Meet Our Team: Dr. Amy Boyers

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What is your name and what are your credentials?
 
Amy Boyers, Ph.D., Director of Adolescent Services for Clementine, Oliver-Pyatt Centers new program focused exclusively on the treatment of adolescent girls.

Please give us a brief description of your background.
 
I am a clinical psychologist. I completed my training in Clinical Health Psychology at the University of Miami where I received a Department of Defense Fellowship to study Psychoneuroimmunology. I completed my internship at the University of Miami Counseling Center, where I first worked with individuals with eating disorders and then completed two Post-Doctoral positions. I was a Post-Doctoral Fellow at University of Miami in the Department of Psychology for two years and I also completed a one year Post-Doctoral Residency at the Renfrew Center in Coral Gables. 

What does a typical day look like for you at Oliver-Pyatt Centers?
I am currently transitioning to the position of Director of Adolescent Services for Clementine, Oliver-Pyatt Centers new program focused exclusively on the treatment of adolescent girls. For the last six years, I have worked as a consultant and have served as the Director of Clinical Training. I have run a number of different groups over the years and currently facilitate a group for parents once a month. I have supervised over 30 trainees and staff in my time at Oliver-Pyatt Centers. 

In your own words, please describe the philosophy of Oliver-Pyatt Centers.
My experience of the “OPC Philosophy” is that we do whatever we need to do (within reason of course!) to help the patient recover. That is why we are able to provide an individualized experience for our clients. We have the capacity to hold our clients emotionally in a way that can be quite profound and nurturing and allows them to make changes they haven’t been able to in the past. I love that we are willing to “think outside the box” with our clients in order to help them engage in the recovery process. As a result, the therapy offered at Oliver-Pyatt Centers is not only of high quality, but is quite creative in its delivery.

How does your team work together? How do your roles overlap and differ? 
As I mentioned above, I am moving into the role of Director of Adolescent Services for Clementine, the adolescent treatment program at Oliver-Pyatt Centers. Our team is new and are currently in the planning stages. I will be overseeing the larger picture, clinical aspects, including programmatic issues. I have developed the clinical programming and structure that will be used for the Adolescent Program. Bertha Tavarez, Psy.D. (to be introduced on the blog soon!) will be handling all day to day clinical issues while I will be overseeing and providing additional support during more complex or emergency issues. I will also be providing many of the services in the parent education program. I will be attending all staff meetings to ensure the care of the patients is consistent with Oliver-Pyatt Centers philosophy and goals.

What is your favorite thing about Oliver-Pyatt Centers?
My favorite thing about Oliver-Pyatt Centers is how much creativity is encouraged. I don’t only mean creativity in the artistic sense, but in finding new ways to use well-established interventions so we really reach the client. I always tell new therapists at Oliver-Pyatt Centers that they are free to try something “out of the box” as long as they can provide a sound theoretical and clinical argument for doing so.

What are three facts about you that people do not know?
I moved to Miami at one and a half years old. I have 2 dogs that I am obsessed with. I love to cook.

For more information about Oliver-Pyatt Centers and Clementine,a residential program exclusively for adolescents girls please call 866-511-HEAL (4325), subscribe to our blog, visit our website, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

The Sun and Wind Dispute: Navigating Motivation and Readiness for Change in Adolescents with Eating Disorders

Dr. Bertha Tavarez, PsyD shares her experience and expertise working with resistant adolescent clients. Dr. Tavarez has been working as a highly skilled primary therapist and will be stepping in to the position of Clinical Director of Clementine, Oliver-Pyatt Centers new residential program exclusively for adolescent girls this fall.  

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“The sun and the wind were having a dispute as to who was more powerful. They saw a man walking along and they had a bet as to which of them would get him to remove his coat. The wind started first and blew up a huge gale, the coat flapped but the man only fastened the buttons and tightened up his belt. The sun tried next and shone brightly making the man sweat. He took off his coat.” – Anonymous

The metaphor of the sun and the wind is an accurate depiction of the challenges that many clinicians face while working with adolescent clients. Although we may have access to the gravity of our client’s clinical needs, simply communicating our concerns and providing much needed skills can be met with resistance. Our clients remain “locked in” to their emotional experience while simultaneously feeling “locked out” of the insight and motivation needed to increase their receptivity to much needed skills development. The adolescent, preoccupied with exerting and maintaining control and autonomy, may hold tightly to their coat, rendering our intentions to provide care futile.

So how do we, like the sun, create shifts in awareness and influence change?

The power of reflection

It may be tempting to adopt the roll of cheerleader (“You can do this!”) or problem solver (“Why don’t you try this?”) When an adolescent client presents with resistant talk (“I don’t want to be here”) or talk that inhibits change (“I got straight A’s with ED, what’s the problem?”) Often the simplest and most effective way of building rapport and loosening the grasp of resistance is to simply reflect the client’s message in your own words. Often, clients are primed for persuasion and direction. Reflections statements can contribute to feelings of validation and interpersonal trust.

