Eating disorders are serious mental illnesses that can have a severe, and even fatal, impact on a person’s physical health. Individuals who are living with an eating disorder can have unhealthy eating patterns, disturbances in their relationship with food and the perception of their own bodies. In this post, I discuss 15 eating disorder group therapy activities you can use with your clients.
The National Institute of Mental Health (NIMH) identified binge eating disorder and bulimia nervosa as common eating disorders. Anorexia Nervosa is less common; however, it is still present in the United States.
NIMH shared that the average age of onset for binge eating disorder was 21 years old, whereas the average age of onset for bulimia nervosa and anorexia nervosa was 18 years old.
Research has shown that females are more likely to struggle with an eating disorder than males. While it may not be as common, men can have a significant struggle with eating disorders. The National Comorbidity Survey Replication (NCS-R) showed that from 2001-2003, eating disorders were more common in individuals between the ages of 45 to 59, followed closely by individuals 18-29 years old.
As Counselors, when we work with individuals who are living with an eating disorder, we need to be mindful of other mental health concerns that our clients may be living with. The 2001-2003 NCS-R showed that other common mental health concerns include anxiety disorders, mood disorders, impulse control disorders, and substance use disorders.
While the average onset for the most common eating disorders is in an adult age, the prevalence of eating disorders in adolescents. The 2001-2003 National Comorbidity Survey Adolescent Supplement (NCS-A) showed that eating disorders were most common in individuals who were 17-18 years old, followed by 15–16-year-olds, and 13-14-year-olds, respectively. Similarly to adult populations, eating disorders are more common in female adolescents than in males.
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder where individuals limit what they eat, however, they do not worry about their body shape, size, or weight. ARFID can be present in adults and children. Children living with ARFID may be extremely picky eaters which can have a concerning impact on their health.
How Does Group Therapy Help Individuals with Eating Disorders?
There are a variety of benefits that can come from group therapy in eating disorder treatment programs. Group therapy sessions can be a healthy environment to provide psychoeducation about various topics related to a healthy recovery.
Group therapy gives our clients the opportunity to connect with others who can relate to their challenges and experiences. Individuals who are living with an eating disorder may have withdrawn from their friends and family, leading to an isolated life. Connecting with others can be a validating experience that supports recovery. Additionally, it provides our clients with a safe environment to practice social skills that they may feel uncomfortable with.
Group therapy provides our clients with a safe and supportive environment where they can come and speak about their struggles and triumphs. They will also have the opportunity to provide support, compassion, and encouragement to others which can be a rewarding experience in itself.
Counselors who are facilitating eating disorder group therapy activities can tailor group activities to address common concerns group members are experiencing. Group therapy eating disorder activities can promote group discussion and participation among group members.
List of Group Therapy Activities for Clients with Eating Disorders
There will be notable differences in the ideal group therapy activities for your group based on group member characteristics. As an example, if you have a group of adolescents who are living with an eating disorder, your group activities will likely look different and address different topics than group activities for adults. Below is a brief list of group therapy activities for eating disorders:
- Provide the group with the materials needed to write a letter about their eating disorder. Ask them to name it, and write to it as if it were an external entity. Let them know that they will be sharing these letters with the group, will be provided with support, and will have their choice of what to do with the letter. Group members can keep the letter, rip it up, throw it away, shred it, or burn it. This exercise should focus on allowing them to openly express themselves.
- Spend a group session providing education about different forms of eating disorders and their prevalence of them. This would also be an appropriate time to talk about individuals who find themselves crossing over to other disordered eating behaviors when they struggle.
- Ask group members to write down their top triggers for their eating disorders. This can include external factors such as locations or certain people, or internal factors such as boredom and emotional distress. Remove each trigger independently, and spend time talking about ways to healthily respond and manage the identified triggers.
- Spend time reviewing different forms of meditation. Allow time in the group to practice various forms of meditation to expose group members to the types of meditation. This can include guided imagery and muscle relaxation. Encourage group members to use one or more of these before the next group session. Follow up in the next session to explore any practices outside of the group.
- Spend time exploring the role that healthy support can have on group members’ recovery. Talk about characteristics associated with individuals who are healthy supporters and those associated with individuals who are not supportive.
- Provide psychoeducation about other mental health concerns that can occur when an individual is struggling with an eating disorder. This can include anxiety disorders, mood disorders, impulse control disorders, and substance use disorders.
- Spend a group talking about mindfulness, specifically the 7 principles associated with it. Spend time exploring which of these members feel would be challenging for them, and which may come easier to them.
- Spend a group talking about the use of grounding exercises as a healthy coping skill. Talk about how using our 5 senses can help bring us back to the moment, and out of the thought patterns that we are stuck in. Ask the group to identify situations where they feel grounding exercises could be helpful and encourage them to try using them before the next session. Allow time to follow up in your next session.
- Focus on providing group members with an understanding of how our thoughts, feelings, and behaviors are intertwined. Spend time exploring what thoughts lead to challenging emotions and unhealthy behaviors for the group members. Spend time exploring how group members can work to be more aware of their thoughts to catch them as they occur, and what they can do to manage them.
- Spend a group talking about cognitive distortions. Normalize the presence of cognitive distortions, as this is something we all live with. Spend time reviewing how group members can effectively evaluate the reality of these thoughts, and how they can challenge them. Thought challenges can be an effective way to respond to cognitive distortions.
- Spend time reviewing mindfulness exercises that can be practiced anywhere, at any time. The convenience of these exercises supports their use as effective coping skills. This can include body scans, mindful seeing, mindful listening, mindful breathing, and exploring your 5 senses.
- Provide the group with materials needed to draw their safe place. Try to leave the directions vague, so that the group members can think about what their safe place truly is. This can be a fictional place, somewhere familiar, somewhere they’ve never been, or even being with a safe person. Review the identified safe places, and talk about how these locations can be incorporated into meditations.
- Spend time talking about what group members think self-care is. Provide education if needed, and talk about the role that regular self-care has on our mental health. Provide the group with a worksheet that lists various forms of self-care and ask the group to identify 2-3 new practices that they can try. Emphasize that self-care does not have to include spending money, or doing something extravagant.
- Provide the group with materials needed to create a timeline regarding their eating disorder. Ask them to include life events that they feel are relevant. Review the group members’ timelines, and connect any themes or common experiences that become apparent. Towards the end, ask the group to share where they would like to go moving forward, and what they are hopeful about.
- Spend time providing the group with information about the stages of change and what each stage can look like. Ask the group to talk about where they feel they are, and what that means for their recovery.
Final Thoughts on Eating Disorder Group Therapy Activities for Your Clients
Group therapy activities for eating disorders can be useful tools in outpatient and inpatient treatment programs. Group therapy tends to be more affordable than individual therapy, so for many, group sessions may be their only exposure to mental health treatment at that time. With that in mind, it is important to be mindful of the exercises that are used to ensure a purposeful use of your group session.
If you prefer to have a formal handout to guide your group therapy activities for eating disorders, resources such as our Eating Disorder Worksheets, can provide you with individual worksheets or packages that can guide your group sessions. A benefit to using handouts is that it gives your client something to take home from them that can be reviewed when needed.
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