Therapy for Eating Disorders

Schema Therapy and CBT-E for Eating Disorders | Melbourne & Online

Schema Therapy and CBT-E for adults with eating disorders

Eating disorders are serious mental health conditions that affect how people think about food, eating, and their bodies. They can look very different from person to person, and they occur in people of all genders, backgrounds, and body sizes.

Behaviours such as restricting, bingeing, purging, or compulsive exercise often serve a purpose. They might help manage difficult emotions, create a sense of control, or quieten feelings of not being good enough. Over time, though, they tend to take up more space and become harder to step away from.

I work with adults to reduce the impact the eating disorder has on their daily life, and to understand the patterns that keep it going. My main approaches are CBT-E, which focuses on eating behaviours and the thoughts that maintain them, and Schema Therapy, which focuses on longer-standing patterns.

This might resonate if…

+ Thoughts about food, eating, or your body take up far more of your day than you’d like.

+ You follow rules about food (what, when, or how much you can eat) and feel anxious or guilty when they’re broken.

+ You feel caught in a cycle of restricting and bingeing, and each attempt to get back in control seems to make it worse.

+ Eating, or not eating, has become a way to manage difficult emotions, whether that’s numbing, soothing, or feeling in control.

+ How you feel about yourself on any given day depends on your shape, weight, or what you’ve eaten.

+ You check, compare, or avoid your body in ways that leave you feeling worse.

+ Eating feels harder because of sensory needs, routines, or difficulty noticing hunger, and it’s hard to know where that ends and the eating disorder begins.

+ You’ve had treatment before and things improved, but you notice the same patterns returning when life gets stressful.

+ You’re not sure whether things are “bad enough” to seek help. Many people feel this way, and it’s often part of the eating disorder itself.

What people are hoping to move towards

  • How to eat regularly and flexibly, without food rules dictating the day

  • How to breaking out of the restrict-binge cycle

  • How to trusting your body’s hunger and fullness cues again

  • How to eat in a way that works with your sensory needs and routines, rather than against them

  • How to have more space in your mind for the things that matter to you

  • How to cope with difficult emotions in ways that don’t involve food or your body

  • How to develop a sense of self-worth that isn’t tied to weight, shape, or eating

  • How to eat with others without dread or planning around it

  • How to be kinder to yourself, especially to the parts of you that feel vulnerable or ashamed

  • Understanding why the eating disorder developed, so setbacks feel less likely to pull you back in

How I work

I draw on two approaches, and adapt the balance depending on what you need at different points in recovery.

CBT-E (Enhanced Cognitive Behaviour Therapy) is one of the most well-researched treatments for eating disorders in adults. It focuses on what keeps the eating disorder going right now: establishing regular eating, loosening food rules, reducing body checking, and breaking the restrict-binge cycle. This practical work often creates the stability needed for everything else.

Schema Therapy focuses on the longer-standing patterns that can sit underneath. For some people, the eating disorder became a way of coping with emotions, unmet needs, or relationships that felt difficult. In Schema Therapy, we work with the critical, vulnerable, and coping parts of you that show up around food and your body.

In practice, some sessions focus on eating patterns and food rules, and others make space for what’s happening in the deeper layers of your emotional world. Whether you’ve been referred for CBT-E or you’re looking for deeper, trauma-focused work, we’ll work out together what fits.

Care that fits who you are

My approach is weight-inclusive, neurodiversity-affirming, and LGBTQIA+ affirming. Many of the people I work with are neurodivergent or queer, and I adapt therapy to suit how you think, communicate, and experience your body, without asking you to explain or justify who you are.

I also recognise that eating disorders don’t develop in isolation: weight stigma, diet culture, racism, and other forms of discrimination shape how people feel about their bodies, and those pressures are part of the work in therapy.

Working alongside your treatment team

Eating disorders affect physical health as well as mental health, so treatment works best with a team around you. I work collaboratively with:

  • Your GP, who monitors your physical health throughout treatment

  • A weight-inclusive dietitian, who supports nutrition and helps you reconnect with hunger and fullness cues

  • Other specialists, such as a psychiatrist, where they’re involved in your care

With your consent, I liaise with your team so we’re working towards the same goals. If you don’t yet have a GP or dietitian you feel comfortable with, we can talk about this in our first call.

Is outpatient therapy the right level of support?

Therapy at Waxflower Psychology is outpatient, which means it’s suited to people who are medically stable enough to attend regular sessions, with their GP monitoring their physical health. This is crucial to ensure you are receiving safe and effective treatment.

Sometimes an eating disorder needs more support than weekly therapy can offer. If your physical health becomes a concern, or things aren’t shifting with outpatient treatment, I’ll talk with you openly about stepping up care. This might mean a specialist eating disorder day program or an inpatient admission. Needing more support isn’t a failure, and I’ll help you think through your options and connect with the right services.

If you’re unsure which level of support is right for you, we can talk it through in your initial call.

If you need urgent support: If you’re experiencing a medical emergency or mental health crisis, call 000 or go to your nearest emergency department. You can also call Lifeline on 13 11 14, or the Butterfly Foundation National Helpline on 1800 33 4673 for eating disorder support.

Ready to begin?

I offer a free 15-minute phone consultation to see how we can work together.

Request your 15-minute consultation →

Frequently Asked Questions

  • CBT-E is a structured treatment focused on the behaviours and thinking patterns that keep an eating disorder going, such as dietary restraint, food rules, and body checking.

    Schema Therapy focuses on longer-standing emotional patterns, often rooted in earlier experiences, that often underpin the eating disorder. Many people benefit from elements of both at various stages of treatment.

  • No. Eating disorders occur in people of all body sizes.

    If food, eating, or your body are taking up a lot of space in your life, that’s reason enough to reach out. I work with anorexia nervosa, bulimia nervosa, binge eating disorder, and OSFED (other specified feeding or eating disorders).

  • No. Eating disorders develop for many reasons, including biological, psychological, and social factors. Schema Therapy can be helpful when there are longer-standing patterns underneath, but it doesn’t assume you experienced childhood trauma.

    However, Schema Therapy is particularly useful at addressing eating disorders that stem from difficult experiences and relationships in childhood and adolescence.

  • You’ll need a GP who can monitor your physical health while we work together.

    Depending on your stage of recovery, a dietitian is highly recommended for effective treatment. I can suggest weight-inclusive, neurodiversity-affirming dietitians if you don’t already have one.

  • If your GP assesses you as eligible for an Eating Disorder Treatment and Management Plan (EDP), you may receive Medicare rebates for up to 40 psychology sessions and 20 dietetic sessions in a 12-month period, with regular reviews along the way.

    If you aren’t eligible for an EDP, a Mental Health Treatment Plan provides rebates for up to 10 sessions per calendar year. You can read more on my Fees page.

  • Yes. Sessions are available online across Australia, as long as you have a local GP monitoring your physical health. Face-to-face sessions are available in Carlton North and Brunswick East.

  • Beginning therapy is a choice only you can make, however it’s common for recovery to take more than one attempt.

    Previous treatment often lays groundwork even if it didn’t feel like it at the time. In our first sessions, we’ll look at what helped, what didn’t, and what might need to be different this time.

  • The first 2-3 sessions are focused on me getting an understanding of what brings you to therapy, your current eating patterns, your history with food and your body, and the medical and other supports you have in place. We’ll also talk about your goals, so we have a clear sense of what we’re working towards.