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Back to Update A MESSAGE FROM THE PRESIDENT Submitted by Arthur B. Elster, M.D., FSAM As this is my final newsletter article as President, I thought it an appropriate time to reflect on the major accomplishments during the past year. I will expand on these points during my comments at the annual meeting in March. The SAM annual report, which will be distributed in March, will contain the full text of committee reports. This report will describe in greater detail activities for the year. Overall, the influence of SAM as the key advocacy group for the health of adolescents has grown steadily during the year. All of you who participate in the SAM list serve know of the work done by Jon Klein and the Advocacy Committee to keep us informed of federal matters. SAM has also contributed to the advocacy process by writing letters providing our opinion on various legislative decisions. We continue to receive invitations asking us to participate in major health initiatives, both public and private. Through the efforts of Abigail English and a newly formed Task Force, we have now started a process for determining how SAM should promote adolescent health within the evolving managed care environment. I wish I could report that progress in this area was moving faster, but understanding the "systems" that constitute managed care and finding foci upon which SAM can impact will not be easy nor occur quickly. Our managed care position paper has now been completed--I urge you to take the time to read and study it. The authors have done an excellent job in describing the issues. There are a variety of other issues that I would like to briefly inform you about. At the November meeting of the Board of Directors, we discussed ways to better define and, therefore, streamline the process of developing SAM policy. Vaughn Rickert and Rich Brookman have developed a draft of the procedures for policy statements that the Board will be reviewing and voting on in March. Vic Strasburger has continued to further our efforts in public relations. We will be sending out press packets to both national and local media prior to March describing highlights of the meeting. In addition, we will set up a press room in Atlanta to facilitate media coverage. Vic is also working on the process for SAM sending out press releases announcing major SAM efforts, such as the publication of position statements. At the Board meeting last March, we agreed to work with the American Academy of Pediatrics in the development of a historical collection on adolescent health that would be maintained in the AAP medical library. Jerry Rauh has now met with the AAP and we will begin to transfer documents soon. Lastly, Dick Brown and Barbara Cromer have worked hard to develop a commemorative issue of the Journal of Adolescent Health describing the 30 year history of SAM. To the many of you who have contributed to this volume, I offer a big thank you. We anticipate that this special issue will be published during the last quarter of 1998. I look forward to seeing you in Atlanta and enjoying another exciting annual meeting. NOTES FROM THE PROGRAM DIRECTOR Submitted by Howard Schubiner, M.D. The annual meeting in Atlanta should be educational as well as enjoyable. For someone living in the upper U.S. Midwest (where it is snowing like crazy as I write this note), the SAM meeting marks the beginning of spring. The weather in Atlanta in March is usually wonderful, and already I am looking forward to hearing about new developments in our field, seeing old friends, and meeting new colleagues. This spring will also be a time of renewal for SAM. Our 30th anniversary meeting will focus on our future in adolescent health and, in particular, health services research as a way of understanding and documenting our work. We are also planning a birthday bash which should be a lot of fun. There are a couple of new things we are trying this year. First, we will be audiotaping most of the workshops and institutes, as well as the Gallagher lectures and plenary panel addresses. This is an attempt to provide a service to members who can't get to the annual meeting, particularly regional chapter members. In addition, since an individual can only attend up to 5 of the 50 workshops and institutes, this will give those who attend the meeting the opportunity to hear material from workshops they couldn't attend. Finally, some of us may want to have a copy of the Gallagher lectures or plenary panel presentations to hear again or to share with friends. So, look for the booth of the Hour Recording Company, which will audiotape the presentations. If you find this service valuable, please buy some tapes so we can justify the effort. Please note that not all workshops and institutes will be taped, as some presenters may not consent to audiotaping. Edie, Rinda, and/or Mary can let you know which presentations will be taped. Each audiotape will cost $10. The second experiment we are doing will be to ask SAM members for formal proposals for suggested workshops and institutes for the LA meeting (March 17-21, 1999; Century Plaza Hotel, mark your calendars). You have received