How to Intervene with a Friend
Talking to
a student about suspected eating problems is difficult to do,
but it is often a critical component in the student getting needed
help. Here are some guidelines to assist concerned significant
others in this process.
Before:
Decide upon
one or two caring individuals who will approach the person you
are concerned about. Close pre-existing relationships are often
facilitative of a successful conversation. This individual(s)
should be prepared to encourage the person to seek further help
with a trained professional.
Establish
a private, safe environment. Be sensitive to what the student
is doing immediately after your conversation (e.g., choosing
to talk to a student about your concerns immediately prior to
an exam would not be a good choice, as s/he might be upset and
distracted by the conversation).
Consider
rehearsing what will be said.
During:
Start by
letting the person know you are reading and learning about eating
disorders.
Next, express
your concerns in a straightforward, yet caring manner. Share
two or three specific examples/times when you felt afraid or
uneasy. Use an “I” message format:
Example:
I noticed you’ve been avoiding meals with us lately. I
wonder if we could talk about that?
Example:
“I feel concerned about the weight you’ve lost this
past semester. I was hoping we could talk about this.”
Example:
I feel concerned because it seems like you’ve been dieting
for a long time now. Is it possible for us to discuss this?”
Then, give
the person time to talk and encourage him/her to verbalize feelings.
Continue to engage discussion by asking clarifying questions
and accepting responses in a non-judgmental manner.
Be prepared
for strong feelings/reactions from the person (i.e., denial,
anger, confusion).
Throughout
the discussion, strive to avoid:
a.) Offering
advice.
b.) Lengthy discussions that often end up in power struggles.
c.) Offering simplistic solutions (i.e., “why don’t
you just eat?).
d.) Making “you” statements (i.e., “you have
to eat something.”).
e.) Saying things like “you’re getting too skinny.”
Instead, put it in health terms, i.e., “I am worried because
you seem preoccupied and don’t have much energy lately.”
f.) Debate concerning food eaten or not eaten, calories consumed,
and/or looking for reasons that contributed to the development
an eating disorder. Remember—your primary purpose is to
be supportive and to encourage the person to seek further help.
Toward the
end of the discussion, provide information and resources for
counseling/treatment. At this point you might offer to go along
and wait while he/she has a first appointment.
Close the
discussion by letting him/her know you are willing to talk again.
Example:
“I know you feel things are okay, but that will not change
my concerns. So, I may bring this up at another time in the
near future, or we can talk again anytime you would like.”
After:
If the person
declines your request to seek further help, remind yourself
you have done all it is reasonable for you to do. Realize you
will have made important progress in honestly sharing your concerns,
providing support, and offering available information and resources.
You may never see the end result of your interventions, however
your concern can make a real difference in someone’s life.
If you are
concerned about the student’s immediate well-being from
a medical standpoint (and you are not a parent or family member),
you may carefully consider contacting her/his parents or another
trusted close friend or family member. This is a difficult decision
to make and one that should not be taken lightly or without
considering the nature of the student’s relationship with
her/his family.
If you have
written information that you have obtained about eating disorders,
you might consider sharing this along with a list of referral
information with the student. S/he may come back to these resources
some time after your conversation.
If you have
a social relationship with the student, do not stop inviting
her or him to events which include eating. Like others, anorexic
individuals benefit from social interaction, even if they don’t
eat. By eating with bulimic individuals, you will not be encouraging
their bingeing and purging, as these are usually done in private.
In future
casual interactions, don’t mention size or weight or draw
attention to the student’s food intake. Comments on small
size are taken as compliments, whereas statements on weight
gain are threatening and stressful. Do comment on the student’s
internal rather than external qualities. Remind them of their
worth as persons without regard to their outward appearance.
Also, don’t follow a bulimic individual to the bathroom
to listen for vomiting. This will only intensify guilt and encourage
more secrecy.
Attempt
to promote a climate of body acceptance by not recommending
or engaging in fad diets.
These only encourage abnormal eating patterns. Recognize that
others pay attention to and learn from the way you talk about
yourself and your body. Talk about yourself and others with
respect and admiration. Choose to challenge the false belief
that thinness and weight loss are great, while body fat and
weight gain are horrible or indicate laziness, worthlessness,
or immorality.
Talk to
a counselor for consultation and support if you are having strong
reactions or need additional assistance related to a student’s
eating disorder.
Resource
List*
It is ideal
for an individual with an eating disorder to work with a team
of practitioners – often a physician, psychiatrist, psychologist,
and nutritionist. Often, students feel more comfortable with
one type of care provider over the others. If you know of such
a preference, you can gear your recommendations in that direction
and know that the professional involved will make additional
referrals.
Counseling
Center, Parker Hall, 882-6601
The Counseling Center offers consultation services for friends,
faculty and staff; free individual and group counseling for
students; and free short-term counseling and referral information
for faculty and staff (through the Employee Assistance Program).
The Counseling Center also offers educational presentations
for your group. Call to schedule an appointment or request a
program. http://www.missouri.edu/~councwww/
Psychological
Services Clinic, 211 South 8th Street, 882-4677
The Psychological Services Clinic provides individual, couples,
family, and group therapy; the clinic accepts insurance and
provides fee assistance if needed. The Psychological Services
Clinic also offers educational presentations for your group.
Call to schedule an appointment or request a program.
Student
Health Center, 4th floor University Physician's Medical Building,
882-7481
The Student Health center offers medical (including psychiatric
& nutrition counseling), psychological and health education
services. The Student Health Center also offers educational
presentations for your group. Call to schedule an appointment
or request a program. http://www.studenthealth.missouri.edu/EatingDisorders.php
Wellness
Resource Center, 34 Brady Commons, 882-4634
The Wellness Resource Center houses a free resource library
for self-help and research including pamphlets, posters and
books. The Wellness Resource Center also offers educational
presentations for your group and free sessions with a dietician/wellness
coordinator. Call to request a program or an appointment. http://wellness.missouri.edu
Women’s
Center, 229 Brady Commons, 882-6621
The Women’s Center provides free individual and group
counseling and a resource lending library. The Women’s
Center also offers educational presentations for your group.
Call to schedule an appointment or request a program. http://www.missouri.edu/~stulife/women/eatingrp.html
*For more detailed referral information, visit http://loveyourbody.missouri.edu/resources.htm
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