Pathways to recovery: promoting change within a developmental-systemic framework

This article describes a format for the process of achieving therapeutic change through structured individual sessions with adolescents or adults with eating disorders. It is a model for change based on three separate existing theoretical or conceptual strands: Developmental theory; the application of systems theory and cybernetics to clinical practice; and feminist ideology. It was developed as a pragmatic, clinician-friendly model that could be successfully used by therapists from different disciplines, and is referred to here as developmental-systemic-feminist therapy or individual developmental-systemic therapy. Change in this context is defined as the overt and measurable alteration in feelings, thoughts and behaviours of the participant(s) over the course of treatment. The article provides an overview of the treatment model and outlines the five steps used to achieve change (explore; understand; accept; challenge; change). Essential components of the therapist's stance, skills and knowledge are described, followed by a discussion of the structure and content of sessions in different stages of the therapy. Finally, clinical examples are given to illustrate the clinical use of this model in young patients with eating disorders.