a workshop/institute submission form in the January membership mailing. We hope to draw on suggestions from our members for workshops and institutes rather than asking a small number of people on the program committee to generate the total number of workshops. The program committee will still be responsible for choosing workshops and institutes from those submitted as well as generating other topics and speakers. Thanks to all who responded to the membership survey about the content and sites for the annual meeting. Also, a special thank you to Alain Joffe and Rinda Knifong, who are in charge of creating the questionnaire and analyzing the data. We will act on your sentiments and provide you with results from the survey in a future edition of the newsletter. My commiseration to those of you in the colder climates for putting up with winter, and to those of you in the warmer climates for putting up with the lack of seasonal weather changes. Best wishes, Howard Schubiner |
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A BOOK REVIEW: The Secret Language Of Eating Disorders Questions and Controversies There has been a great deal of controversy among health professionals regarding Peggy Claude-Pierre's book The Secret Language of Eating Disorders. The book is based on Claude-Pierre's approach to the treatment of anorexia and bulimia nervosa at the Montreux Counselling Centre's Eating Disorder Program in Victoria, Canada. Since the inception of the Montreux Counselling Centre, followed by Ms. Claude-Pierre's introduction to millions of people throughout the world on television productions (20/20 and Oprah Winfrey) and now with the release of her book, desperate families and patients are drawn to the centre in search of a "cure" for these serious disorders. In the Fall Newsletter of the Academy for Eating Disorders a letter to the publisher of Secret Language of Eating Disorders written by Dr. Michael Strober, the Director of the UCLA Eating Disorder Program and Professor of Psychiatry at UCLA was printed. We thought Dr. Strober's letter would be of interest to our SAM members. 5/10/97 Dear Ms. Sutton: I have just received your promotional flyer for The Secret Language of Eating Disorders by Peggy Claude-Pierre. I have read this book; likewise, I have seen each of the three ABC television (20/20) pieces profiling Miss Pierre and her work at the Montreux Clinic. I understand the enthusiasm you bring to the book's promotion, and accept as genuine your emotional commitment to what you regard as a terribly important effort. I share your sense of urgency regarding the problem of anorexia nervosa, as it is one of the most lethal of psychological illnesses. But moved by an equally strong commitment to the study and treatment of anorexia nervosa, work that I have pursued for some 25 years, I am compelled to bring to your awareness another perspective on the book and the clinic.
You may be inclined to think that what follows is borne out of jealousy, a reactionary defense of the "established" and conventional approach to eating disorders, or other suspect motives. If so, this would be regrettable. I realize that you have a vested interest in the widespread appeal and successful promotion of this book. Yet, certain facts are indisputable. A word about the book itself, specifically, the contention --supported by statements made first by ABC 20/20 reporter Lynn Sher, and later expressed breathlessly by Oprah Winfrey (repeated, once again, in your own promotional flyer) -- that we can now, for the first time, know anorexia nervosa "in a way we never have before." Well, Miss Sutton, only if the reader is heretofore a complete stranger to an already abundant and richly textured literature describing this illness and the many challenges to its treatment. Amongst responsible professionals who have toiled in this area for many years, as well as the many unfortunate people afflicted with anorexia nervosa who have endeavored to learn about their suffering, this gushy praise has provoked puzzlement, indignation, and derision. To be blunt, the media's declaration of Miss Claude-Pierre's "profound, new insights" is incredulous. At the very least, it betrays a pitifully inadequate background research of her efforts. Of greater seriousness, it necessarily raises the question of whether or not Miss Claude-Pierre herself is unfamiliar with this vast body of research on anorexia nervosa. That is not a very comforting possibility for someone who claims profound "knowledge" and therapeutic acumen. We must assume this because she never makes note of this work in her book. If she is acquainted with this literature, truly aware of the terrain already charted by those who came before her or who are her contemporaries (again, one would hope she is), why is this foundational work so completely ignored? If she has such knowledge, then her failure to discuss it in relation to her own efforts is evidence of dreadfully poor scholarship. If she truly thinks she has forged meaningful new ground with her "insights," she has exposed her ignorance of her subject matter. Before her death, the eminent psychiatrist Hilde Bruch, whose life work was devoted to research