Are We Really Helping ? Counseling Diverse Clients With Eating Disorders
One of the most important aspects of counseling is the therapeutic relationship — establishing rapport and creating an environment where all clients feel welcomed . How is this accomplished when working with clients who are Black , Indigenous , and People of Color ( BIPOC )? Consciously and intentionally , the therapeutic space is not only a reflection of you , the clinician , but an invitation to all individuals to whom you provide counseling services .
Paula Edwards- Gayfield , LCMHCS , LPC , CEDS-S , regional assistant vice president at The Renfrew Centers , has more than 15 years of clinical experience . A Licensed Professional Counselor in Oklahoma and a Licensed Clinical Mental Health Counselor Supervisor in North Carolina , she is a member of the American Counseling Association , the Oklahoma Counseling Association , and a certified member and approved supervisor ( CEDS-S ) of iaedp TM . She is also a co-chair of the African American Eating Disorder Professionals — Black , Indigenous and People of Color Committee . pgayfield @ renfrewcenter . com
Unconditional positive regard , a concept developed by psychologist Carl Rogers , PhD , is important for Licensed Clinical Mental Health Counselors ( LCMHCs ) to offer clients so that they have a safe and nurturing environment in which to explore their own diversity and deepen their self-acceptance . This concept , the basic acceptance and support of a person regardless of their identities , is especially vital when considering diverse clients with eating disorders . As providers , it is our responsibility to demonstrate respect for differences and increase our awareness of factors that may affect diverse populations , including values , beliefs , patterns of acculturation , differing worldviews and effects of oppression , as well as individual differences within groups .
EATING DISORDERS IMPACT EVERYONE
When thinking of eating disorders , many people envision a white , female , middle- or upper-class adolescent or young adult . But eating disorders do not discriminate . According to the Academy for Eating Disorders , 9 percent of the population in the United States — 28.8 million Americans — will have an eating disorder in their lifetime . “ Eating disorders have historically been associated with heterosexual , young , white females , but in reality , they affect people from all demographics of all ethnicities at similar rates ,” the National Eating Disorder
Association ( NEDA ) points out on its website ( https :// www . nationaleatingdisorders . org / peoplecolor-and-eating-disorders ). Despite this prevalence , many individuals do not seek treatment for an eating disorder , especially Black people .
Binge eating disorder ( BED ) is the most common eating disorder diagnosed in Black individuals . Black women in particular may face feelings of ineffectiveness and other emotional factors that may drive binge-eating episodes , rather than restrictive diets . However , people of color — especially African Americans — are significantly less likely to receive help for their eating issues .
How eating issues present can be uniquely impacted by a person ’ s identity and experiences . According to social identity theory , the primary function of claiming membership in a social group is the enhanced personal self-esteem . Ethnic identity is positively related to self-esteem for females who are white , Black , and those with Latin heritage ; the more strongly people identify with their ethnic group , the more positive self-esteem they possess .
Black individuals experience higher rates of BED and bulimia nervosa in part due to stress , including acculturated stress
https :// bit . ly / 3xQet5p . Acculturation is the process by which an individual adopts the beliefs , attitudes , and behaviors of the dominant culture . This process may be accompanied by acculturative stress as the person of color navigates the balance of participating in the practices of the dominant culture versus the culture of origin , possibly resulting in discrimination and negative reactions from family and friends . A colleague who is a person of color expressed this as , “ It is like living in two worlds !”
It is important to note that these unique stressors go beyond general life stress . The degree of acculturation may account for body dissatisfaction and eating disorder symptoms ( i . e ., more acculturated = higher reports of eating disorder symptoms ).
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20 The Advocate Magazine Spring 2021 American Mental Health Counselors Association ( AMHCA )
www . amhca . org