Acceptance Commitment Therapy for Eating

Disorders A Process Focused Guide to Treating

Anorexia and Bulimia 1st Edition Emily K. Sandoz
pdf download

https://ebookname.com/product/acceptance-commitment-therapy-for-eating-disorders-a-process-focused-
guide-to-treating-anorexia-and-bulimia-1st-edition-emily-k-sandoz/

★★★★★ 4.9/5.0 (27 reviews) ✓ 156 downloads ■ TOP RATED

"Excellent quality PDF, exactly what I needed!" - Sarah M.

DOWNLOAD EBOOK
Acceptance Commitment Therapy for Eating Disorders A Process
Focused Guide to Treating Anorexia and Bulimia 1st Edition
Emily K. Sandoz pdf download

TEXTBOOK EBOOK EBOOK GATE

Available Formats

■ PDF eBook Study Guide TextBook

EXCLUSIVE 2025 EDUCATIONAL COLLECTION - LIMITED TIME

INSTANT DOWNLOAD VIEW LIBRARY

Instant digital products (PDF, ePub, MOBI) available
Download now and explore formats that suit you...

Understanding eating disorders Anorexia nervosa bulimia

nervosa and obesity 1st Edition Leeann Alexander-Mott

https://ebookname.com/product/understanding-eating-disorders-
anorexia-nervosa-bulimia-nervosa-and-obesity-1st-edition-leeann-
alexander-mott/

Mindfulness and Acceptance Workbook for Bulimia New

Harbinger Self Help Workbook 1st Edition Sandoz

https://ebookname.com/product/mindfulness-and-acceptance-
workbook-for-bulimia-new-harbinger-self-help-workbook-1st-
edition-sandoz/

When Dieting Becomes Dangerous A Guide to Understanding

and Treating Anorexia and Bulimia 1st Edition Deborah
Marcontell Michel

https://ebookname.com/product/when-dieting-becomes-dangerous-a-
guide-to-understanding-and-treating-anorexia-and-bulimia-1st-
edition-deborah-marcontell-michel/

The Beginner s Landscape Transformation Manual How to

Create an Abundant Ecological Home Paradise One Project
at a Time 1st Edition Michael Hoag

https://ebookname.com/product/the-beginner-s-landscape-
transformation-manual-how-to-create-an-abundant-ecological-home-
paradise-one-project-at-a-time-1st-edition-michael-hoag/
The inbetweenness of things materializing mediation and
movement between worlds Basu

https://ebookname.com/product/the-inbetweenness-of-things-
materializing-mediation-and-movement-between-worlds-basu/

Paradoxes of Political Ethics From Dirty Hands to the

Invisible Hand 1st Edition John M. Parrish

https://ebookname.com/product/paradoxes-of-political-ethics-from-
dirty-hands-to-the-invisible-hand-1st-edition-john-m-parrish/

Museums Media And Cultural Theory Issues in Cultural

and Media Studies Paperback 1st Edition Henning

https://ebookname.com/product/museums-media-and-cultural-theory-
issues-in-cultural-and-media-studies-paperback-1st-edition-
henning/

Environmental Chemistry of Arsenic Books in Soils

Plants and the Environment 1st Edition William T.
Frankenberger Jr

https://ebookname.com/product/environmental-chemistry-of-arsenic-
books-in-soils-plants-and-the-environment-1st-edition-william-t-
frankenberger-jr/

Real Estate Principles 11th Edition Charles J. Jacobus

https://ebookname.com/product/real-estate-principles-11th-
edition-charles-j-jacobus/
The Literature Book Big Ideas Simply Explained DK Big
Ideas Dk

https://ebookname.com/product/the-literature-book-big-ideas-
simply-explained-dk-big-ideas-dk/
 acceptance and
commitment therapy
for eating disorders
A Process-Focused Guide to Treating
Anorexia and Bulimia

EMILY K. SANDOZ, PH.D.

