by Emalee Gillis, NAMI Spokane Blog Editor.
The latest developments in brain research have led to a cutting-edge treatment for Anorexia that is now available in Spokane. Temperament Based Treatment with Supports or TBT-S offers a treatment approach for Anorexia that focuses on treating the inside out, starting with addressing the biology before moving on to managing symptoms.
Krista Crotty, founder and Clinical Director of Brain Based Therapy NW, explained that eating disorders are a biological brain based mental health condition.
She added, “Depending on which diagnosis we are talking about we can understand where there are misfirings in the brain for a majority of people.”
Addressing those misfirings are a fundamental part of TBT-S.
“For example,” she said, “if your brain isn’t sending a hunger cue because part of your brain is misfiring, you don’t get the cue to eat. Previously, people said not eating was a choice. But for some of those individuals, their brain is not sending the message to eat or to stop eating for the person who binges. The more we understand the brain, the more we can use interventions that target areas of the brain that are causing the disorder.”
The brain is malleable and can be changed. TBT-S offers a series of interventions aimed at the biology of the disorder. TBT-S provides in-depth psychoeducation about the neurobiological causes of an eating disorder. Treatment is focused towards temperament and using interventions that align with a person’s biological temperament.
Crotty added, “Through our practice, we can see some shifts in the firing of the brain.”
A cornerstone of TBT-S is support. Crotty offers a five-day intensive treatment for TBT-S in which from one to four support people for the client also attend. A support person could be a parent, a sibling, partner, or friend. This involvement of Supports is in contrast to the way clients are typically separated from their support system during treatment. Through TBT-S, the role of each support person is identified and each person knows what is most helpful for them to do for the client. People walk away with a very specific plan for their own recovery that includes the use of their Supports.
“TBT-S believes that involving family and caregivers in the treatment process can help individuals with eating disorders recover faster and/or maintain their recovery. TBT-S understands that support from family and loved ones plays a crucial role in a patient’s long-term recovery,” said Crotty.
Other components of the program include meal coaching through an on-staff nutritionist, skills training that involves elements of Cognitive Behavioral Therapy and behavioral agreements.
TBT-S was designed initially for adults with Anorexia. However, since its inception, there is evidence that it is effective with adolescents with Anorexia and research is exploring efficacy with other types of eating disorders. Positive outcomes have already been seen in the treatment all types of anorexia and some with Bulimia. Crotty offers programs for both adults and adolescents through her practice.
Crotty said it has been rewarding to watch people recover, especially for those who have struggled for a long time and tried other treatments.
“TBT-S works because people understand their own neurobiology, so they are able to understand what is happening in their specific brain. In addition, after the training, they are able to identify and communicate their needs to their support team. The support team becomes aware of avoiding saying things that are not helpful and learns what to say that is helpful. Clients feel more supported by their loved ones,” said Crotty.
Crotty has been training in TBT-S since 2018. She has completed multiple courses and certifications. She is certified as a trainer and treatment provider by the authors of TBT-S at the TBT-S Treatment Institute. She trains others nationally and internationally. She recently trained a team in Norway as well as a team in Boston.
To learn more, visit the website of Brain Based Therapy NW, send an email, or call 509.904.6404. The next five-day intensive treatment program for adults in Spokane is scheduled for March and the next five-day intensive treatment program for adolescents is scheduled for June. If you are a treatment provider, the next training for treatment providers is in May in Seattle, WA. Some insurance companies cover part of the treatment on a case-by-case basis, and Crotty is working to expand insurance coverage for TBT-S,
Krista Crotty is the founder and Clinical Director of Brain Based Therapy NW. She has been treating eating disorders for over twenty years. She offers five-day intensive treatment programs in Spokane and also offers training nationally and internationally.
Emalee Gillis is a writer and blog editor. She is the author of the memoir Adventures on the Path to Living Well with a Mental Illness and has a related TEDx Talk.