U of M – TEP Dietetic Internship

Eating disorders are complex, difficult, challenging, and sometimes fatal.  Because food and eating are at the center of eating disorders, dietitians are essential to effective treatment and recovery.

This internship is unique because ED-TEP interns work directly with experienced eating disorder dietitians to observe, learn, and participate in the specialized practice of treating clients with eating disorders. Through hands-on experience, interns develop and draw upon their skill, ingenuity, and resilience to help clients progress along their recovery from the cunning, baffling, and powerful force of their eating disorder.

The portion of the internship focused on eating disorders takes place at a variety of residential and outpatient Emily Program sites throughout the Minneapolis-Saint Paul area. The Emily Program provides outstanding personalized care with passion, integrity, and respect for clients and one another.  The Emily Program work environment supports wellness, creativity, research, commitment, and flexibility.

You should expect to be challenged. You should expect to be frustrated and inspired by our clients. You should expect to have an experience unlike any other dietetic internship in the United States.

Among other things, you will be exposed to and work with:

• The full spectrum of eating disorders: compulsive overeating, anorexia nervosa, binge eating disorder, bulimia nervosa, Avoidant/Restrictive Feeding Intake Disorder, and other eating disorder not otherwise specified
• Various levels of care, from individual outpatient appointments to intensive daylong outpatient programs to 24/7 residential treatment
• Adults, adolescents, pre-adolescents, and their loved ones
• Multiple ethnicities, classes, sexual orientations, faith traditions, beliefs, and values
• Psychological comorbidities, including:
  • chemical dependency
  • trauma/PTSD
  • bipolar disorder
  • schizophrenia
  • social dysfunction or awkwardness
  • body image dysmorphia
  • GI dysfunction
  • other psychological, emotional, and physical disorders
• Multidisciplinary treatment teams that include therapists, physicians, psychiatrists, and medical staff
• Therapeutic meals, nutrition and therapy groups, individual counseling, team consultation
• Skills needed to provide basic nutrition counseling and therapy (open-ended questions, mirroring, etc.)
• Skills needed to identify and address eating disorder behaviors
• Client goal setting, nutritional needs, meal planning, tube feeding recommendations, etc.
• Skills needed to assess a client’s readiness to change

For eight weeks, you will be immersed in The Emily Program’s process of providing comprehensive, personalized treatment for eating disorders and related problems.

You will be expected to model normal eating. You will also be expected to be able and willing to eat a variety of foods, while at the same time learning to coach clients through challenging situations that arise during therapeutic meals.  Modeling balanced eating is a key component of the client’s recovery, providing a safe place for the client to challenge eating disorder thoughts and beliefs.  Any and all food aversions/intolerance must be disclosed to the preceptor before beginning the rotation.

The U of M’s ED-TEP internship is one of the only dietetic internships in the United States that specializes in eating disorders and related issues.

This opportunity gives you the real-life experience of what it’s like to be a dietitian working in eating disorders treatment, working with clients of all diagnoses and at every stage of the illness, as well as other mental and physical health issues.

Unfortunately, the incidence of eating disorders is on the rise in the U.S. Fortunately, the options for treatment are growing. A dietitian specializing in eating disorder treatment will be in high demand because they can provide uniquely valuable services for eating disorder programming in treatment centers, hospital settings, schools, workplaces, community education, and many other areas.

One of the most important advantages of this dietetic internship concentration is the least tangible: a greater appreciation for the human condition. You will be called to draw upon—and discover among your peers—new reserves of patience, compassion, understanding, and acceptance.

Food and eating are central to all of our lives. Meanwhile, the prevalence—and normalization—of disordered eating behaviors is on the rise in our culture. Given these realities, it’s no surprise that challenges and concerns arise when an intern actively participates in this rotation. Some of those challenges may include:

Discovering personal eating and/or body image issues

If an intern is struggling with their own food or body image issues, spending time with eating disorder clients can trigger one’s own eating disorder thoughts and behaviors. It is essential that you are aware of and are addressing your own food or body image struggles—and that you have a support plan in place if those problems arise during the rotation.

Unearthing personal preconceptions and bias

Our culture is rife with positive and negative preconceptions, prejudices, and biases based on a person’s size, weight, and appearance. We are all influenced by this cultural environment. To be effective with our population, you will probably need the support of preceptors and colleagues to explore, challenge, and revise some of your existing (if still unconscious) preconceptions and biases.

Discussing uncomfortable topics

Many clients in treatment for an eating disorder have a traumatic personal history or a challenging past that contributes to the eating disorder. You are likely to hear sometimes graphic conversations about domestic violence, sexual abuse, suicide attempts, self-induced vomiting, self-harm, extreme exercise abuse, laxative, and drug abuse, and other serious mental health and physical health problems. You are likely to interact with individuals whose appearance has been altered by starvation or self-harm.

Taking It Personally

Emotions can run high for a client, especially before, during, and after a meal or snack. For example, a client may be experiencing high levels of anxiety, anger, sadness, fear, frustration, mistrust, and excitement when a meal is presented or eaten.

Sometimes, clients direct these emotions toward the dietitian or intern, blaming them for how they feel. You will need to work with your preceptor and colleagues to learn how to best manage the situation and not take it personally. You will need to develop and use skills like humor and helping a client reframe perspective.

It is important to remember that it is often a good thing when a client is able to express their emotions with a provider. It can be a sign that they trust the treatment team and are willing to allow the team to help express their emotions in a more beneficial way.

Of course, other unforeseen challenges may arise. We encourage interns to discuss any and all challenges with the preceptors.

All eating disorder concentration interns are expected to act in a compassionate and professional manner. This includes dressing comfortably yet professionally, arriving on time, meeting weekly with your preceptor at their clinical sites, and completing projects and assignments by the due date. We expect a complete commitment to the internship, our clients, and our personalized treatment approach.

We expect high motivation and a desire to help this population.  We expect an ongoing willingness to learn, accept challenges, and grow in skill and compassion.  We expect—indeed, we require—that interns uphold the confidentiality of our clients, and abide by The Emily Program’s confidentiality, compliance, and human resource policy and process.

To learn more about the nine-month U of M dietetic internship and concentrations, visit the University of MN Dietetic Internship site.