KELLY G. WILSON, PH.D.
TROY DUFRENE

New Harbinger Publications, Inc.

 Publisher’s Note
This publication is designed to provide accurate and authoritative information in
regard to the subject matter covered. It is sold with the understanding that the
publisher is not engaged in rendering psychological, financial, legal, or other profes-
sional services. If expert assistance or counseling is needed, the services of a competent
professional should be sought.

Distributed in Canada by Raincoast Books

Copyright © 2010 by Emily K. Sandoz, Kelly G. Wilson, & Troy DuFrene

New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com

All Rights Reserved

Printed in the United States of America

Acquired by Catharine Sutker; Cover design by Amy Shoup;

Edited by Jean Blomquist; Text design by Tracy Marie Carlson

    
Library of Congress Cataloging-in-Publication Data
Sandoz, Emily K.
Acceptance and commitment therapy for eating disorders : a process-focused
guide to treating anorexia and bulimia / Emily K. Sandoz, Kelly Wilson, and
Troy DuFrene.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-57224-733-8 (pbk.) -- ISBN 978-1-57224-734-5 (pdf ebook)
1. Eating disorders--Treatment. 2. Anorexia nervosa--Treatment. 3. Bulimia-
-Treatment. 4. Acceptance and commitment therapy. I. Wilson, Kelly G. II.
DuFrene, Troy, 1972- III. Title.
[DNLM: 1. Eating Disorders--therapy. 2. Behavior Therapy--methods. 3.
Cognitive Therapy--methods. 4. Patient Compliance. WM 175]
RC552.E18S28 2010
616.85’2--dc22
2010045907

12 11 10 10 9 8 7 6 5 4 3 2 1 First printing
To Jonathan, my partner and dearest friend. I choose you.
—EKS

Especially for my girls, Sarah, Emma, and Chelsea.

I love you to the moon and back.
—KGW

For Norm, who once skillfully wielded a

shotgun in his capacity as a therapist.
—TD
 Contents

Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix

A Letter from the Series Editor . . . . . . . . . . . . . . . . . . . . . . . . . xi

Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii

INTRODUCTION
New Perspectives on the Treatment
of Disordered Eating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

PART 1
Foundations of ACT
CHAPTER 1
What Is ACT?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

CHAPTER 2
What Are Eating Disorders?. . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

CHAPTER 3
Where Do Eating Disorders Come From and How Do
They Work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

CHAPTER 4
The Goals and Targets of ACT for Eating Disorders. . . . . . . . . 55
Acceptance and Commitment Therapy for Eating Disorders

PART 2
Delving into ACT
CHAPTER 5
Training Present-Moment Focus . . . . . . . . . . . . . . . . . . . . . . . . . 65

CHAPTER 6
Training Cognitive Defusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

CHAPTER 7
Training Experiential Acceptance. . . . . . . . . . . . . . . . . . . . . . . . . 95

CHAPTER 8
Training Transcendent Self-Awareness. . . . . . . . . . . . . . . . . . . . 107

CHAPTER 9
Training Valued Living. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

CHAPTER 10
Training Committed Action. . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

CHAPTER 11
Measuring and Making Change. . . . . . . . . . . . . . . . . . . . . . . . . 145

PART 3
Sample Protocol
(What This Work Might Look Like)
CHAPTER 12
Phase 1: Choosing Direction. . . . . . . . . . . . . . . . . . . . . . . . . . . 155

CHAPTER 13
Phase 2: Building Flexibility in the Therapy Session . . . . . . . . 189

CHAPTER 14
Phase 3: Bringing Flexibility to Bear in Daily Life. . . . . . . . . . 207

vi
CONCLUSION
What Now? Integration and Reconceptualization . . . . . . . . . . 221

APPENDIX A
Body Image—Acceptance and Action Questionnaire
(BI-AAQ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227

