Assessment, Consultation, and Intervention for Eating Disorders in Schools
Jennifer Maskell Carney and Heather Lewy Scott
Mr. James is a school counselor at a large public high school. A few months into the school year, a teacher came to him with concerns about Elena, a freshman straight-A student. Mr. James knew Elena as a rather quiet and shy girl who kept to herself. The teacher said that she had heard from other students that Elena had lost a considerable amount of weight over the summer. One of the students also told the teacher that Elena had stopped coming to the cafeteria for lunch. Recently, the teacher noticed that Elena did not eat her cupcake when there was a celebration in the classroom. The teacher said she did not know whether there was a real problem but thought it might be a good idea to inform Mr. James about the situation.
As this brief vignette illustrates, knowledge about eating-related concerns in children and adolescents is essential for counselors who work in the school setting. These types of concerns in young people can range from body image issues to full-syndrome eating disorders (EDs) that threaten physical health and devastate self-esteem. Because anorexia nervosa most often occurs in young women between the ages of 15 and 19 (Keski- Rahkonen et al., 2007), and bulimia nervosa most often occurs in young women between the ages of 16 and 20 (Keski-Rahkonen et al., 2009), many individuals who develop EDs are students who spend significant time at school around their peers and school faculty. School counselors, therefore, are in a unique and important position to detect student eating issues in the early stages and to take steps to ensure student needs are being met. The purpose of this chapter is to provide a resource for school counselors to assist in identifying, assessing, and intervening with students who have eating-related concerns.