How did you get started in your career? I began work in a private clinic that specialized in treating those with eating disorders, but initially I was not involved in their treatment. Over time, I was introduced to working with these clients, and I was delighted to find that I enjoyed it immensely. Of course, most with eating disorders are women, which raises the question of what it means to work with a male therapist in these sensitive issues. For some, a male therapist is simply not a good option. For others, there is an opportunity to experience a redemptive therapeutic relationship that challenges wounds that often were inflicted by men. I’m honored to walk with clients in these places.

What advice would you give to someone interested in the eating disorders field?
Your own self-care will be key to being a vibrant resource for your clients. Seek others who work in the field. A supervisor is very important to help in becoming accustomed to the (sometimes dramatic) ups and downs of working with difficult clients, and a solid consultation group is extremely valuable. Apply your knowledge with confidence, while being willing to question what you’ve learned. Beyond this, guard your time outside of work. An exhausted therapist is likely an ineffective one. ]]> http://eatingdisorderjobs.com/main/archives/122/feed 0 http://eatingdisorderjobs.com/main/archives/120 http://eatingdisorderjobs.com/main/archives/120#comments Fri, 29 Jul 2011 20:26:35 +0000 owen http://neweatingdisorders.com/main/?p=120 Continue reading →]]> Gina Scarano-Osika, PhD
Psychologist in Private Practice and at North East Center of Excellence in Eating Disorders

How did you get started in your career? 
I focused on research in the beginning, published a few journal articles and became well versed in evidence-based treatment for eating disorders. I began work at a private practice in 1994 and five years later moved closer to home and opened my own practice with my husband, a child psychologist. Now I am an out-patient provider for the North East Center of Excellence in Eating Disorders, which is an in-patient hospital affiliated with Strong Memorial and NY Presbyterian. I also do mental health evaluations for people seeking gastric bypass surgery at Albany medical Center or Ellis Hospital.

What advice would you give to someone new to the field? 
Read contemporary research articles about the mind-body connection and consult with a specialist in the field. Treat the patient until you find something that works.

How did you get started in your career? 
I began my career in counseling at a general mental health care facility in Arkansas. I did outpatient counseling with individuals with a variety of problems, both acute and chronic. I did psychological testing for the court system and was on call at their in-patient hospital one day a week. At that facility, I ultimately opened two satellite offices, one in a rural area and another on a local college campus.

I applied for a job at West Oaks Hospital in Houston, TX and grabbed the opportunity to work as a counselor in their large eating disorder program. I was excited to specialize in something so complex and at that time, one of the few specialized eating disorder treatment programs in the south. I eventually became the coordinator of that program. Several years later, I moved to Dallas to become the coordinator of the Baylor Outpatient Eating Disorder Program.

What advice would you give to someone new to the field? 
Begin your career in a general mental health setting because so many of the eating disordered population have co-existing diagnoses. This broad background will provide a firm foundation to build upon.

As you move into counseling eating disorders, affiliate with a group of treatment professionals to serve as mentors and build a team of allied professionals that you know have experience in treating eating disorders. I routinely refer my clients to a dietician, a cardiologist, a psychiatrist, and an internist who orders blood work and bone density scans. Become familiar with the network of local free support groups.

My final piece of advice is “feed your own mind, body, and soul as you guide your client to do the same.”

How did you get started in your career? 
I got started in my career when I was 12 years old. People, and their stories fascinated me and a truly believe my inner psychotherapist has been budding since I was a child.

Formally speaking, my career started when I chose psychology as my major in college. I wrote my thesis on “Body Image Dissatisfaction: the parallel subcultures of heterosexual women and homosexual men. My first job after college was as a management consultant, -a job in which I felt I was like a therapist to companies, helping them to define problems and create solutions.

Finally, there was a defining moment in my life. I took a good, hard, look at what I kept being drawn back to: people and their stories and when I had that epiphany I knew I had to become a psychotherapist. I chose the field of eating disorders because it is a disorder that to me, makes intuitive sense. Moreover, I find that people who struggle with eating disorders recovery or who are recovered tend to be people that live more deeply, have the capacity for amazing growth and connection and have so much to offer. I went back to school to get a second master’s, this time in counseling psychology.

Scared, young and yet eager, I began my internship at a hospital, and in-patient treatment program for those suffering from eating disorders. I found the multi-disciplinary approach was daunting and fascinating. I liked that the field of clinician’s seemed small and supportive and that conferences on eating disorders would bring familiar, friendly faces together. I felt challenged and stimulated and a profound sense of calm in that I was trying to help people and following what I believe is my vocation.

What advice would you give to someone new to the field? 
Learn as much as you can about the medical and psychiatric components of eating disorders because knowing when to recommend a higher level of care is often a tough call to make. Being able to speak with doctors, and nutritionists about potassium levels and urine specific gravities makes more meaningful collateral contact and hence good care.

Be grounded in your self, your strengths and your limitations so as to be able to maintain healthy therapeutic boundaries. Modeling good boundaries is something that our patients constantly challenge. Being able to ask “Am I doing ____ in the service of my patient or to service my own need in some way?” is a really important question to be able to ultimately respond : “I am acting in the service of my patient.”

How did you get started in your career? 30 years ago, my private practice in psychotherapy offered me too few opportunities to treat family cases, so I went to my neighborhood hospital to ask if I could treat a few cases for them each week. They put me on their Eating Disorders Unit where I was immediately captivated by the challenging nature of the cases, the excitement of inspiring changes that could save lives, and of creating optimism and motivation where there had been none. Best of all, I so enjoy these clients; generally bright, charming, talented and committed human beings, they are so easy to enjoy, if not to love.

