Harm Reduction: Colluding with the Eating Disorder or Connecting with the Person Beneath It?

Many traditional approaches to eating disorder treatment focus primarily on behaviors such as meal plan compliance, and strategies that aim to support and reinforce these behaviors.

In higher levels of care, and some outpatient settings, the goal is to make eating disorder behaviors non-negotiable. This may be accomplished through contingency management, where access to certain privileges depends on meeting specific behavioral expectations.

In this model, the eating disorder is the enemy that sabotages a person's life and medically compromises their health. Clinicians and clients are positioned as working together to challenge this enemy by reinforcing more adaptive behaviors.

The harm reduction model, in contrast, focuses on the complex inner world of the client and acknowledges when meal plan compliance is inaccessible. Rather than enforcing symptom abstinence from the outset, harm reduction focuses on meeting the client where they're at, and collaborating around manageable goals while reducing immediate risk.

In this episode, Gabby Morreale shares her story around why she adopted a harm reduction approach and how she applies it in her current practice. We also discuss how to manage high-risk situations within this model and how to clearly communicate when a different level of care or approach is needed.

Gabby is the owner and clinical director of Recovered and Restored Eating Disorder Therapy Center, where she leads with a relational, social justice-oriented approach rooted in compassion and encouragement. She is a Licensed Professional Counselor in Pennsylvania, Delaware, New Jersey, Connecticut, Maryland, South Carolina, and Florida. Gabby has over 12 years of experience in the field and holds certifications in cognitive behavioral therapy, dialectical behavior therapy, and trauma-informed care. She is currently pursuing certification in exposure and response prevention. Gabby specializes in treating eating disorders, maternal mental health, OCD, anxiety, depression, and PTSD. She is a professional presenter on topics related to eating disorders, anxiety, and maternal mental health, having presented at eating disorder conferences, universities, and community organizations.

For more on Gabby

Instagram: @gabriellelpc and @recoveredandrestored

Website: Recoveredandrestoredtherapy.com

Email: gabby@recoveredandrestoredtherapy.com

Binge eating recovery with Elka https://elkacubacub.com/