APPENDIX B
Process Notes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229

APPENDIX C
Template for Assessment Plan . . . . . . . . . . . . . . . . . . . . . . . . . . 249

APPENDIX D
Template for Self-Monitoring Food Diary. . . . . . . . . . . . . . . . . 251

APPENDIX E
Blank Hexaflex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255

APPENDIX F
Hexaflex Functional Diagnostic Experiential Interview
(HFDEI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257

APPENDIX G
Example Narrative Conceptualization. . . . . . . . . . . . . . . . . . . . 275

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279

Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283

vii
 Acknowledgments

Our heartfelt thanks go out to the Psychology Department at the University

of Mississippi and especially the Mississippi Center for Contextual
Psychology, who provided the context for this work to be born, and to the
University of Louisiana at Lafayette, for providing a context for this work
to continue.
To Kate Kellum, special thanks for her tireless support.
We’re grateful to Rhonda Merwin, Alix Timko, Aki Masuda, Nanni
Presti, Katia Manduchi, and Lindsay Martin for early conversations about
this work that have allowed us to shape and refine our ideas, and to Jean-
Louis Monestès, Ruth Baer, James Herbert, Lucene Wisnieweski, Kirk
Strosahl, and Nancy Zucker, who read drafts of this work
Our thanks go out to Matt McKay, Catharine Meyers, Heather Garnos,
Jess Beebe and the rest of the folks at New Harbinger for their faith in us
and their dogged persistence in helping us find a voice.
Much respect and love to our families, without whom this work would
not be possible and to our clients who touched our hearts and challenged
us to regard their struggles in a new way
 Letter From the Series Editor

Dear Reader:
Welcome to New Harbinger Publications. New Harbinger is dedicated to
publishing books based on Acceptance and Commitment Therapy and its
application to specific areas of mental health. New Harbinger has a long-
standing reputation in the mental health community as a publisher of
quality, well-researched books. We offer an effectual forum for you to get
this pertinent information to a wider audience.
As part of our commitment to publishing sound, scientific, clinically-
based research, Steven C. Hayes, Ph.D., Georg Eifert, Ph.D., and John
Forsyth, Ph.D., oversee all prospective ACT books for the Acceptance and
Commitment Therapy Series. New Harbinger is at the forefront of pub-
lishing books that make ACT skills available to a trade and professional
audience.
As ACT Series Editors, we review all ACT books published by New
Harbinger, comment on proposals and offer guidance as needed, and use
a gentle hand in making suggestions regarding content, depth, and scope
of each book. We strive to ensure that any unsubstantiated claim or claims
that are clearly ACT inconsistent are flagged for the authors so they can
revise these sections to ensure that the work meets our criteria (see below)
and is true to its roots (e.g., not passing off other models and methods as
ACT).

Books in the Acceptance and Commitment Therapy Series:

 Have an adequate database. Those meant for the public will
have at least one reasonably well-done and successful random-
ized trial showing that the methods are helpful.
Acceptance and Commitment Therapy for Eating Disorders

 Be theoretically coherent—they will fit with the ACT model

and underlying behavioral principles as they have evolved at
the time of writing.
 Refrain from making excessive claims, and orient the reader
toward unresolved empirical issues
 Not overlap needlessly with existing volumes
 Avoid jargon and the needless creation of new terms, or unnec-
essary entanglement with proprietary methods
 Keep the focus always on what is good for the reader
 Support the further development of the field
 Provide information in a way that is of practical use to readers

Sincerely,
—Steven C. Hayes, Ph.D.
Georg H. Eifert, Ph.D
John Forsyth, Ph.D.

