Community Integrated Care : An Anti-Oppression and Arts-Based Approach to Addressing Marginalization in Eating Disorders Care
In this workshop, we address intersectionality through an example of a community-integrated model of care for eating disorders taking place in Hamilton, Ontario. We suggest that a community-integrated model of care holds potential for fostering social responsibility, community support and anti-oppression action rather than focusing on the clinical presentation of individuals. Using an anti-oppressive and feminist lens, we propose an approach to eating disorders care that also challenges the hierarchical structure of current treatment models – a dynamic that we argue marginalizes individuals and creates barriers for many individuals seeking support. We discuss how a collaborative and more holistic approach to eating disorders care can not only help support individuals in recovery, but also those individuals outside of a clinical diagnosis who self-identify as vulnerable to experiences of suffering related to their bodies and food. Finally, we discuss the role of arts-based practices in eating disorders care and explore how such an approach can empower by focusing on embodiment, communication, voice (agency), expression, meaning-making and the exchange of ideas.
This workshop makes the case for a community-integrated model of care for eating disorders and related forms of suffering as a partial antidote to the present inaccessibility of such support to all but a minority. Our model is premised on the aim of taking current valuable forms of care and making these tools and strategies available to those individuals who are otherwise disempowered or barred from receiving such support. Specific areas of marginalization addressed in this workshop include: access to a doctor, body type, diagnostic criteria and/or stereotyped presentation, family structure, socioeconomic status, gender presentation, age, and race/culture. We also argue that the current hierarchical structure within medicalized eating disorder treatment models creates a dynamic which typically orients the service-users in a role that inhibits agency. We propose a model of care that is informed by feminist and anti-oppression theory and uses non-hierarchical facilitation and self-referral, endeavouring to establish a collaborative group setting that empowers participants as co-facilitators and facilitators as co-participants. This design also introduces therapeutic support to those who are struggling with experiences related to eating disorders without necessarily being clinically diagnosable. Therefore, this model also provides opportunities for prevention in self-identified vulnerable individuals. Furthermore, we argue that it is incumbent on the community to contribute to the creation of “an environment toxic to eating disorders”; a community-integrated support initiative for eating disorders stands in relief to a model where individuals are left with their eating disorder as the purvey of the medical profession and the community is a world apart, in which there is no recognition of eating disorders or the experience of a recovering person. We also consider the arguments against community-integrated models, and explore the value of those arguments in favour of specialised medical-field interventions for sick people.
In our workshop, we review critiques of traditional eating disorder treatment approaches, and we discuss examples of existing community-integrated models of care for eating disorders and other mental health problems. We present our experiences from co-facilitating a community-integrated group in Hamilton, Ontario according to our proposed model. Our group also centres arts and creative expression as tools of care; in our presentation, we demonstrate the role of arts-based practices in our approach to implementing meaningful anti-oppressive care for eating disorders. We explore the strengths and weaknesses of our approach, and suggest directions for future investigation and application.
Knowledge Level: All
Rachel Nolan is a music therapist intern from Capilano University in North Vancouver. She is pursuing a specialisation in clinical music therapy with people with eating disorders, as well as focusing on community models of music therapy with youth. She has anti-oppression training through Hamilton Freeskool and the Ontario Public Interest Research Group, as well as through the Sexual Assault Centre for Hamilton and Area. She is devoted to the integration of her anti-oppression background into her practice as a therapist.
Olivia Strohschein is a recent graduate from the University of Toronto; her Master’s research explored the use of arts-based practices in eating disorder recovery, within the context of embodied pedagogy. She is interested in anti-oppressive recovery models that focus on the affective body. She has a background in Gender Studies and has received anti-oppression training through her volunteering at the Sexual Assault Centre Kingston, Kingston Interval House and the Sexual Education Centre (University of Toronto).