Keynotes
International Keynote Address on Friday 23 August
Can psychotherapy for eating disorders have neurobiological effects?
We have long considered psychological therapies for eating disorders to be “psychosocial interventions” and other treatments (such as medications and brain stimulation) to be “biological interventions.” But is this a classic error of Cartesian dualism? In psychotherapy we aim to intervene on cognitions and behaviors, but successful changes in these psychosocial domains may have profound downstream effects on brain structure and function. For example, cognitive and behavioral changes may lead to normalization of brain function, or the recruitment of additional brain areas to facilitate normalization of mental and behavioral processes. In turn, these neurobiological changes may impact subsequent cognitions and behavior in a reciprocal feedback loop. Indeed, mounting evidence from psychotherapy trials for anxiety and mood disorders suggest that these neurobiological effects are common across diagnosis, and that biological changes often align conceptually with the very psychological mechanisms that are theorized to underlie symptom change. To date very few studies have evaluated the neurobiological effects of psychotherapy for eating disorders. Join Dr. Jennifer Thomas, whose team is conducting the first randomized controlled trial to understand brain mechanisms of cognitive-behavioral therapy for avoidant/restrictive food intake disorder, to explore exciting new findings, and discuss their potential applications to the eating disorder treatments of the future.
Can psychotherapy for eating disorders have neurobiological effects?
We have long considered psychological therapies for eating disorders to be “psychosocial interventions” and other treatments (such as medications and brain stimulation) to be “biological interventions.” But is this a classic error of Cartesian dualism? In psychotherapy we aim to intervene on cognitions and behaviors, but successful changes in these psychosocial domains may have profound downstream effects on brain structure and function. For example, cognitive and behavioral changes may lead to normalization of brain function, or the recruitment of additional brain areas to facilitate normalization of mental and behavioral processes. In turn, these neurobiological changes may impact subsequent cognitions and behavior in a reciprocal feedback loop. Indeed, mounting evidence from psychotherapy trials for anxiety and mood disorders suggest that these neurobiological effects are common across diagnosis, and that biological changes often align conceptually with the very psychological mechanisms that are theorized to underlie symptom change. To date very few studies have evaluated the neurobiological effects of psychotherapy for eating disorders. Join Dr. Jennifer Thomas, whose team is conducting the first randomized controlled trial to understand brain mechanisms of cognitive-behavioral therapy for avoidant/restrictive food intake disorder, to explore exciting new findings, and discuss their potential applications to the eating disorder treatments of the future.
Dr. Jennifer Thomas is the Co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, and an Associate Professor of Psychology in the Department of Psychiatry at Harvard Medical School. Dr. Thomas’s research focuses on avoidant/restrictive food intake disorder and other atypical eating disorders, as described in her four books — most recently Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults; and The Picky Eater’s Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder. She is principal investigator on several studies investigating the neurobiology and treatment of avoidant/restrictive food intake disorder, funded by the U.S. National Institute of Mental Health and private foundations. She is the author or co-author of more than 170 scientific publications. She is the immediate Past President of the Academy for Eating Disorders and recently completed a 5-year term as Associate Editor for the International Journal of Eating Disorders.
National Keynote Address on Saturday 24 August
Venturing out of our Cultural Comfort Zones: Diary of an Undercover Sister
This Keynote presentation addresses the evolving context of what bi-cultural responsiveness means for health practitioners and researchers in Aotearoa New Zealand, from the perspective of a Pākehā (New Zealanders of primarily European descent) psychologist and health researcher. The damning legacy of colonisation for Māori continues in plain sight across population indices of health and wellbeing, despite many decades of official reports decrying continuing inequities, but little, if, any improvement in outcomes. Mainstream health services In Aotearoa New Zealand competently deliver internationally-developed evidence-based treatments, albeit in the context of ever-increasing demand and complexities, with still limited treatment outcomes for eating disorders. Treatment recipients though are largely Pākehā, the dominant culture. Services continue to do less well in ensuring equitable uptake and appropriate treatment for Māori, including those with eating disorders. Parallel processes are evident in health research, with application of mainstream methods meaning most participants again are from the dominant culture, meaning Māori may be excluded from the benefits of research. Continuing to do things in the same way inevitably guarantees the same outcomes. Further development of health care services delivered by Māori for Māori is necessary but most health care delivery will still sit with mainstream services. Solving deeply entrenched inequities requires systemic change at every level, including across the entire health and health research workforce. Over the past decade in particular, expectations have increased for non-Māori practitioners regarding their cultural responsiveness and capacity for safe treatment delivery for Māori. If Pākehā practitioners are not part of the solution, we remain part of the problem. Becoming part of the solution though requires non-Māori to overcome our Pākehā paralysis - recognising our privileged positions within mainstream society and institutions, and stepping up to step outside our comfort zones. It requires venturing into unfamiliar spaces with different frameworks and world views, navigating mixed messages, sitting with uncertainties and especially with our fear of getting it wrong. This address illustrates these issues, informed by observations of developments over the course of my career, with reflections and hopes for the way ahead.