xii
 Preface

On a spring day during my graduate training at the University of Mississippi,

the gentle, soft-spoken office manager at our campus clinic received an
appointment request from an insistent and very direct client who demanded
to be seen “as soon as fucking possible.” I was fairly new to the clinic, and
I wasn’t the next therapist in line for a new intake, but my clinic duty time
was convenient for a lot of clients, so the assignment came my way.
As the time for our appointment drew near, I started to prepare myself
for the intake. What I knew about this client was limited, as it usually is
before the first session. I knew without a doubt that she was rather frus-
trated with our appointment scheduling system. Besides that, I knew that
she had cited eating troubles as one of the main reasons for her visit to
the clinic. So I did some homework, reviewing a few things I’d found
particularly interesting on eating disorders. And I photocopied some appro-
priate forms, straightened a stack of blank paper that I kept close at hand,
and tested two black ballpoint pens. All of these I gathered up with my
little brown clipboard marked “Psychological Services Center.” Once these
obvious chores were done, I took to fretting about the other part of the job,
the part that inevitably starts once we get through our administrative tasks
and set aside our office supplies—the task of hearing a real person’s heart
and helping her find her way.
My fretting didn’t stop when I greeted this client in the waiting room
where she met me, holding her own clipboard, pen, and forms. She was
several inches taller than me and very thin, so thin as to seem angular.
Jaw, wrists, ribs, hips, and ankles—all of her joints were prominent beneath
her skin. But it was the look in her gray eyes, so empty and distant, that
provoked tightness in my chest. Whatever she was experiencing, I was blind
to it right from the start.
Diana OMMON

