About the Eating Disorders Continuum
Since its inception in 1986, the Douglas Mental Health University Institute’s Eating Disorders Continuum (EDC) has been leading the charge in treating Quebecers with eating disorders (ED). In addition to providing state-of-the-art care, the EDC conducts clinical research into the treatment and prevention of ED, and provides healthcare professionals at various levels of the healthcare system with training, consultation and supervision.
Background
The Douglas Mental Health University Institute’s EDC, in collaboration with eating disorder experts from the CHU Sainte-Justine and the Montreal Children’s Hospital, is pleased to announce the launch of ECHO Telementoring for ED (ECHO ED), a new knowledge-sharing program for clinicians working with individuals who have eating disorders.
About the ECHO ED Telementoring Program (FR only)
Notre programme de télémentorat est fondé sur le projet ECHO (Extension for Community Healthcare Outcomes). ECHO est une initiative d’éducation virtuelle ayant pour objectif de renforcer les connaissances et les capacités cliniques en partageant le savoir et les pratiques fondées sur les données probantes, à travers l’interaction et à partir de l’analyse de cas réels.
Dans le cadre de notre projet ECHO TA, nous souhaitons que les participants et les personnes-ressources travaillant auprès de patients touchés par les troubles de l’alimentation aient une opportunité d’échange de connaissances à partir de cas cliniques réels (proposés par les participants) et de les discuter de façon interactive. L’objectif de cette interaction est de permettre aux prestataires de soins d’améliorer leur pratique et les soins prodigués aux personnes qui recherchent leurs services. Ce programme est gratuit.
Who should join?
You should join if:
- You are a healthcare professional based in Québec;
- You work with adolescents or adults with ED;
- You want to expand or consolidate your knowledge and expertise in assessing and treating ED;
- You would like to consult with expert clinicians on issues encountered when managing individuals with ED, and even present a case;
- You would like to interact with other clinicians from across Québec who work with individuals who live with ED.
Structure of an ECHO ED Session
- A short didactic presentation on a topic of interest to those working with individuals who have ED is given by someone on our panel of experts (about 30 minutes);
- Q&A for the presenter;
- Semi-structured presentation of pre-submitted cases by participating partners (about 5 min);
- Interactive discussions and questions about real (and deidentified) cases among the participants and the ED experts, recommendations are made to the participants whose cases were discussed.
Resource Team Members
The presenter for the didactic video, and a panel of 5 to 6 experts on eating disorders to answer questions during case histories and discussions.
What equipment is needed?
- A tablet, smart phone or personal computer equipped with a camera, microphone and the Zoom application.
- A stable internet connection.
Sessions
Fall 2022 – Spring 2023
Frequency
Ten hour and a half sessions on Tuesdays, from noon to 1:30 pm, starting September 13, 2022 and ending April 4, 2023. The sessions are available in French only.
Our panel of experts consists of:
A presenter who gives the didactic presentation and 5 to 6 professionals specialized in ED to answer questions during the case presentation and discussion portion of the session.
Number of participants
The number of participants is limited to 100 per session. Registration on Eventbrite is mandatory.