What advice would you give to someone interested in the eating disorders field?

• With effective treatment, remember that ED are curable in 90% of cases.
• This sub-specialty demands unique requirements for care, standing apart from generalist practice or other specialties. Recognize and respect this.
• Highly skilled clinicians need to be open to an integrative treatment perspective (modes, methods and milieus) in response to an integrative disorder; and to using oneself with mindful versatility (and sometimes courage), particularly in the face of counter transference issues.
• Keep expectations for recovery changes realistic; the process of achieving recovery feels worse before it feels better, and sometimes the best learning is camouflaged in behaviors that may at first appear to represent failures.
• When a clinician and client sit down together face to face, he or she needs to become aware of the presence of three separate entities; you, the client, and the eating disorder. All must be respected, addressed and managed.
• When the individual ED client walks through your door, it is safe to anticipate that effective treatment will address a virtual “crowd,” including families and loved ones, members of the professional team inpatient as well as outpatient, the school, etc.
• There is hardly a more fulfilling specialty. Nothing is more gratifying than creating hope where none exists, where recovered clients declare that they have “their life back” or that they are now “the very best self they can be.”

How did you get started in your career? My career started in 1998 when I was accepted into a post-doctoral fellowship in Clinical Neuropsychology which brought me to Arizona. Following this two year position, I accepted my first “real” job in eating disorders at Remuda Ranch Treatment Programs.

What advice would you give to someone interested in the eating disorders field?
It’s important to get a diverse and broad range of clinical experience and training before specializing too soon in one area in your undergraduate or graduate program. I felt my diverse clinical training and experience prepared me well to work with the co-morbidity and clinical issues present with those suffering from eating disorders. If possible, I also suggest working with a multidisciplinary team. I have learned a tremendous amount about eating disorders from my colleagues from other disciplines.

My connection with eating disorders began 38 years ago. For 17 years I battled with my own eating disorder, while graduating with my BSN and working as an emergency department RN as a manager, educator and clinician. During these years I always thought if I ever was to recover, which seemed impossible at the time, I would do whatever I could to assist others in their own recovery. A few years after my own treatment and recovery, I decided to return to school to get my MS in Counselor Education so I could work with individuals with eating disorders as a psychotherapist. I have had the opportunity to work in a variety of treatment settings with individuals, couples and groups; acting as a guide to those embarking on their own recovery path. With the opening of Eating Recovery Center in October 2008, a treatment center providing a full continuum of services, I have been able to combine my nursing and psychotherapy background as the Director of Nursing. This has allowed me to assist in program development while supervising and educating the nursing staff in performing high quality patient care. Treating a patient with an eating disorder requires a multi-disciplinary approach and having the combination of a medical and psychiatric skill set has enabled me to have a much broader picture of each individual patient.

Working with individuals with eating disorders provides an awesome opportunity to assist amazing women (and men) in learning to really “live life” through their recovery from this devastating illness. Anorexia nervosa has the highest mortality rate of any psychiatric disease. Some individuals recover, some die, and some have a chronic course of the illness with repeated treatment episodes. Patience, flexibility and passion about this type of work are imperative as there are many challenges awaiting the practitioner i.e., treating a combination of medical and psychiatric issues, combating a fierce disease (it takes the average person 7-10 years to recover from anorexia nervosa), treating the associated medical and/or psychiatric co-morbidity, and having the ability to identify and encourage the patient in each step they take towards recovery.

Center for Change
Business Development Representative

How did you get started in your career? 
After a 9 month sabbatical; I realized I wanted a career in which I could make a difference. I didn’t have any experience with eating disorders or marketing so I accepted an entry level position in the Marketing department. In that position I learned everything I could about eating disorders and about Remuda Ranch.

What advice would you give to someone new to the field? 
It takes dedication and hard work to make it in the Marketing field. You have to be self-motivated and self-disciplined and stay in constant communication with your target audience. You need to be on top of the latest research and have a systematic approach to getting the information communicated.

How did you get started in your career? 
I’ve always had a passion for enhancing the lives of girls and women. In 2006, I started a non-profit self-esteem organization for girls as a way of giving back to adolescents, www.pearl-girls.org. I also decided to pursue my Master’s Degree in Counseling, and then applied for my current position at the Renfrew Center because I believed in the empowering treatment philosophy of the program. I serve as a liaison for community members, parents, patients, and professionals in regards to Eating Disorder treatment at the Renfrew Center. My ultimate charge is to spread the word about eating disorders, including signs and symptoms and treatment options, in efforts of helping girls and women take steps towards recovery.

What advice would you give to someone new to the field? 
Network, network, network. It’s all about who you know, and how you can add value to other people.

How did you get started in your career? 
My vision of having flexibility with my work schedule, being my own boss, and being able to make executive decisions mixed with my interest in health and nutrition is what got me started in my career as a private practice dietitian. However, this is not where I started out. I climbed the ladder through clinical and outpatient dietitian positions through a local hospital and gradually built my private practice simultaneously. As far as my specialty area…I developed an interest in the field of eating disorders in college and began researching on the topic and networking with professionals. I’d have to say that knowing my passion (helping clients develop a more peaceful relationship with eating and their body) is what has allowed me to build my business successfully.

What advice would you give to someone new to the field? 
My #1 piece of advice is to share your passion and work interests with others. By this I mean talk about what you aspire to do, network with other professionals (both those in your field of choice and those outside of the field), perhaps volunteer your time or shadow a professional to gain experience in your area of interest. This might mean stepping out of your comfort zone. Believe that you can achieve anything!