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Conceptualizing counsellor competence in the treatment of eating disorders Williams, Meris Andree Lineham


Counsellors are ethically obligated to provide only those services that are within the bounds of their professional competence (American Counseling Association [ACA], 1988; Canadian Counselling Association [CCA], 1999; Canadian Psychological Association [CPA], 1991). Counsellors who provide services to individuals with eating disorders (EDs) must be competent to do so, and must recognize the boundaries of that competence. The purpose of the study was to begin to identify the competencies associated specifically with psychotherapy for EDs. A three round Delphi procedure was employed to answer the following research question: according to experts in the treatment of EDs in British Columbia, what competencies are essential for basic, independent therapeutic practice with clients who have EDs? A panel of 29 expert participants from a variety of disciplines reached a consensus on 188 competencies thought to be "essential" to this work, and on 21 competencies thought to be "useful but not necessary". Based on an informal categorization of items, several topic areas were identified as having potential importance for competent practice: (1) aspects of the ED therapist's role may overlap with the activities of other health professionals involved in the treatment of EDs; (2) an interdisciplinary approach is key for client care; (3) the strength and quality of the therapeutic relationship can help or hinder a client's recovery from an ED; (4) empirically supported treatments for EDs were not considered "essential"; and (5) the therapist's resolution of his/her own experience of body dissatisfaction/disordered eating/an ED requires consideration. The list may help counsellors and counsellors-in-training who wish to work in the field of EDs to identify the competencies they possess and those they would like to develop in their education, continuing education, and training. Thus, the list could help them take steps in their responsibility to assess their competence to work with clients who have EDs.

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