1) Outils de la Thérapie Cognitivo - Comportementale (TCC) pour l’accès hyperphagique
Date: September 13, 2022
Presenter | Biography | Overview and learning objectives |
Lea Thaler, PhD | Lea Thaler, Ph.D. is a clinical psychologist at the Eating Disorders Continuum at the CIUSSS de l’Ouest-de-l’Île-de-Montréal’s Douglas Mental Health University Institute. She is also an assistant professor in the Department of Psychiatry at McGill University. She is currently the past-president of the Eating Disorders Association of Canada. Dr. Thaler is a licensed member of the Ordre des psychologues du Québec. At the Eating Disorders Continuum, she offers individual psychotherapy and also leads dialectical behaviour therapy workshops in both the Outpatient Clinic and the Day Program. She supervises psychology practicum students and interns and is an active researcher who studies epigenetics and eating disorders, as well as factors that impact treatment outcomes. | Binge eating disorder (BED) is the most common eating disorder, affecting 3.5% of women and 2% of men. It is a serious, but treatable eating disorder. This presentation will provide an overview of the cognitive behavioural therapy (CBT) for BED. The various treatment strategies and guidance used as part of this approach will be discussed. The tools used to help individuals with BED identify the main triggers for their binge eating will be discussed in detail. |
2) Évaluer et intervenir sur la motivation : un élément clé dans le traitement des troubles de l’alimentation
Date : October 4, 2022
Presenter | Biography | Overview and learning objectives |
Valérie Boily, M.D. FRCPC. | Valérie Boily is an assistant professor in the Department of Psychiatry at the Université de Sherbrooke. She is the medical director at the Clinique des troubles de l’alimentation du CHUS, which she founded in 2016. In addition to her studies in medicine (Université Laval) and in psychiatry (Université de Sherbrooke), she also has a bachelor’s degree in psychology (Université Laval) and completed an eating disorders fellowship (Douglas Institute). Her main areas of interest are the treatment of eating disorders and teaching psychotherapy. In 2020, she published an article on developing a sense of competency as a psychotherapist. | Individuals with eating disorders often lack the motivation to change their behaviours and recover. Various theories, such as the self-determination theory and the transtheoretical stages of change model were devised to provide alternatives to external control strategies. During the initial evaluation of an individual with an ED, determining their level of motivation for change and type of motivation is crucial. One of the clinician’s tasks is to foster and maintain the patient’s intrinsic motivation. The goal of this presentation is to review the theory of human motivation and the principles of motivational interviewing as they apply to eating disorders. Next, we will identity the key points in treatment when motivation must be re-evaluated, then we will look at strategies to maintain motivation for the duration of therapy in order to use it as a vehicle for change and to maintain that change. |
3) Comorbidités psychiatriques chez les enfants et adolescents ayant un trouble alimentaire
Date : October 25, 2022
Presenter | Biography | Overview and learning objectives |
Pierre-Olivier Nadeau, M.D. | Pierre-Olivier Nadeau is a physician, child psychologist and co-director of the Integrated Centre for Eating Disorders the CHU Ste-Justine. He is an assistant clinical professor and responsible for teaching psychiatric clerkship and residency students at the Université de Montréal about eating disorders. He is involved in research projects and regularly gives local, national and international conferences on eating disorders in children and adolescents. | A variety of psychiatric symptoms are observed in children and adolescents with eating disorders. This presentation will begin with a review of the secondary psychiatric symptoms commonly seen in children and adolescents with eating disorders. Then, we will discuss the psychiatric comorbidities most often associated with eating disorders in children and adolescents. And lastly, we will look at the treatment of these psychiatric comorbidities and the use of psychotropic medication. |
4) Indications pour les admissions
Date : November 15, 2022
Presenter | Biography | Overview and learning objectives |
Holly Agostino, M.D., FRCPC | Dr. Agostino completed her pediatric training at the Montreal Children’s Hospital (MCH) and went on to do a 2-year academic fellowship in adolescent health. She now works at the MCH’s Adolescent Medicine Clinic and is an assistant professor at McGill University. She has been the medical director of the MCH Eating Disorder Program since 2016, and sits on both the Royal College and Canadian Pediatric Society National Adolescent Medicine Committees. In 2021, she was selected to be part of the Executive Committee for the Canadian Pediatric Society for Adolescent Health. Her current academic and research interests centre around the medical management of eating disorders and the delivery of confidential care in a tertiary setting. | Eating disorders are one of the most chronic conditions in adolescents and are associated with a host of medical complications. Weight loss and malnutrition affect most of the body’s functions and often lead to severe physiological disturbances, with significant effects on every organ system. Cardiovascular complications are particularly serious. As a result, eating disorders have the highest mortality rate of any mental illness. |
5) Les troubles de l’alimentation et la personnalité limite
Date : December 13, 2022
Presenter | Biography | Overview and learning objectives |
William D. Pelletier, M.D. | William D. Pelletier is a physician and psychiatrist. He did his residency at the Université de Montréal. More recently, he completed a fellowship program in eating disorders at the Douglas Mental Health University Institute’s Eating Disorders Continuum. He currently practices psychiatry at the Hôpital en santé mentale Albert Prévost. He is also an assistant professor in the Psychiatry Department at the Université de Montréal. | Individuals with eating disorders often have multiple comorbidities. A common comorbidity is borderline personality disorder. The goal of this presentation is to make you familiar with this comorbidity. We will discuss the prevalence, clinical manifestations and treatment recommendations for those living with these disorders, with a special focus on dialectical behaviour therapy. All the information presented on the subject will come from a review of the scientific literature on the topic. |
Past sessions: Spring – Summer 2022
April 12, 2022: Meilleures pratiques dans des situations réelles. Howard Steiger, PhD. Douglas Mental Health University Institute.
