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Chapter 10


or another member of the treatment team can feel like a rejection that then impairs your working relationship. Nevertheless, you should not remain in uncomfortable situations to avoid “rocking the boat” with a patient. Speaking with another professional (even one who does not know the patient, as in professional supervision or mentoring) is the best way to determine your course of action, whether verbal redirection, intervention from another member of the treatment team or a supervisor, or other options. If a patient fails to attend scheduled appointments,


does not pay you the agreed-upon fee, is not compliant with recommendations that you think are essential for the patient’s safety, or is threatening to you or your staff, you should definitely tell the patient that you will not con- tinue to be part of the treatment team unless certain con- ditions (which you specify) are met. Such conversations can feel confrontational and even emotional, so keep in mind that setting these boundaries is an intervention in the best interest of the patient, and once again seek sup- port from the team, a colleague or your supervisor.


COUNSELING STRATEGIES FOR TIMES WHEN PATIENTS ARE VERY EMOTIONAL


You may occasionally meet with a patient who is experi- encing very strong feelings. These feelings may or may not be eating disorder–related. If they are related (“I’m devastated that I can’t go to college because of my eating disorder!”), you may be able to use a transitional state- ment or channel the conversation toward what can be done to advance recovery. Try to validate the patient’s feelings first, and then transition. In response to the patient who cannot attend college, you might say, “I can see that


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