Resistance as an interpersonal process/Resistance as developmentally appropriate

It’s important to keep in mind that resistance is both developmentally appropriate for adolescent clients and an interpersonal process that occurs within the therapeutic alliance. Although, we may expect a certain degree of resistance on a developmental level, we can provide corrective experiences around resistance that still promote autonomy. A clinician may benefit from awareness about the resistance that is brewing in a session, abstain from engaging in a power struggle, and promote an alliance with the client’s desire for autonomy.

Highlight intrinsic control

An effective technique that facilitates a shift from resistance talk to change talk is the clinician’s emphasis on the client’s access to her personal control. A clinician may reflect the pros and cons experienced by the client:                  

Client: “I got straight A’s with ED, what’s the problem? Gosh! That was so hard!”

Therapist: “It sounds like you did well in school this year, but ED made it more difficult.”

A clinician may also reflect a client’s choice within the constraints of the treatment environment while having the knowledge of the consequences. For example, the client may be informed of her choice to select what day an exposure is initiated or asked to reflect on her choice to not participate in a group while being aware of consequence of losing a daily privilege as a result.

Shifting focus  

If resistance talk persists, the clinician can shift the focus to another closely relevant therapeutic topic that may tie into the overall theme beneath the resistance. For example, if the client states, “I don’t want to take medications and that’s final!” the clinician can say, “Ok, how about you tell me how you’re feeling about your overall health today?”

Working with clients experiencing resistance and treatment ambivalence can be challenging. However, there are great opportunities at this treatment phase that can strengthen the therapeutic alliance and build the ground work necessary for lasting change. Motivational interviewing and person-centered techniques are an integral component of the clinical work at Clementine, Oliver-Pyatt Center’s new residential program exclusively for adolescent girls.

For more information about Clementine, please contact Oliver-Pyatt Centers at 866.511.HEAL (4325) and subscribe to our blog, visit our website, or connect with us on Facebook, LinkedIn, Twitter, and Instagram

The Unburden of Truth

We hope you enjoy the final of this five-part guest blog series from one of our OPC alumna – sharing a glimpse inside her path of recovery and lessons learned along the way. We are continually inspired by all of our women and are proud to share this post with you, our readers. To read the first, second, third, and fourth posts please visit the preceding links. 

A few weeks after I left Oliver-Pyatt Centers, I received a text from my mom, “Martha made reservations at a French restaurant at 6. We will be there at 1 for lunch.” I’d had a stressful week already, and, of course, I panicked. (Yes, that can still happen in recovery.) Work had been especially dull; I was probably having body image insecurity; my parents were driving up for the weekend – and French cuisine is known for its richness.

I began madly texting a friend explaining the situation – mainly I knew the anxiety over it would make me snippy and evasive. I would want to get something “healthier” (read: less caloric) for lunch because of the dinner plans, but my parents would start worrying if I did. I didn’t want to be rude, but that’s how I express anxiety. Especially toward my parents. Then suddenly this crazy plan came to me. It seemed kind of hair-brained, but I thought it just might work. I could tell them the truth, “I don’t mean to be snappish, but I am anxious about going out to lunch at 1 and then going out for French food early.” But, who does that? You don’t expose eating-disordered thoughts. You lie about them, right?

Upshot

I told my mom and did not get the response I was hoping for. (I am not even sure there was a response I wanted.) But it didn’t matter. I felt better because I had told the truth. I would rather be judged for the reality, which was that some eating disordered thoughts had resurfaced temporarily, than think their daughter is just mean spirited and snippy. 

So many of these moments have happened throughout recovery. Times when I would have lied to get out of intimidating social situations, but instead told someone that I was anxious, and went anyway. I am probably the most candid person at work, which makes people want to tell me things. And I have even been open about my eating disorder with a few of them, not because I want them to feel obligated to look out for me (that wouldn’t be fair,) but as a point of connection. To say, “This is what makes me vulnerable and therefore human.”

It is difficult to describe the difference it makes to walk through the world without needing to spin an ever-growing web of lies. Trying to remember how to avoid trapping yourself is exhausting, and the reality is as I tried to remember every little section of thread I’d spun, everyone else could see the web for what it was… a gigantic shroud of deception.

I believe most people with eating disorders inherently are not liars. In fact, I’d say it is the opposite. But suddenly, there is no choice but to lie to cover up this thing you know others would try to take from you if you didn’t. One of the greatest parts of recovery for me was realizing that regardless of how anyone else might react to it I had regained the right to tell the truth. 

For more information about Oliver-Pyatt Centers and our newly introduced Embrace, a binge eating recovery program and Clementine,a residential program exclusively for adolescents girls please subscribe to our blog, visit our website, and connect with us on Facebook, LinkedIn, Twitter, and Instagram