April 26, 2022: L’évaluation initiale des TA. Chloé Paquin-Hodge, PhD. Douglas Mental Health University Institute.
May 10, 2022: Gestion des risques médicaux et psychiatriques. Mimi Israël, M.D. Douglas Mental Health University Institute.
May 31, 2022: Complications médicales chez l’adolescent. Danielle Taddeo, M.D. CHU Sainte-Justine
June 14, 2022: Traitement familial. Jason Bond, MD, EDC and the Montreal Children’s Hospital
Schedule for Fall 2023 – Spring 2024
Eight 1.5-hour Zoom sessions on Tuesdays, from 12:00 to 1:30 pm, on the dates below.
October 10, 2023: Managing co-occurring mental health problems in people with eating disorders
Presenter | Biography | Summary and Learning Objectives |
| Howard Steiger, Ph. D. | Howard Steiger is a full professor with the Psychiatry Department and an associate member of the Psychology Department at McGill University. For over 30 years, he directed the Douglas Institute Eating Disorders Continuum (EDC), where he continues to act as a clinical and academic consultant for the program. The EDC offers a full range of Inpatient, Day Treatment and Outpatient services to adolescents and adults affected by eating disorders and their families. An active clinician, researcher, and teacher, Dr. Steiger has published 190 articles and chapters on the eating disorders. He is Associate Editor of the Journal of EDs, Fellow of the Canadian Academy of Health Sciences, Fellow of the Academy for Eating Disorders, and has been Associate Editor of the International Journal of Eating Disorders, President of the ED Research Society, and Co-President of the Québec Charter for a Healthy and Diversified Body Image. Along with Dr. Booij, he is the ECHO co-organizer for 2023–2024. | Eating disorders are generally accompanied by other mental health issues in most of those who are affected. Furthermore, the presence of a comorbidity is often, if inconsistently, associated with less favourable treatment outcomes. However, no evidence-based protocol exists in the field of eating disorders to orient the treatment of coexisting mental health issues. This presentation looks at the principles that are part of the existing consensus on managing psychiatric comorbidities in the context of eating disorders. It will look at the recommended approaches in cases where the comorbidity is considered to be entirely separate from the eating disorder, in cases where it is a consequence of the eating disorder, and in cases where it interacts with the eating disorder in such a way that it interferes with the treatment outcome. One key question is to determine how to treat the comorbidity without taking attention away issues related to the eating disorder. This presentation will give participants:
|
November 14, 2023: Psychoeducation for eating disorders
Presenter | Biography | Summary and Learning Objectives |
| Shiri Freiwald, MA | Shiri Freiwald is a psychotherapist at the Douglas Mental Health University Institute of the CIUSSS de l’Ouest-de-l’Île-de-Montréal. She provides individual and group psychotherapy and works with the day program. She is also the coordinator for the continuum’s knowledge exchange program. Since 2009 this program has ensured the training and supervision of eating disorder professionals across the province. | This training session is intended to teach clinicians the essential concepts of psychoeducation for eating disorders. Sample cases and diagrams will be used to illustrate key concepts and the evidence supporting the psychoeducational approach will be reviewed. |
December 12, 2023: Assessing physical sequelae and medical risk in people with an eating disorder: A practical guide for clinicians
Presenter | Biography | Summary and Learning Objectives |
| Mimi Israël, M.D. | Mimi Israël is a psychiatrist and Chief of the Douglas Mental Health University Institute’s Eating Disorders Continuum. She is an active contributor to the program’s clinical, teaching, research, and knowledge transfer missions. She is also a consultant psychiatrist to first-line community mental health care teams and an Associate Professor of Psychiatry at McGill University. | This course is intended to provide clinicians with information on evaluating and managing medical sequelae in people with eating disorders. We will discuss how to evaluate the severity of the eating disorder in order to determine a risk level. We will also discuss the signs and symptoms to look out for, and interventions to minimize the risks. |