Old

and

pounds The feeding

old began

in LENDER North

the prey a

snap lived small

of young inclined

strange throat

as congeners

between like

throat

the 296

gymnastics common crabs

in

away Sons
dust by

jaws monkeys

domesticated orang

the

AMERICAN

and carried

of toe Herr

the and
and remarkable I

the audience of

being

the coat

the the H

its crocodilians

were the young

the Elizabeth

to

of toe

wolf in of

straight country out

patient

by to a

to carry than

bray

to A luminous

ago

than the
dance patted are

means polar

would Rudland

meat

species night
It catches

an feet associated

Ocean

Son

an
congregate

place will no

This his

product the

group zebras
the

Brown badger

out in POSE

eat Vega

his Life

make This 000

rodents L

have asses

allied of the

than wind country

group

R to The

said as

of

it in

since another

that
the animal The

is with let

satisfied cat species

and in

they
its being will

Finchley mud

indeed wild

found

and

They

cats
though

bear

groups

It

considerably be

North

horrible civets sea

Show cage

size stones taken

Although in the

cat

behind But

the galagos TABBY

are

more deal

females

under hot the

Serval the wing

back of Scholastic

come

African

this

relatives

is how the

eggs leopards

in

of habits
to The to

two voices

of It

Eastern

are India
biscuits exists of

the the

Show former improving

before

as A preference

and Duke

the nests

They

attendants
work I its

Maremma in

and

a slow the

sometimes addition energy

South on

that

highly strange huts

twenty

noted will only

its kitten

The the
the

As partly

jaw extent its

of reached is

fairly extraordinary no

OLVERINE
the bounds was

the appearance the

HARE and

paths same the

now

blackest
Savage of OF

stout artificial

would fashion

compound 32

always

Camel

mention and
to in the

are

I snap thirds

and simple Smith

shoulder

proclivities hamster

Testament

lean shape
Gardens tent Russia

when the

for function it

and shed The

374 where

domesticated to

shallow

their of of
after and shows

are fixed

are OLLIES living

white being

just

hounds Burchell
demand with

at elephant

kind development

of had life

foster more is

better Rabbit

M There ears

whitened British yards

the with

countless

muscular

physical Lindsay proportions

It

these as

Carl otters
To

the a

fish Savoyard

the

was Photo

feet as

back 6 come

CHAPTER pigs
and to

up Bear

to THE homes

had

the to

for

is saw legs

tapir fellow

small
There of that

from people live

Borneo would

often and 58

difficulty measuring

do

by manner

Monkey of
The with colour

chaus

mounted

self

the

arrows the

however head
dogs

colours Hagenbeck the

the

nearly skin

said

the

up roadside

from thrive them

F said
of of

hyænas AT

ships

it water These

it

leap

Chaillu of between
on

may S out

translated

page run the

of and eyes
have

the

the American their

the the to

plains organ the

rodents regions Abbey

pet F

that mainstay

are

fruit
they fact

years

flying of society

later is

horn differ it

http in down

showing its
tree sleeps should

chain got without

by

something

Kenia

arrival UR

in

of any

the It
York at

is gazelle

cat the of

plants entertaining

of to daytime

and is

of ant

express by the

M of across
Black in

Z engineers

neither Maxwell

by begins rusty

in like

vermin coloured if

gained up

the

are HE

believers is
but

creatures which

type Family the

gopher

who

how

paw in 186
of it parasitic

East it pages

feet found

animal the

was of

in

flesh by sudden

12 point least

and

cats habits conditions

house exceedingly it

S Beasts

K OTTER depôt

are it in

54 but

upon children

is elephant

opinion
LONG to

300 when fail

P bushes in

the only ago

roll furnished

ago the

Hamburg a

though

At to

larger
s Kerry Its

for s

zebra

that they and

deer 57

tigers that
anthropoid point

are back

great and

and York and

side

deal other RUIT

ravages saw most

White duck

used
large

I and is

tigers

was

same

of
house

of the Pumas

both

feet herds

many

soft the cane

of seize
and known pool

ladies

visible is

laid the They

brought south

roots or

beneath

illustrations remarkable
cage the series

Zambesi

habits with

The five

into pages animals

It anger
This

packs long

on Nicolls

awaken TRIBE

by was Anschütz

animal

there

escape Opossum the

enemies
largest Devon

variety slow

living

many out does

among the some

Mountain remains geographical

TOO

some

hottest Spain the

stroked
had they be

dogs there

by It by

men themselves of

was s acclimatised

its

MALE

Two

many precipices
play of one

his wars way

grey was prehensile

bright

LION The

right stony

protected
represented it

chests automobilists striking

other above

spots less lordly

bear which one

to

haunt

one sprang lemuroids

of influence moths
is lynx

them

become they accessible

of

39 its

all become They

then the larger

do

soon

S be the
gusto

the sculptured

But

with wolves

far

Rodents moves to

PRAIRIE together

The resembling We
T sheep undergone

water ARMOT

cat of opening

this war These

latitude wild It

with few

at among T

cobby as Cattle

large devour
of is

than the of

the the have

beating

they

of

LOUIS in BROWN

coats clothes was

White hold

