeaway: whatever you want to call it, it is about moving your body. I like to keep it simple. So instead of categorizing and labeling movement, see what happens when you just call it movement. Does that take some of the pressure off?  Refraining from strictly defining movement allows us to move away from unrealistic expectations. Other names that I like equally as much are: enjoyable movement, mindful movement, and intuitive exercise.

Secondly, identify the type of body movement that you like or enjoy that makes you feel good. This might be a bike ride with your children, a yoga class with your best friend, paddle boarding with your dog, or a walk on the beach at sunset. The music at the yoga class, your dog’s tongue flapping in the wind, or the salty beach breeze might make that experience rewarding and enjoyable enough to want to do it again! Unsure of where to begin, try to think about what you used to enjoy doing as a child, chances are these activities may still be something you have fun doing now. Did someone say kickball?

Lastly, consider what the benefits of movement are that you personally connect to. These may include: increased strength, flexibility, endurance, a more cheerful outlook, improved mental functioning, feeling of vigor, greater bone density, improved sleep, stimulation of immune function, improved circulation and lung function, reduced risk of chronic disease. Try to think of exercise as self care and health promoting instead of punishing, stress inducing, or negatively interfering with your health or well-being. I challenge you to focus on how moving your body is part of you taking care of you and know that it is okay to feel good about any movement that achieves this.

How can movement be part of your full life?


Sizer, F.S ., & Whitney, E . (2014) Nutrition concepts & controversies. Belmont, CA: Wadsworth, Cengage Learning.

Tribole, E., & Resch, E. ( 2012). Intuitive eating: A revolutionary program that works. New York, NY: St. Martin’s Press.

Willer, F. (2013). The non-diet guidebook for dietitians. Raleigh, N.C: Lulu Publishing, Ltd.


Courtney is a registered dietitian who specializes in sports nutrition and eating disorder treatment. She incorporates HAES and non-diet principles into her practice. In addition to nutrition consultations, Courtney leads a weekly meal support group. Meal group provides a safe space to challenge food rules and behaviors that prevent one from enjoying food or feeling comfortable in their body.

The week of May 1st-May 7th is Maternal Mental Health Week, where different organizations will partner to bring awareness to the most common birth complication, postpartum mental health issues. It is reported that anywhere from 11-20% of women who give birth each year will suffer from postpartum depression symptoms; that is more than 600,000 women annually. This number only represents women who had a live birth, leaving out all the women who miscarry or have a stillborn child who may also suffer from postpartum depression symptoms. That would increase that number immensely. Furthermore, the original number of approximately 600,000 women that is reported by the Centers of Disease Control is not a comprehensive number in other ways. That number was derived from women who self-reported symptoms. What about all the women who do not speak up about their suffering? What about all the women who do not know that what they are feeling is PPD? What about all the women who have anxiety or OCD symptoms instead of depression and do not realize it is from postpartum issues? Many resources state that it is likely that more than 1 million women suffer from some sort of postpartum mood disorder or anxiety disorder each year, making it the most common complication of childbirth.

Many women do not ever seek treatment even though this is a disorder that is highly treatable. So why not seek treatment? Especially since research shows that postpartum mood disorders affect not just the women suffering, but the children involved as well. It impacts their development and can make them more likely to suffer from a psychiatric illness themselves. When women are not treated properly, the symptoms last much longer, and can even turn into a lifelong psychiatric illness.

So, again, why are women not seeking treatment? There are so many reasons- none of which are fair or valid for women in our society. They do not seek help because there is stigma attached to admitting they are struggling. They do seek help because providers are not screening for these issues. They do not seek help because the information is not available for them to understand what is happening to them. They do not seek help because much of the time, there is not help available. Which is not only unfortunate, but unacceptable. We need to take better care of our women at their most vulnerable time so they can be mentally healthy to care for our most vulnerable members of society. We need to all do more- increase awareness, increase screening, increase resources.

Over this next week, Motherhood Matters, as a partner in Maternal Mental Health Week, intends to do just that. Increase knowledge, awareness, screening, and resources. Tune in here all week to learn more.

Megan Schlude, LPA is a psychologist and mama who is passionate about helping women with all types of perinatal mental health issues. She has extensive training and experience in women’s mental health through pregnancy and postpartum and developed the Motherhood Matters program offered at Chrysalis Center. For more information or to join the next Motherhood Matters therapy group, starting May 23rd, please call Chrysalis at 910-790-9500.


How much weight should I be losing?
Am I losing weight fast enough?
Questions similar to these are asked everyday in my office.
Let’s dive into some research for realistic expectations and mathematics to answer this question for each of you.

So here’s the research:
RNYGB patients are predicted to lose 70-80% of their excess weight by 18 months post-op.  By 15 years post-op, maintaining the loss of 60-65% of excess weight is considered successful.  Most people do not maintain the lowest weight they achieve; it’s normal to gain a small amount of weight typically between 3-5 yrs post-op.

SG patients are predicted to lose 55-60% of their excess weight by 5 years post-op.

Another marker of success is to stabilize in an overweight BMI category.  Most of you want to get to your dream weight and be in a normal BMI category but WLS does not get rid of 100% of your excess weight.  Unrealistic expectations can lead to feeling like a failure or sabotaging your success.  Remember to also measure your success by how much better you feel physically and how you’re able to move more comfortably in your body.

