NEDA TOOLKIT for Coaches and Trainers
Enema The injection of fluid into the rectum for the
purpose of cleansing the bowels. Enemas may be used
as a bulimic compensatory behavior to purge after a
binge eating episode.
Equine/Animal-assisted Therapy A treatment program
in which people interact with horses and become
aware of their own emotional states through the
reactions of the horse to their behavior.
Exercise Therapy An individualized exercise plan that
is written by a doctor or rehabilitation specialist, such
as a clinical exercise physiologist, physical therapist,
or nurse. The plan takes into account an individual’s
current medical condition and provides advice for what
type of exercise to perform, how hard to exercise, how
long, and how many times per week.
Exposure and Response Prevention (ERP) A type of
behavior therapy strategy that is based on the theory
that eating disorder behaviors serve to decrease
negative emotions, which creates a cycle of negative
reinforcement. The goal of ERP is to modify the
association between the relief of these emotions and
the eating disorder behaviors by encouraging someone
to refrain from behaviors until the negative emotions
subside. (See Behavioral Therapy.)
Expressive Therapy A nondrug, non-psychotherapy
form of treatment that uses the performing and/or
visual arts to help people express their thoughts and
emotions. Whether through dance, movement, art,
drama, drawing, painting, etc., expressive therapy
provides an opportunity for communication that might
otherwise remain repressed.
Eye Movement Desensitization and Reprocessing
(EMDR) A nondrug and nonpsychotherapy form of
treatment in which a therapist waves his/her fingers
back and forth in front of the patient’s eyes, and the
patient tracks the movements while also focusing
on a traumatic event. It is thought that the act of
tracking while concentrating allows a different level of
processing to occur in the brain so that the patient can
review the event more calmly or more completely than
before. Family Therapy A form of psychotherapy that involves
members of a nuclear or extended family. Some
forms of family therapy are based on behavioral or
psychodynamic principles; the most common form is
based on family systems theory. This approach regards
the family as the unit of treatment and emphasizes
factors such as relationships and communication
patterns. With eating disorders, the focus is on the
eating disorder and how the disorder affects family
relationships. Family therapy tends to be short-term,
usually lasting only a few months, although it can last
longer depending on the family circumstances.
Guided Imagery A technique in which the patient is
directed by a person (either in person or by using a
tape recording) to relax and imagine certain images
and scenes to promote relaxation, promote changes in
attitude or behavior, and encourage physical healing.
Guided imagery is sometimes called visualization.
Sometimes music is used as background noise during
the imagery session. (See Alternative Therapy.)
Health Insurance Portability and Accountability
Act (HIPAA) A federal law enacted in 1996 with a
number of provisions intended to ensure certain
consumer health insurance protections for working
Americans and their families, establish standards for
electronic health information and protect the privacy of
individuals’ health information. HIPAA applies to three
types of health insurance coverage: group health plans,
individual health insurance, and comparable coverage
through a high-risk pool. HIPAA may lower a person’s
chance of losing existing coverage, ease the ability to
switch health plans, and/or help a person buy coverage
on his/her own if a person loses employer coverage
and has no other coverage available.
Health Insurance Reform for Consumers Federal law
has provided to consumers some valuable–though
limited–protections when obtaining, changing or
continuing health insurance. Understanding these
protections, as well as laws in the state in which one
resides, can help with making more informed choices
when work situations change or when changing health
coverage or accessing care. Three important federal
laws that can affect coverage and access to care for
people with eating disorders are listed below. More
information is available at:
http://www.cms.gov/CCIIO/Programs-and-Initiatives/ Other-Insurance-Protections/mhpaea_factsheet.html
• Consolidated Omnibus Budget Reconciliation
Act of 1985 (COBRA)
• Health Insurance Portability and Accountability
Act of 1996 (HIPAA);
• Mental Health Parity Act of 2014 (MHPA).
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