Disorders in Disguise: Proposed Clinical Competencies in Eating Disorders for All Child and Adolescent Mental Health Providers

Early detection and treatment of child and adolescent eating disorders is strongly linked to positive outcomes and can be achieved by recognizing the diverse and often concealed ways in which these conditions commonly present within mental health care settings. In particular, eating disorders are frequently disguised by the appearance of more familiar presenting problems, such as symptoms of anxiety, depression, and emotion or behavioral dysregulation. As a primer for child and adolescent mental health therapists seeking to provide efficient and effective treatment to young patients who may be presenting for mental health care with an undetected eating disorder, we present six cases of patients from differing child and adolescent mental health settings who presented for the treatment of psychiatric symptoms that ultimately were related to an eating disorder. In each case, the detection and treatment of an underlying eating disorder was paramount to improving the presenting problems. Within this context, we discuss key concepts and basic clinical competencies in child and adolescent eating disorders that are essential for mental health providers, including those who do not consider eating disorder treatment as within their scope of practice.