on the causes and treatment of anorexia nervosa, published four books exploring these questions. Informed professionals, patients, and involved family members are familiar with other accounts in the literature of the psychological underpinnings and long-term therapy of anorexia nervosa. Bruch's work was seminal, detailing with exceptional clarity, brilliant insight, eloquent prose, and deep empathic understanding the torment suffered by these young women and essential aspects of effective treatment. Miss Sutton, to be simple and to the point, nothing we read in Miss Pierre's book is new, profound, or unconventional. Her awkwardly put concept of "conditioned negativity" was first described with far greater eloquence and probing intelligence by Hilde Bruch nearly 30 years ago. Since then, the importance of this concept, as well as related psychological aspects of anorexia nervosa, has been elaborated upon in several thousand published papers and books. Miss Claude-Pierre, it would seem, is unaware that the ground she explores -- permitting, as asserted so ridiculously, an understanding of the mind of the anorexic "in a way that we never have (had) before" has been previously well traveled. If you think I am alone in my harsh disdain for this book, let me assure you that colleagues around the world have reacted to this work with criticism of the media's failure to engage in a more probing consideration of what the Montreux Clinic really does offer to its patients. The book has been widely denounced, and that is to put it mildly. I grant that criticism of the media's "light-weighted" treatment of this matter should be less harsh (not all of my colleagues would be so charitable), but Miss Pierre's acceptance of the mantle of authority via gushing praise for her book is deserving of scathing criticism, and deep suspicion. Which comes to the second point: the bold assertion that her methods will "cure" those who come to Montreux -- everyone. Of this she is certain, stating so in somber tone but with spirited determination to Lynn Sher during her first ABC television 20/20 interview. Well, Miss Sutton, this hope-inspiring, truly revelatory promise is patently false. I am not prepared to tell you that Miss Claude-Pierre knows this to be false; I have no direct way of knowing. But whether she does or does not is quite immaterial; the statement is damning either way. Here are some pertinent truths. Over the past three years, I have consulted with three former residents of the Montreux Clinic who relapsed, or remained symptomatic, after completion of their Montreux "treatment." Their stays at the clinic ranged from 12 to 27 months. One additional patient, who was under my personal care before her year-long stay at Montreux, remains unrecovered. I am not alone in having discovered people who remain curiously resistant to the "miracle." cure. Similar consultation and treatment of Montreux residents who relapsed following completion of their stays in Vancouver has been discussed on the Internet by trusted and internationally esteemed authorities on anorexia nervosa from New York, London, Vancouver, and Toronto. Miss Claude-Pierre has intimated that some of these patients were too resistant to benefit from treatment. If she believes this, then some might take the position that she is unaware of how tautology (if you do not accept the "cure," you are inherently resistant to it; hence, my efforts cannot be construed as having failed you) utterly obscures her understanding of these treatment failures. But more disturbing, frankly, though quite revealing, is Miss Claude-Pierre's baffling admission during a recent Canadian television show examining her clinic that she has not pursued any systematic, objective, long-term examination of the outcome of former Montreux residents. How, then, asked the reporter, was she able to claim universal treatment success in the absence of such research? Miss Claude-Pierre seemed to back off from her previous affirmations, telling the interviewer that her "success" rate was actually close to 87%. (I have yet to receive a copy of the edited broadcast, but the reporter confirmed this exchange with Miss Claude-Pierre.) But, asked the reporter, further pressing the point, how could she assert that her success was indeed 87% in the absence of long-term follow-up? The question remains unanswered, yet the implications of Miss Claude-Pierre's admission are self-evident; maybe not to Miss Claude-Pierre, however. But to be fair, this, too, remains uncertain. I have no doubt that the Montreux experience has been life-saving, even "curative" for some. It is a sad fact, as Miss Claude-Pierre states, that preciously few people with severe anorexia nervosa are able to receive long-term care delivered in a warm, comfortable, loving and tender environment. And Miss Claude-Pierre is also correct in noting that these necessary elements of effective treatment are lacking in many of the non-specialty medical and psychiatric hospitals to which these patients are so frequently admitted in panic and desperation. Even so, whatever the virtues of Montreux (I have other reasons to be very skeptical based on information that I am