ARFID 101
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
Earlier today, I was honored to present a webinar on Avoidant-Restrictive Food Intake Disorder (ARFID) for Families Empowered and Supporting Treatment for Eating Disorders (FEAST). AFRID is a relatively new diagnostic category which was first added to the Diagnostic and Statistical Manual of Mental Disorders – Volume 5 (DSM-5) in 2013. ARFID is characterized by a pattern of avoidant or restrictive eating behaviors which led to significant nutritional, medical, developmental, and/or social-emotional consequences. Individuals with ARFID may restrict their food intake for a variety of reasons. So ..read more
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FIGHT, FLIGHT, FREEZE: The Acute Stress Response in Anorexia Nervosa Recovery
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
The human body has evolved to protect itself from danger.   The acute stress response, also known as the “fight or flight” response, describes the body’s physiological reaction to a perceived threat.   In response to acute stress or danger, the body’s sympathetic nervous system is activated by the sudden release of hormones.  In turn, the adrenal glands secrete hormones, including adrenaline and norepinephrine, which prepare the body for immediate action to fight off a predator (“fight”) or flee from danger (“flight”).   The “fight or flight” response involve ..read more
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Fasting and Eating Disorders: A Slippery Slope
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
Monday, September 28, is Yom Kippur, the Day of Atonement. Yom Kippur is considered the most important holiday in the Jewish faith and is typically observed by a day of fasting and religious services. Every September, as Yom Kippur approaches, I engage in conversations with my Jewish patients and their families about observing this holiday.   Families that are dealing with eating disorders frequently ask me if they, or their child, should fast for Yom Kippur.  I believe strongly that anyone who has an eating disorder, is predisposed to developing an eating disorder, or has a hi ..read more
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Metamorphosis: Long-Term Therapy with Young Adults
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
One of the most rewarding aspects of my job is the opportunity to engage with patients in long-term therapy.  In my practice today, I have a number of patients who began treatment with me years ago, in adolescence, and are now in their 20’s.  These patients first presented in my office with their parents during middle school or high school, suffering from severe eating disorders or depression or debilitating anxiety or, in some cases, all of the above.  Some entered treatment kicking and screaming; others reluctant but resigned; still others wanting help and suffering despe ..read more
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The 4 P’s of Mental Health Treatment
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
I like to conceptualize the etiology and treatment of mental illness using the framework of the 4 P’s: predisposing factors, precipitating factors, perpetuating factors, and prognostic factors. Predisposing Factors are risk factors which create vulnerability to developing a particular illness.   Examples of predisposing factors: Genetics Temperament Multiple adverse childhood experiences (childhood traumas) Why are they important? Predisposing factors are important in helping individuals and their families understand their vulnerabilities and in alleviating the guilt, shame, blame ..read more
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For Teens, Smartphone Dependence Predicts Later Depression
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
We have known for years that excessive smartphone use is correlated with depression. However, until recently, the direction of causality was not known. Does excessive smartphone use cause people to become depressed? Or do people who are already depressed use their smartphones more often, leading to unhealthy dependence? A recent study published in the Journal of Adolescent Health lends support to the former hypothesis. This study, which followed adolescents between the ages of 17-20, found that dependence on smartphones at the start of the study predicted depression and loneliness three months ..read more
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Kids who Diet: There’s an App for That, But Shouldn’t Be
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
WW International, the company formerly known as Weight Watchers, recently launched an app called Kurbo which is designed to help children ages 8-18 to diet and lose weight. The app is marketed as a “health coaching” tool, but a closer look at the company’s website reveals testimonials of children losing weight and dropping BMI points, complete with “before” and “after” photos. In recent years, the words “diet” and “dieting” have been replaced with words like “wellness” and “healthy eating” in popular nomenclature. But more often than not, when people refer to “eating healthy,” they are talkin ..read more
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Empowering Parents to Support Adolescent Eating Disorder Recovery
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
I am honored to be spotlighted by LEAD, inc as a mental health advocate.  LEAD is a nonprofit mental health advocacy organization founded in 2012 by a group of high school students.   LEAD offers innovative, engaging, evidence-based programs which improve early intervention for mental illness. As a clinical psychologist treating children, adolescents, and young adults, I am a strong proponent of early, aggressive, evidence-based interventions for young people who are struggling with mental illnesses.  My personal and professional values align closely with those of LEAD, so ..read more
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Updated Summary of Treatment Outcomes
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
Since opening my private practice in 2009, I have been privileged to work with over 300 individuals and families, providing consultation, evaluations, and treatment for a variety of mental health conditions.  I believe in being transparent and straightforward about the services I provide and why I provide them.  Individuals who are seeking mental health services for themselves or for their children have a right to know what treatment with a particular provider will actually be like, how long it will last, what outcomes they can expect, and what factors contribute to a more or less fa ..read more
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End of Treatment Outcomes for Patients with Bulimia Nervosa (2009 – 2017)
Dr. Sarah Ravin | Eating Disorders, Depression, Anxiety, Psychotherapy
by Dr. Ravin
2y ago
The following is an analysis of all patients who presented for treatment with a primary diagnosis of Bulimia Nervosa between the start of my private practice in 2009 and spring 2017.  Given that this is an analysis of end of treatment outcomes, patients who were currently in treatment with me as of spring 2017 or later were not included in this sample.  Patients and families whom I saw only for evaluations or consultations rather than treatment were not included in this sample. Description of the Sample This sample includes 13 individuals, all female, who were between the ages of 14 ..read more
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