Sanford Comprehensive Treatment for Eating Disorders (SCTED) recreational therapists Tori TerAvest, CTRS, and Raina Bawden, CTRS, are back to discuss creative art, social media, values clarification, and more. In a follow-up to Recreational Therapy for Eating Disorders, Raina and Tori share their thoughts on building a community at all levels of eating disorder treatment.
“You get out of therapy what you put into therapy; for some, that might mean sharing the slightest bit about themselves. Others are willing to share more: it is an individual thing. But I think you have to share some aspects of your story to get the full benefit of treatment. Eating disorders are less likely to survive in an environment of openness, honesty, and vulnerability.” Tori TerAvest, CTRS
Community, Creativity & Vulnerability
SBH – At Sanford Comprehensive Treatment for Eating Disorders, examples of personal artwork are displayed, like masks, lanterns, and watercolor paintings. What is the role of creativity and art therapy?
Raina – We have a certified art therapist who comes in once a week to work with our eating disorder clients. We are not art therapists, but we do a lot of creative art in recreational therapy and display it around the treatment center. Our team does not want SCTED to be a sterile environment. We try to make a homelike space by putting up what our clients have worked on. I think it builds a sense of community for current clients to see past clients’ work. Creative art supports the therapeutic work we do here. If a client is struggling, they may see a work of art from another client that reframes their thinking.
Tori – Acknowledging our clients’ creativity is a powerful tool. It says, ‘In your eating disorder, you did not have the energy for this, but look how creative you are. You can use that. It’s a colorful world!’ In a sense, we are challenging our client’s need for order with everything clean, neat, and perfect.
SBH – Eating disorders can affect people of any age, race, gender, or sexual orientation. How do we work with this diverse group of people?
Tori – Our residential treatment unit accommodates adult (18+) female-gendered individuals, including trans individuals, and we are as gender-affirming as possible in that milieu. In our day programs (PHP) and half-day programs (IOP), we are blessed to admit various age ranges and genders. It is often assumed that eating disorders are cisgender and young woman-focused, but that is far from the case. We have a diverse environment that includes and welcomes everyone. Actually, diverse groups are my favorite because they bring in different perspectives.
SBH – You have said recreational therapy helps build community; why is that important?
Raina – Across all treatment levels, we build a strong community. Because of this, our clients begin to open up. Whether during a process group or one-on-one time, they become vulnerable with each other. Especially at the residential level of care, where they spend extra time with each other in the evening. There is an added level of connection and vulnerability built. It reminds me of going to summer camp, but add in being the most vulnerable you’ve ever been. So, you meet your best friends in that short period because you have a connection to people who understand you for the first time in your life. It is empowering and comforting.
SBH – What is the key to successful eating disorder recovery? Community? Vulnerability?
Tori – You get out of therapy what you put into it. I always say, “You can’t recover on an island.” Even inviting one person onto your island is huge. Eating disorders do not survive in the light. So the more light you shed on yourself and your behaviors, the more honest and vulnerable you are, the less likely your eating disorder will survive.
SBH – What are the pitfalls to successful recovery?
Raina – Rushing treatment and not giving yourself time to develop healthy new behaviors. Also, skipping levels of care. There is something of value in day programs (PHP) and half-day programs (IOP) before heading right to outpatient care. The full continuum of care at SCTED gives you time to practice more independence, accountability, and skill-building.
Tori – Another issue for PHP and IOP care levels is beating yourself up over the little things. Recovery is going to be far from perfect. I know a clinician who calls recovery a “beautiful disaster.” It encompasses recovery well. I always tell clients that there will be days when they miss a meal or have a lapse. They should be honest with themselves but place less importance on every small misstep and more on how they have maintained recovery.
SBH – What about the role of family in recovery?
Tori – It is important, especially for our adolescent folks, to have family support. Whether your biological or chosen family, you must have those people you can turn to outside treatment. They are leaving this level of support to be picked up by another version of support at home. Leaving treatment can be a high relapse timeframe. But life happens outside these four walls, and family can help with accountability and translating what our clients learned in treatment to real-life situations.
SBH – What is values clarification?
Raina – Values clarification is exploring your past before an eating disorder took over your life. You are exploring your authentic self. Do I value not being with my friends and focusing on food? Or is it important to engage in things that bring me joy and a sense of purpose? Values will change throughout your life but should correlate with your lifestyle.
Tori – Values clarification is using values as a compass. If my value is exploring nature, and that is my true north, but I am not engaging in nature, which way am I going? Am I in line with where I want to be? Values can keep you focused on your priorities and goals. We use a lot of creative ways to explore values. I use the values thermometer – how much our clients value a particular thing on a scale and why. I have a group where I tape up different values around the room and ask our clients questions, and they have to move around the room and sit by the value that answers the question.
SBH – How do you talk to SCTED’s clients about social media?
Raina – We have a social media group where we explore a “happy medium.” In other words, we talk about using social media positively to find events in your community or connect with family members and friends. But we also discuss diet culture that is so pervasive and how to prune our social media feed intentionally.
Tori – If you want social media in your life, what is its intentional use? Because eating disorders are comparison monsters. And social media is a breeding ground for comparison. It can be used effectively or become a trigger for eating disorders.
Thank you, Raina and Tori!
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