As a therapist helping someone with a binge eating problem, you can take one of two roles with respect to this self-help program. You can directly help the person follow the program (“guided self-help”), or you can provide a completely different form of therapy while at the same time supporting his or her use of the program. In the latter case you may decide to have little or no direct involvement with its use. But even with this approach I suggest that you familiarize yourself with the program in case it clashes in any way with the help that you are providing.
An extensive and robust body of research in the United States and elsewhere has shown that guided self-help is a potent way of helping those with binge eating problems. It is certainly an excellent first step. It involves the person following the program supported by regular sessions with you. These can be quite brief (less than 30 minutes long) and need not be scheduled every week, although it is best to start this way. Since the program involves the person becoming his or her own therapist, your role differs from that in more conventional forms of therapy. In guided self-help you serve as a “facilitator.” Your primary role is to monitor the person’s progress, provide encouragement and, at times of difficulty, help him or her to identify solutions from within the program. To do this, you need to be thoroughly familiar with it.
An important aspect of your role in guided self-help is to keep the person motivated. Reviewing the monitoring records at the beginning of each session is a good way of achieving this goal since it provides a means of identifying and highlighting progress. Another aspect of your role is to ensure that the person moves through the program at an appropriate pace. Some want to go too fast; others want to go too slow. The sections titled “When to Move On” provide clear guidelines for when it is appropriate to progress from one step to the next. A third role is to keep the person focused on the goal of the program, which is to overcome his or her binge eating problem. While fulfilling these roles you must stay in the background, an unfamiliar stance for some therapists. Remember, guided self-help is a form of “self-help.” The person with the binge eating problem must remain in charge and be his or her own therapist.
There is one other way that this book can be used. Since it provides sound information and advice, it can supplement more conventional approaches to treatment. For example, it is widely employed as an adjunct to pharmacotherapy, cognitive behavior therapy, and other psychological treatments. In addition, it is often used by inpatient programs.