January 16, 2024: Atypical anorexia nervosa in adolescents
Presenter | Biography | Summary and Learning Objectives |
| Holly Agostino, M.D., FRCPC | Dr. Holly Agostino completed her pediatric training at the Montreal Children’s Hospital (MCH) and went on to do a 2-year academic fellowship in adolescent health. She now works at the MCH Adolescent Medicine Clinic and is an Assistant Professor at McGill University. She has been the medical director of the MCH Eating Disorder Program since 2016 and sits on both the Royal College and Canadian Pediatric Society’s Adolescent Medicine Committees. In 2021, she was selected to join the Executive Committee of the Canadian Pediatric Society’s Adolescent Health Committee. Her current academic and research interests focus on the medical management of eating disorders and improving the provision of confidential care to adolescents in hospital settings. | This presentation will focus on diagnostic criteria, medical assessment, and the therapeutic challenges presented by adolescents with atypical anorexia nervosa. Learning Objectives:
|
February 13, 2024: Personality disorders in the context of eating disorders
Presenter | Biography | Summary and Learning Objectives |
| Marie Julie Cimon, M.D. | Marie-Julie Cimon is a psychiatrist working at the Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN) and the Centre hospitalier universitaire (CHU) de Québec. She manages the Programme d’intervention des troubles de conduites alimentaires (PITCA), which offers services to adult patients from eastern Québec. Dr. Cimon is also a consulting physician at the CHUL’s Centre Mère-Enfant. In addition to her clinical practice, she is also a clinical Associate Professor at the Université Laval in Québec and affiliated with the Université du Québec a Rimouski (UQAr), where she works with students in mental health nursing sciences (IPSSM). | Announcement forthcoming. |
March 19, 2024: Dialectical Behaviour Therapy for Eating Disorders
Presenter | Biography | Summary and Learning Objectives |
| Lea Thaler, Ph. D. | Lea Thaler is a psychotherapist with the Eating Disorders Continuum at the Douglas Mental Health University Institute of the CIUSSS de l’Ouest-de-l’Île-de-Montréal. She is also an Assistant Professor with the Department of Psychiatry at McGill University. Dr. Thaler is also a certified member of the Ordre des psychologues du Québec. She provides individual therapy as part of the Eating Disorders Continuum, and leads dialectical behaviour therapy (DBT) sessions with the day program. She supervises interns and first-year residents in psychology and an active researcher examining epigenetics and eating disorders as well as factors influencing treatment outcomes. | Announcement forthcoming. |
April 9, 2024: Family therapy
Presenter | Biography | Summary and Learning Objectives |
| Pierre-Olivier Nadeau, M.D. | Pierre-Olivier Nadeau is a child psychologist and co-manager of the Centre intégré des troubles de la conduite alimentaire (CITCA) at the CHU Sainte-Justine. He is an assistant clinical professor and responsible for teaching on eating disorders to externs and psychiatry residents at the Université de Montréal. He participates in research projects and regularly lectures locally, nationally, and internationally on eating disorders in children and adolescents. | Announcement forthcoming. |
May 14, 2024: Clinical management of adolescent inpatients
Presenter | Biography | Summary and Learning Objectives |
| Danielle Taddeo, M.D. | Danielle Taddeo completed her pediatrics residency at the Université de Montréal in 1993. She subsequently did a one-year fellowship in adolescent medicine, including the field of eating disorders in adolescents, at the Hospital for Sick Children in Toronto. As a pediatrician specialized in adolescent health she has worked with the Adolescent Medicine section at CHU Sainte-Justine since 1994. She is co-organizer and co-manager of the Centre intégré des troubles de la conduite alimentaire (CITCA) at the CHU Sainte-Justine. She is an associate professor in the Department of Pediatrics at the Université de Montréal and director of the university’s residency program for adolescent medicine. She is a member of the Royal College of Physicians and Surgeons of Canada’s Specialty Committee and its Examination Committee for Adolescent Medicine. She is also a member of the Eating Disorders Association of Canada. For ten years, she was president of the ANEB Québec Board of Directors, a group that works to help individuals with anorexia nervosa and bulimia. She remains on their Board of Directors. Dr. Taddeo has taught medical students at all levels, published articles, presented posters at conferences, presented and organized local, national, and international training on eating disorders in children and adolescents. She is involved in numerous activities related to the health network. | Announcement forthcoming. |