unable to divulge), they are invalidated by Miss Claude-Pierre's actions, however well intentioned her motives may be. The sweeping promise of "cure" in the absence of a speck of data substantiating the validity of such a promise betrays a potentially dangerous, misguided naiveté that is deserving of the harshest and most unforgiving of criticisms. As the parents of one patient stated after watching Miss Claude-Pierre's 20/20 interview: "Our daughter wasn't cured after 19 months at Montreux. Does this mean, Dr. Strober, that she is hopeless, because she is convinced this is the case and thinks that any further treatment would be a waste of our time and money.' It is not surprising to me then, Miss Sutton, that the testimonials appearing on your promotional flyer come from people unfamiliar to those of us who work in this field. I suspect you are largely unaware of the level of outrage leveled at Miss Claude-Pierre for her unsubstantiated -- thereby -- false statements about promised cures. Given the unfathomable terror and confusion that grips people with anorexia nervosa as they contemplate living a life without thinness, and the equally unbearable suffering of loved ones, unsubstantiated promises are potentially cruel and dangerous. Each and every seasoned and compassionate therapist understands why this is so. Miss Sutton, this letter is not to be construed as a criticism of you, or of your publisher. Allow me to reiterate that I have no reason to doubt the genuine regard and enthusiasm you have for your new book. But sadly, this enthusiasm is not felt by others with deeper knowledge and understanding. It is "lightweight" and very, very dated. The claims made by Miss Claude-Pierre are already disproved by those women who have sought out further consultation in order to make sense of their ongoing, post-Montreux struggles. Thank you for your time. Any comments or reactions you wish to share would be welcome. Respectfully, Reproduced with permission from the Academy for Eating Disorders Newsletter: Fall, 1997 and Michael Strober, PhD. UPDATE FROM THE INFORMATION TECHNOLOGY COMMITTEE Submitted by Aric Schichor, M.D. During the Fall 1997 meeting of the SAM Board, the Computer Technology Committee was renamed as the Information Technology Committee and its status was changed from ad-hoc to standing. Many thanks for the advocacy by Gail Slap and for the Board's support for continued technological growth for the Society. The Board also approved that the SAM Newsletter be posted to the SAM home page. This will start with this issue. Iris Litt continues to develop a Journal home page which will be linked to the SAM home page, permitting access to the Journal's content page as well as to other information not limited by copyright. The SAM home page continues to grow. You can find further details about many of the Regional Chapters and Special Interest Groups; you can find out when your SIG will be meeting by checking the outline of the SAM meeting schedule on the home page. The three new position papers will be posted to the home page: Clinical Preventive Services for Adolescents, Confidential Health Care for Adolescents, and the Position Paper on Driver Education. Here is a brief guide for those of you who may be new to the SAM home page and have not had a chance to explore all the sections. The SAM meeting schedule is in the Update section. Click on the name of the meeting and you will open a new page including the outline of the meeting. Once you are done with that page, you need to close it in order to return to the home page. The Regional Chapters are in the Background section. The SIGs and Position Papers are in the Activities section. You can link to the home page at: http://cortex.uchc.edu/~sam Don't forget to tune into SAM-L, the SAM listserv, for the latest discussion related to adolescent health. Please send me an e-mail at schichor@uconnvm.uconn.edu if you are interested in becoming a subscriber to SAM-L. OVERVIEW OF THE ROLE OF SIGS IN SAM Submitted by Arthur B. Elster, M.D., FSAM Included in this newsletter is a report from Seth Ammerman on the organization and role of Special Interest Groups (SIGs) in SAM. I would like to underscore my thoughts on the value of participation in SIGs, especially for young SAM members who would like to become more involved in the operations of a national organization. Professional development is key to the future of SAM. The Board of Directors this year, and for past years, have discussed how to foster and to identify SAM leaders of the future. Election to the Board is limited to members who have demonstrated a commitment to SAM, usually through their work on a Committee (either Standing or Ad-Hoc). Since Committees are limited to only 10 members, then the question arises to how are these members identified. I believe strongly that SIGs are the life blood of our organization and it is through work on SIGs that new leadership is both developed and identified. SIGs are where members come together on topical issues for which they are passionate. I offered last March to develop an algorithm for how SIGs could function as a vehicle for leadership development. SIGs, because of their