● Distress tolerance: Based on the theoretical framework that a low tolerance
for negative affect elevates the risk of BN, specific skills for regulating
emotion when in a state of negative affect are taught. Young people are
supported by their families to develop a distraction plan, and asked to
create and use a self-soothe box including means of soothing themselves
with each of the five senses. The “Cope Ahead” skill is used to help adolescents
develop exposure to thinking about difficulties and ways to cope
and to promote discussion within the family about upcoming challenges
and appropriate joint plans to manage these.
● Emotion regulation: the intolerable experience of negative affect is further
challenged through psychoeducation about the functions of emotions and
through development of skills for managing emotions including opposite
action, and working on developing opportunities for experiencing positive
emotions.
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