You’ll need a few numbers to answer “how much weight will I lose after bariatric surgery” including your pre-op weight, ideal weight and excess weight.

Pre-Op Weight – Ideal Weight = Excess Weight
Excess Weight x 65% = Expected Weight Loss
Pre-Op Weight – Expected Wt Loss = Expected Goal Weight

Patient is 5’8″ with pre-op wt of  375 lbs.
On a BMI chart, his ideal wt at a 24 would be 158 lbs.  Subtracting 158 lbs from 375 lbs determines he’s carrying 220 lbs of excess weight.
Multiple 220 by 65% and this patient can expect to loose a total of 143 lbs.
Subtract 143 lbs from starting weight of 375 lbs gives patient a goal weight of 232 lbs.

Check out this resource via Obesity Help; it calculates expected weight loss for you:

Keep in mind, these calculations are averages, not guarantees.  Lifestyle habits such as meal planning, reading labels, food tracking, staying hydrated, vitamin compliance and moving your body are all significant factors in improving your health and maximizing your weight loss.  Use your bariatric dietitian for education, support and accountability!



As parents, there is no one who we love more than our children. From the moment they are born, our mission becomes to do whatever it takes to make sure that our children have happy, healthy lives. This can involve going to great lengths to help our children when they are sick or in pain. When our child is sick and not getting well, we are quick to seek help from medical professionals and rightly so. But for some reason that fast action does not translate as directly when it comes to our children’s mental health. Why is it that it is okay to ask for help for a physical health problem but when it comes to our child’s mental health, we are supposed to have all of the answers?

As a child and adolescent mental health specialist, I have found that people often make the mistaken assumption that parents are the problem, which could not be farther from the truth. The parents who come through my door are heroes. They have already done so much to get it right. Unlike some parents who are struggling on their own, the parents who come to me for treatment have taken the important action of seeking professional help when they have reached their limits. They have put aside the myth that they must have all of the answers when it comes to their child’s emotional or behavioral problems.

Really, our children’s mental health is no different than their physical health. If our child has a virus, we take them to the pediatrician to be checked and to receive advice on how to help them get well. Similarly, if our child is struggling with peers or in school, we can do the same by taking them to a mental health professional. Research has shown that seeking treatment for our children not only vastly accelerates the pace of recovery from mental health problems but it also prevents more serious problems down the road.

The majority of mental health problems that adults experience can be traced back to untreated mental health problems in childhood and adolescence. It is a myth that children are resilient and will grow out of their problems. Just like leaving your child’s ear infection unchecked can have serious negative consequences, allowing your child to endure bullying without the aid of professional help could also lead to lasting problems.

To the parents who have taken that crucial step and brought their child to my office door, you have already conquered half of the battle to solving your child’s mental health problem. You are serving as a role model for your child by demonstrating that it is okay to seek help from professionals when you are struggling. For those who are hesitant to do so, I encourage you to think about what you would do if your child had a serious stomach bug and suggest that you take the same action if your child is experiencing anxiety, depression, inattention, bullying, or other changes in behavior that are negatively impacting your family or your child’s day to day life.

As a parent, you are the best expert on your child and you should always let your expertise as a parent guide your decisions for your child. This should include listening to yourself when your expertise tells you that you have reached your limits and need help. By seeking help you are not only putting your child first, you are also putting your child on a path of lifelong mental health and well being. There is no greater gift than that.

Dr. Kate Brody Nooner is a licensed clinical psychologist and associate professor of psychology at UNCW. She also holds an adjunct appointment at Duke University and is the principal investigator of NIH funded grants aimed at reducing child and adolescent trauma and preventing alcoholism.


Function of Families in the Recovery Process

Eating disordered behavior reflects a dysfunctional relationship with the self. Family members cannot “fix” the eating disordered individual. It is a unique combination of heredity, environment, culture and conditioning that cause eating disorders to develop…..It is not anyone’s “fault”; it is important to remember that everyone has the same goal of a healthy and happy life for the individual with an eating disorder…be patient and non-judgmental, listen, and remember that it is their responsibility to do the recovery work.

Parents and Eating Disorders

Parents possess amazing imaginations. They picture the day when their daughter/son will graduate from college, marry; perhaps even have children of her own. Here’s what they never imagine: a daughter/son with an eating disorder. Unfortunately, millions of children, adolescents and adult women suffer from anorexia and bulimia This means even greater numbers of parents are dealing with something they never anticipated, and worse, cannot possibly understand.

The most frequently asked question is “why?” Regrettably, there isn’t an easy answer. The best course of action for parents dealing with an eating disorder is to get help. A wise first step is to take the daughter to a physician, simply to ascertain the extent of the problem. If she/he has a full-blown eating disorder, then it is time to seek professional counseling for her, and very possibly, separate counseling for the parents and other children. Three important points to keep in mind: first, eating disorders rarely resolve on their own; second, if one daughter has an eating disorder, the entire family is impacted; and third, parents must not blame themselves the blame game accomplishes nothing.

Remember…Eating disorders are devastating to the individual and highly destructive to the family. You did not cause this; therefore, you cannot fix this on your own.  Please get help.

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