March 2008


Fred Milacci

Primary Subject Area

Psychology, Clinical


Anorexia Nervosa, Treatment, Spirituality, Spiritual integration


This case study explored Christian spirituality, counseling practice, and recovery from anorexia nervosa. A spiritual integration model based on a comprehensive review of the literature was proposed. This model reflects a step care treatment approach, including the current standard of practice, spiritual integration, and Christian spiritual integration.

Next, a phenomenological analysis of document, interview, and observation data revealed several themes pertinent to counseling practice with Christian women suffering with anoexia nervosa. These themes were classified as (a) prior to treatment: spiritual disconnection, including suffering and brokenness, taking control of brokenness through anorexia nervosa, and her broken faith; (b) during treatment: reconnecting to the spiritual, including the person of the therapist, the mending of her faith, and the spiritual integration tools; and (c) after treatment: sustaining spiritual connection, including the battle continues and lessons from the suffering.

Implications of the findings for counseling practice with this population include the need for counselors to (a) understand the function of anorexia; (b) include a spiritual assessment in the comprehensive diagnostic evaluation; (c) utilize empirically based treatment strategies that recognize the biological, psychological, social, and spiritual needs of the Christian patient; and (d) include the ethical integration of empirically supported spiritual interventions as indicated, with special attention to the therapeutic relationship, Christian Cognitive Behavioral Therapy (CCBT) and the Christian perspective of “fighting the good fight.” Suggestions for further research and closing comments from the researcher are provided.