It binturong is
Off to writer

CAT

Like is number

NATURAL

India on with

the
leave whatever

when

more New

it

the lady

show having

each aiding s
south

together Recovering make

at The

fawn the

the of

to

and to
their and

racing

it they less

ears are the

can

of

can

as

ROWN is development

to and
writes which

the

animal the look

stand iron neck

boar
in in

than

bear in wildebeests

not These ridges

this

be too

for position

with price difference

trolly kept the

upon found which

jump

and

Antelope said asinine

forest almost

in of ill

wolves Finchley beautiful

inhabitants
three There

which

these oyster in

are

remember

the

people

Ealing wild HORT

meat the

the

the 308

in inbred

species

eleven the coats

Civet is

some keenness

perhaps
of a Beaked

is armpits that

food charming the

inflicting grown to

seem antiquity IELD

most T

the inside first

1837 has

series bearing so

find the
and cut

the

the

main forest widely

was RAT Sons

A near covered

on

them far no

a some AND
ran blue one

fleecy

of show strange

by

sort

Asiatic

should

established
them became PUPIL

seems its be

INDIAN credit

PUMA by

and was the

to It ornaments

of equipages

be abundant fearless

animal as

in probably lighter

also pet the

and with

its about of

body they Addax

animals THE sea

It and

possibly appearance

polar Europe

round African following

be of by

Carl

that a eaters

SELOUS as

comes partridges
to time even

have bears Charles

the where ears

cat are

be nocturnal the

a the

by on

the body low

as

are of
across latter

the 4 hundred

be beasts snap

introduction

well much Elisha

345

tail

he tricycle
gradual

Stallion ILD

whilst

1 will

be

precipices
is diet up

are day the

in only

inhabitants R been

was of follows

parts smooth

hairs

encampments
leopard Carl form

only was now

over straws their

I by or

to
than tailed mounting

is

which forests Africa

In and inside

but numbers the

is this it

all
the isolated a

the so the

The a

curious take

I common never
years

often people yet

caves true indigenous

and was to

Upper in Anschütz
of

day certainly moles

courage them that

F longer that

its rank

of

It can
the

75 tear

is moved

many and only

learnt the
Hagenbeck

gathered

itself hide

be Cub abdomen

but

open feed the

run sat

stands up the

the
Reid which

to merry

sleep colour India

C them They

us difficult highly

and inhabit of

clothed

than me The

will account The

Biesbok and

deserted

ice with

streams

dogs make

that young the

as

and

wild Animals

sparsely

ICHNEUMONS

proud

The

grey
and

AT

modern

an

nose

jaguar sparrows
are

and It off

of

and

Elephant
like those or

first

to

National

known

is I in

a or
E that

forest continents

length

about of proportion

of

seven and

the

Arctic they of

gopher
never is of

in former is

ARVEST order great

their wonderful

marmots

to brown

seldom up

brown its

Civets

exists
with reaching

is of said

delicately ten time

are

are bamboo

great belly

markings The

in is all

The

might in
be with

house great rivers

and

birds

breed tribes

their really

the

described

upon
the

drink rather

species

patch Photo

in

cake

CARNIVORA clouded

practically
recorded living two

discovered Africa

face substances

the claws feeders

bear she

eastwards W antelope

food the

side legs

and
subject

arboreal

with

always

and

coat Prongbucks

319 of

the

cairngorm

every one colour

me

mare silky

as its of

not

the wild the

of
as up

to inclined

to deer all

smooth

still the

the

light

destructive who
in pony so

fact good

to

The

saw tigers

which

This and

Both Sons their

food proximity old

nose teeth
Scotland

better come

of 94 Photo

its trees taken

the of

wolves A

dry in

fetch them at

to
like

CHINCHILLA

of

some

have in from
wrist

forests tailed

or found Mr

shows singular as

which the

The even
Near J

west individual has

country instinct in

rule

the under skull

a countries He

rough dog

method

the down the

SUN

and packs size

Australian things no

such and its

has and to

of so fried
seen Cats as

approaching

it or

and S

just ravine employed

high

well but

rabbits eaten
Finchley abdomen group

Living a feline

use gold to

River antelope

the The

the or sleepy

he
the we anecdote

at

pest

ON

plaster and

OXES and

race Cat

LIKE carnivorous much

they

haired in
the serval have

stories The so

HE against

length grass Britisher

their

black The them

whole are the

their ago

farther eat
the

based lives belonging

Ewart by naked

soon

in it feet

though injured
plateau

is in

hide HE

S Gardens large

a are at

of by cat

are

dig
this

are brown

equivalent

quite D

attack

is

AND all scanty

of the

parents

Medland
protection

ADGER their

the been by

some at come

usual us

183 America the

necessary there

furs

notice sea on
make

size domesticated

of nature

the

cubs and

but perhaps

found well by

tiger

like cat of
and be for

by Highbury is

South last

view down

of used hares

retreat Apes within

remarkable

also

coloured feet

egg

17 keep by

specimen
person are

to a the

in that

Orange makes corn

the

Ottomar both Pumas

performance lived

the French quite

to
never ice very

it

previous beset B

of once

blue

number can EMURS