What Happens in an Eating Disorder Therapy Session?

Most people who get in touch with me don’t quite know what to say.

That in itself tells me a lot. Not about how serious things are, or how long this has been going on, but about how much courage it took to get to the point of pressing send.

If you’ve been sitting with this for a while, wondering whether you’re struggling enough to deserve help, whether a therapist will judge you, whether sessions will feel cold and clinical and nothing like what you actually need, this page is for you.

What follows is an honest, step-by-step account of exactly what the eating disorder counselling process looks like when you work with me, from your very first conversation through to ongoing therapy. No vague reassurances. No clinical jargon. Just the truth of what happens.

I want to address the things people don’t always say out loud, because I hear them often enough to know they’re there.

This is the one I want to be really honest about. My Harry Potter wand is completely broken. Therapy is not something I do to you. It’s something we do together, and you’re the one who has to be willing to do the work. I will walk alongside you, every step of the way. But I can’t want your recovery more than you do.

That’s not a rejection. It’s actually the most hopeful thing I can tell you, because it means the change comes from you, and it’s yours to keep.

Before I describe what happens in each stage, I want to give you the full picture. Working with me as a specialist eating disorder therapist isn’t the same as booking a standard counselling session. There are three stages, and each one matters.

First, a free 20-minute consultation. This is a no-pressure conversation where we find out if this is the right fit.

Second, a specialist 2-hour eating disorder assessment. Before weekly therapy begins, I carry out a thorough assessment that gives us a clear picture of where you are, how the eating disorder is affecting your life, and what we’re working towards.

Third, weekly 50-minute therapy sessions. Once the assessment is complete and we’re both happy to continue, we begin the ongoing work.

This process is more thorough than most people expect, and that’s intentional. It means that by the time we start weekly sessions, we’re not guessing. We know what we’re dealing with and we have a direction.

This is where working with a specialist is genuinely different from seeing a general counsellor.

Before weekly therapy begins, I carry out a thorough two-hour eating disorder assessment. This gives me a proper understanding of you, not just the eating disorder, but everything around it.

We’ll explore your eating history and your relationship with food over time. We’ll talk about your current patterns, including exercise, routines, and how food and your body affect your daily life. We’ll look at body image, your relationships and support network, any relevant medical history, and what has or hasn’t helped in the past.

We’ll also talk about what you want things to look like going forward. If you imagine yourself as an eighty-year-old looking back, what do you want to have been able to do or feel that feels out of reach right now? That question tends to open something in people. It moves us away from the eating disorder as the whole story and towards you as a person with a life that matters.

By the end of the assessment, we’ll both have a clearer picture of where you are and what the work needs to focus on. We’ll also begin to explore what you think might have contributed to where you are today. There isn’t a right answer to that. It’s the beginning of a conversation, not a test.

I want to be honest about this, because I think it matters more than most therapists will say.

If someone else has pushed you to come, if a family member has booked you in or you’re arriving mainly to make someone else feel better, I’d gently suggest waiting. Therapy works when you’re the one who wants it. Not perfectly ready. Not fearless. Just genuinely willing to try.

If you expect me to do this for you, I won’t take your money. I mean that sincerely, and it applies no matter how long the waiting list is or how much I’d like to help you. It goes against my values as a therapist and as a person. And if the readiness isn’t there yet, the kindest thing I can do is tell you honestly and invite you to come back when it is. I will always welcome you back.

I’ll let others speak to this rather than speak for it.

Clients often tell me they were really surprised. That they hadn’t expected to laugh. That they’d come in braced for something formal and clinical and left feeling heard and seen in a way they hadn’t felt in a long time, with a weight lifted from their shoulders and, more than once, actually looking forward to coming back the following week.

And parents, too. More than once a parent has sent me a short message after their young person’s first session. One I won’t forget: “I finally found a little glimmer of hope for my child again. Thank you so much.“

That is what I’m here for.

 Yes. I work with both adults and young people. If you’re a parent or carer looking for support for your child or teenager, please do get in touch.

You don’t need a formal diagnosis to reach out. If your relationship with food is causing you distress, that’s reason enough to have a conversation. The specialist assessment will help us understand what you’re dealing with and whether I’m the right person to support you.

It’s a twenty-minute conversation via Zoom where you can ask me anything you want to know and I can find out a little about what’s brought you here. There’s no pressure and no obligation to continue. If we both feel it’s right, the next step is the specialist assessment.

All sessions are held online via Zoom. This means I can work with you wherever you are in the UK, from the comfort of your own home.