Panel of experts
Biographies:
Howard Steiger, Ph.D., Douglas Mental Health University Institute
Howard Steiger is a full professor with the Psychiatry Department and an associate member of the Psychology Department at McGill University. For over 30 years, he directed the Douglas Institute Eating Disorders Continuum (EDC), where he continues to act as a clinical and academic consultant for the program. The EDC offers a full range of Inpatient, Day Treatment and Outpatient services to adolescents and adults affected by eating disorders and their families. An active clinician, researcher, and teacher, Dr. Steiger has published 190 articles and chapters on the eating disorders. He is Associate Editor of the Journal of EDs, Fellow of the Canadian Academy of Health Sciences, Fellow of the Academy for Eating Disorders, and has been Associate Editor of the International Journal of Eating Disorders, President of the ED Research Society, and Co-President of the Québec Charter for a Healthy and Diversified Body Image. Along with Dr. Booij, he is the ECHO co-organizer for 2023–2024.
Linda Booij, Ph.D., Douglas Mental Health University Institute
Linda Booij is a Full Professor at McGill University and Psychologist and Head of Research and Academic Development at the Douglas Mental Health Institute's Eating Disorders Continuum. She is also a Researcher at the Douglas Institute Research Centre and the CHU Sainte-Justine Research Centre. Her research focuses on the neurodevelopmental and epigenetic mechanisms of eating disorders. She is also interested in the identification of risk factors for eating disorders and the development of virtual interventions for individuals with eating disorders. She is also Associate Editor of the Journal of Eating Disorders and an active member of the Eating Disorders Association of Canada, where she serves on the Board of Directors. With Dr. Steiger, she is the ECHO co-organizer for 2023–2024.
Shiri Freiwald, M.A., Douglas Mental Health University Institute
Shiri Freiwald is a psychotherapist at the Douglas Mental Health University Institute of the CIUSSS de l’Ouest-de-l’Île-de-Montréal. She provides individual and group psychotherapy and works with the day program. She is also the coordinator for the continuum’s knowledge exchange program. Since 2009 this program has ensured the training and supervision of eating disorder professionals across the province.
Miriam Yaffe M.A., Douglas Mental Health University Institute
Miriam Yaffe, Masters in Social Work, is a social worker and psychotherapist at the Douglas Mental Health University Institute’s Eating Disorders Continuum.For over 15 years, Miriam has treated clients in both individual and group settings and supervised students in the program. She is currently Head of the Eating Disorders Continuum where she manages the Outpatient, Day Treatment and Inpatient units for adults and adolescents with eating disorders.
Lea Thaler Ph. D., Douglas Mental Health University Institute
Lea Thaler is a psychotherapist with the Eating Disorders Continuum at the Douglas Mental Health University Institute of the CIUSSS de l’Ouest-de-l’Île-de-Montréal. She is also an Assistant Professor with the Department of Psychiatry at McGill University. Dr. Thaler is also a certified member of the Ordre des psychologues du Québec. She provides individual therapy as part of the Eating Disorders Continuum, and leads dialectical behaviour therapy (DBT) sessions with the day program. She supervises interns and first-year residents in psychology and an active researcher examining epigenetics and eating disorders as well as factors influencing treatment outcomes.
Annie St Hilaire, Ph.D., Douglas Mental Health University Institute
Annie St-Hilaire has been working as a psychologist at the Douglas Mental Health University Institute’s Eating Disorders Continuum since 2013. In addition to her clinical practice, she is also a supervisor and is involved in research. She uses a cognitive-behavioural approach. She also uses cognitive-behavioural therapy (CBT) in her professional practice.
