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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). Page  | 53