unlimited size, are a starting point for networking and special interest advocacy. Structurally, SIGs have informal leadership and are under the jurisdiction of the Program Committee for monitoring purposes. We are not trying to be over-structured, however, SAM leadership has an obligation to the membership for oversight. What this means in practical terms is that in order to implement projects, SIGs need to request to the Board that an Ad-Hoc Committee be assigned to address a particular issue. SIG members would usually comprise the Task Force. Activities could include writing a position paper, sponsoring a conference, applying for a grant, etc. Ad-Hoc Committees have a limited life, usually three years. One possible outcome of these efforts is to request that the Ad-Hoc Committee be turned into a Standing Committee. I hope this clarifies the role of SIGs in SAM. I urge SAM members, whether seasoned veterans or newcomers, to find their niche through the network provided by our SIGs. If there is an area or issue not covered and you wish to form a new SIG, please talk with one of the Board members or Howard Schubiner, Director of Programs. SPECIAL INTEREST GROUP AD-HOC COMMITTEE Submitted by Seth Ammerman, M.D. Following receipt of a letter on Special Interest Groups from Seth Ammerman, the Board of Directors named an Ad-Hoc Committee to address Special Interest Groups. This committee was chaired by Seth Ammerman with members being Bob Blum, Art Elster, Robert Morris, and Howard Schubiner. After thoughtful study, the group proposed to the Board of Directors:
Everyone agreed that SIGs serve a unique and important function for SAM, and that no single approach fits the diversity of SIGs and their participants' interests. EDITORS NOTE: In March 1997, one representative from each Special Interest Group met for dinner with Drs. Ammerman, Elster, and Schubiner. During that dinner, the Special Interest Group leaders determined to keep procedures and reporting mechanisms the same. Since this group has met its charge, the Ad-Hoc Committee on Special Interest Groups has been disbanded. PROFESSIONAL DEVELOPMENT OHIO, Toledo |
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1997 "FRIENDS OF SAM" CONTRIBUTE GENEROUSLY Submitted by Edie Moore Thank you to the following donors who made voluntary contributions to the Society for Adolescent Medicine during the calendar year 1997. These voluntary contributions have been made in four ways: the Society's annual ContributionCircles, "Friends of SAM," by signing a SAM Annual Meeting Credit Voucher back to the Society, and/or by signing anearned Membership Drive Premium back to SAM. Contributors are: |
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SOCIETY FOR ADOLESCENT MEDICINE Friends of SAM Tributes Following is a donation received to support the Mission and Goals of the Society for Adolescent Medicine: In loving memory of my father, who provided for my education, and of my son, who provided education for me Richard R. Brookman, M.D, FSAM REGIONAL CHAPTER NEWS Submitted by Charles Wibbelsman, M.D. As the year 1997 ends and 1998 begins, several Chapters have passed the gavel to new leaders: Laurie Hornberger is now President of the Midwest Chapter, Ruth Worthington becomes President of the Michigan Chapter, Anthony Acquavella leads the Mid-Atlantic Chapter, while Warren Seigel takes over the New York Chapter, and Ann Giesel guides the Northwest Chapter. Congratulations to all new leaders; we wish them well and look forward to hearing great things from all our Chapters. News from Regional Chapters include:
For the first time, an award from the Regional Chapters of the Society for Adolescent Medicine was presented to an outstanding chapter member who is not a SAM member. The recipient of this award is a member of the Michigan Chapter: Paul N. Sheehan, Executive Director of the Council for Maternal and Child Health in Michigan. Award recipients receive a one year free membership in the Society for Adolescent Medicine and a one year subscription to the JOURNAL OF ADOLESCENT HEALTH. . . .FROM THE EXECUTIVE OFFICE Compiled by Edie Moore, SAM Administrative Director March 4-8, 1998 -- Atlanta, Georgia -- SAM Annual Meeting and 30th Year Anniversary...have you registered yet? If not, please do so...we are running short on time. You should prioritize your choice of session attendance in each category as some sessions are already closed. As I mentioned in the last newsletter, the SAM Office will NOT be calling you personally this year as we have in the past if your registration form is not completed correctly or if you have forgotten to prioritize your session selections. What does this mean to you? You will have to stand in line on-site and receive entry tickets for whatever is available, so please complete your registration form in its entirety prioritizing sessions you want to attend. I look forward to seeing you in Atlanta!
OTHER MEETINGS OF POSSIBLE INTEREST: NEW PUBLICATIONS: SAM NEWS... Annual Meeting Sites
SAM NEWSLETTER
The Society for Adolescent Medicine Opinions expressed herein are the views of the author(s) and are not necessarily the view of the Society for Adolescent Medicine. |