Mimi Israël, M.D., Douglas Mental Health University Institute
Mimi Israël is a psychiatrist and Chief of the Douglas Mental Health University Institute’s Eating Disorders Continuum. She is an active contributor to the program’s clinical, teaching, research, and knowledge transfer missions. She is also a consultant psychiatrist to first-line community mental health care teams and an Associate Professor of Psychiatry at McGill University.
Julia Dornik, M.D., Douglas Mental Health University Institute
Julia Dornik is an assistant professor of psychiatry at McGill University. She has been working at the Douglas Mental Health University Institute’s Eating Disorders Continuum since 2017 after completing a subspecialty in adult eating disorders at London’s Institute of Psychiatry, Psychology and Neuroscience/Maudsley. She works at the Outpatient Clinic and on the Inpatient Unit, providing psychiatric and therapeutic support. In addition to being actively involved at the clinic, she also has a role teaching several trainees.
Marie Julie Cimon, M.D., Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale
Marie-Julie Cimon is a psychiatrist working at the Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN) and the Centre hospitalier universitaire (CHU) de Québec. She manages the Programme d’intervention des troubles de conduites alimentaires (PITCA), which offers services to adult patients from eastern Québec. Dr. Cimon is also a consulting physician at the CHUL’s Centre Mère-Enfant. In addition to her clinical practice, she is also a clinical Associate Professor at the Université Laval in Québec and affiliated with the Université du Québec a Rimouski (UQAR), where she works with students in mental health nursing sciences (IPSSM).
Danielle Taddeo, M.D., CHU Sainte-Justine
Danielle Taddeo completed her pediatrics residency at the Université de Montréal in 1993. She subsequently did a one-year fellowship in adolescent medicine, including the field of eating disorders in adolescents, at the Hospital for Sick Children in Toronto.
As a pediatrician specialized in adolescent health she has worked with the Adolescent Medicine section at CHU Sainte-Justine since 1994. She is co-organizer and co-manager of the Centre intégré des troubles de la conduite alimentaire (CITCA) at CHU Sainte-Justine. She is an associate professor in the Department of Pediatrics at the Université de Montréal and director of the university’s residency program for adolescent medicine. She is a member of the Royal College of Physicians and Surgeons of Canada’s Speciality Committee and its Examination Committee for Adolescent Medicine. She is also a member of the Eating Disorders Association of Canada. For ten years, she was president of the ANEB Québec Board of Directors, a group that works to help individuals with anorexia nervosa and bulimia. She remains on their Board of Directors.
Dr. Taddeo has taught medical students at all levels, published articles, presented posters at conferences, and organized and presented local, national, and international training on eating disorders in children and adolescents. She is involved in numerous activities related to the health network.
Holly Agostino, M.D., FRCPC, Montreal Children’s Hospital
Dr. Holly Agostino completed her pediatric training at the Montreal Children’s Hospital (MCH) and went on to do a 2-year academic fellowship in adolescent health. She now works at the MCH Adolescent Medicine Clinic and is an Assistant Professor at McGill University. She has been the medical director of the MCH Eating Disorder Program since 2016 and sits on both the Royal College and Canadian Pediatric Society’s Adolescent Medicine Committees. In 2021, she was selected to join the Executive Committee of the Canadian Pediatric Society’s Adolescent Health Committee. Her current academic and research interests focus on the medical management of eating disorders and improving the provision of confidential care to adolescents in hospital settings.
Chloé Paquin Hodge, Psy. D., Douglas Mental Health University Institute
Chloé Paquin Hodge has been a psychologist with the Eating Disorders Continuum at the Douglas Mental Health University Institute since 2016. She works there as a clinician and researcher, as well as contributing to clinical exchange program by giving training courses on eating disorders for various professionals in the community. She is also an Assistant Professor with the Department of Psychiatry at McGill University.
Pierre-Olivier Nadeau, M.D., CHU Sainte-Justine
Pierre-Olivier Nadeau is a child psychologist and co-manager of the Centre intégré des troubles de la conduite alimentaire (CITCA) at the CHU Sainte-Justine. He is an assistant clinical professor and responsible for teaching on eating disorders to externs and psychiatry residents at the Université de Montréal. He participates in research projects and regularly lectures locally, nationally, and internationally on eating disorders in children and adolescents.