Jenny Jordan is an Associate Professor in the Department of Psychological Medicine, University of Otago, Christchurch, New Zealand where she teaches on postgraduate mental health and addiction papers. She also works as a clinical psychologist for Te Whatu Ora- Waitaha Canterbury Specialist Mental Health Clinical Research Unit on psychotherapy research studies, and clinically in an outpatient alcohol and drug service. Her primary research interest is clinical research for significant mental health problems, including comparative psychotherapy trials, translational research, and examining factors influencing psychotherapy outcomes. She co-leads the New Zealand site of the EDGI (eating disorders genetics initiative) international consortium study. She has been an investigator and therapist on two randomised controlled trials for eating disorders: the original trial where SSCM was utilised for anorexia nervosa for the first time, and a trial of three cognitive therapies for those with bulimia nervosa or binge eating disorder. She has a strong interest in improving equity in research participation and health outcomes and is privileged to work with and support emerging Māori researchers as they develop their research platforms in eating disorders. She is an author or co-author of more than 120 scientific publications and is on editorial boards for IJED and Eating Behaviors.
Venturing out of our Cultural Comfort Zones: Diary of an Undercover Sister
This Keynote presentation addresses the evolving context of what bi-cultural responsiveness means for health practitioners and researchers in Aotearoa New Zealand, from the perspective of a Pākehā (New Zealanders of primarily European descent) psychologist and health researcher. The damning legacy of colonisation for Māori continues in plain sight across population indices of health and wellbeing, despite many decades of official reports decrying continuing inequities, but little, if, any improvement in outcomes. Mainstream health services In Aotearoa New Zealand competently deliver internationally-developed evidence-based treatments, albeit in the context of ever-increasing demand and complexities, with still limited treatment outcomes for eating disorders. Treatment recipients though are largely Pākehā, the dominant culture. Services continue to do less well in ensuring equitable uptake and appropriate treatment for Māori, including those with eating disorders. Parallel processes are evident in health research, with application of mainstream methods meaning most participants again are from the dominant culture, meaning Māori may be excluded from the benefits of research. Continuing to do things in the same way inevitably guarantees the same outcomes. Further development of health care services delivered by Māori for Māori is necessary but most health care delivery will still sit with mainstream services. Solving deeply entrenched inequities requires systemic change at every level, including across the entire health and health research workforce. Over the past decade in particular, expectations have increased for non-Māori practitioners regarding their cultural responsiveness and capacity for safe treatment delivery for Māori. If Pākehā practitioners are not part of the solution, we remain part of the problem. Becoming part of the solution though requires non-Māori to overcome our Pākehā paralysis - recognising our privileged positions within mainstream society and institutions, and stepping up to step outside our comfort zones. It requires venturing into unfamiliar spaces with different frameworks and world views, navigating mixed messages, sitting with uncertainties and especially with our fear of getting it wrong. This address illustrates these issues, informed by observations of developments over the course of my career, with reflections and hopes for the way ahead.
Jenny Jordan is an Associate Professor in the Department of Psychological Medicine, University of Otago, Christchurch, New Zealand where she teaches on postgraduate mental health and addiction papers. She also works as a clinical psychologist for Te Whatu Ora- Waitaha Canterbury Specialist Mental Health Clinical Research Unit on psychotherapy research studies, and clinically in an outpatient alcohol and drug service. Her primary research interest is clinical research for significant mental health problems, including comparative psychotherapy trials, translational research, and examining factors influencing psychotherapy outcomes. She co-leads the New Zealand site of the EDGI (eating disorders genetics initiative) international consortium study. She has been an investigator and therapist on two randomised controlled trials for eating disorders: the original trial where SSCM was utilised for anorexia nervosa for the first time, and a trial of three cognitive therapies for those with bulimia nervosa or binge eating disorder. She has a strong interest in improving equity in research participation and health outcomes and is privileged to work with and support emerging Māori researchers as they develop their research platforms in eating disorders. She is an author or co-author of more than 120 scientific publications and is on editorial boards for IJED and Eating Behaviors.
