{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:16:06Z","timestamp":1789042566779,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Sci.","Behavioral Sciences"],"abstract":"<jats:p>Eating disorders are associated with substantial morbidity and mortality yet remain underidentified in general mental health practice, delaying intervention and worsening outcomes. Counselor preparation often provides limited eating disorder content within broader psychopathology coursework, leaving trainees underprepared to recognize subtle, culturally diverse, and nonstereotypical presentations. This conceptual paper draws on scholarship in counselor education, body image, embodied self-awareness, and eating disorder training to propose a four-domain framework intended to strengthen counselor preparation for eating disorder recognition and clinical response. The framework includes foundational knowledge of eating disorder diagnosis, medical and nutritional risk, levels of care, and multidisciplinary treatment; reflective body-related self-awareness concerning clinicians\u2019 beliefs about food, weight, health, exercise, appearance, and culture; embodied and creative practices that strengthen awareness of bodily and relational responses; and clinical translation through direct assessment, supervision, consultation, and referral. A seven-session graduate course illustrates how the framework can be implemented while protecting students from coerced personal disclosure. Within the U.S. counselor education and mental health training context, policy recommendations address curriculum infusion, weight stigma, countertransference, competency assessment, and basic detection and referral preparations. Integrating body-related reflection with diagnostic knowledge may offer a promising approach for helping clinicians recognize when eating disorder and body image concerns warrant further inquiry, reduce stereotype-based omissions, and respond more deliberately across diverse clinical settings; however, whether embodied training improves detection outcomes remains an empirical question.<\/jats:p>","DOI":"10.3390\/bs16091618","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:38:39Z","timestamp":1789040319000},"page":"1618","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Awareness to Action: Advancing Counselor Education Policy to Improve Early Detection of Eating Disorders Through Embodied Reflection"],"prefix":"10.3390","volume":"16","author":[{"given":"Rebecca E.","family":"Taylor","sequence":"first","affiliation":[{"name":"School of Counseling, Colorado Christian University, Lakewood, CO 80226, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9401-4275","authenticated-orcid":false,"given":"Sarah","family":"Jarvie","sequence":"additional","affiliation":[{"name":"School of Counseling, Colorado Christian University, Lakewood, CO 80226, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1002\/eat.23956","article-title":"Food insecurity and binge eating: A systematic review and meta-analysis","volume":"56","author":"Abene","year":"2023","journal-title":"International Journal of Eating Disorders"},{"key":"ref_2","unstructured":"Accreditation Council for Graduate Medical Education [ACGME] (2026, September 01). The psychiatry milestones, Available online: https:\/\/www.acgme.org\/globalassets\/pdfs\/milestones\/psychiatrymilestones.pdf."},{"key":"ref_3","unstructured":"American Counseling Association [ACA] (2026, July 15). 2014 ACA code of ethics, Available online: https:\/\/www.counseling.org\/docs\/default-source\/default-document-library\/ethics\/2014-aca-code-of-ethics.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association [APA] (2022). Diagnostic and statistical manual of mental disorders, American Psychiatric Association. [5th ed., text rev.].","DOI":"10.1176\/appi.books.9780890425787"},{"key":"ref_5","unstructured":"American Psychological Association [APA] (2026, July 20). Multicultural guidelines: An ecological approach to context, identity, and intersectionality, Available online: https:\/\/www.apa.org\/about\/policy\/multicultural-guidelines.pdf."},{"key":"ref_6","unstructured":"American Psychological Association, Commission on Accreditation [APA-CoA] (2026, July 18). Section C: Implementing regulations related to the Standards of Accreditation, Available online: https:\/\/digital.apa.org\/accreditation-files\/policies_procedures\/apa-ir-section-c-082224.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1002\/erv.2745","article-title":"Duration of untreated eating disorder and relationship to outcomes: A systematic review of the literature","volume":"29","author":"Austin","year":"2021","journal-title":"European Eating Disorders Review"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s40337-022-00597-8","article-title":"Screening, assessment and diagnosis in the eating disorders: Findings from a rapid review","volume":"10","author":"Bryant","year":"2022","journal-title":"Journal of Eating Disorders"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1002\/eat.23371","article-title":"Where identities converge: The importance of intersectionality in eating disorders research","volume":"53","author":"Burke","year":"2020","journal-title":"International Journal of Eating Disorders"},{"key":"ref_10","unstructured":"Council for Accreditation of Counseling and Related Educational Programs (2026, July 15). 2024 CACREP standards, Available online: https:\/\/www.cacrep.org\/wp-content\/uploads\/2023\/12\/2024-CACREP-Standards.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1002\/eat.24374","article-title":"Weight stigma\u2019s effects on misdiagnosis of eating disorders among laypeople and healthcare professionals","volume":"58","author":"Walker","year":"2025","journal-title":"International Journal of Eating Disorders"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s40337-024-00982-5","article-title":"A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide","volume":"12","author":"Ghazzawi","year":"2024","journal-title":"Journal of Eating Disorders"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1002\/eat.23519","article-title":"Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature","volume":"54","author":"Harrop","year":"2021","journal-title":"International Journal of Eating Disorders"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"212","DOI":"10.15241\/tji.14.2.212","article-title":"Enhancing counselor trainee preparedness for treating eating disorders: Recommendations for counselor educators","volume":"14","author":"Irvine","year":"2024","journal-title":"The Professional Counselor"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jpsychores.2018.04.005","article-title":"Self-reported interoceptive deficits in eating disorders: A meta-analysis of studies using the Eating Disorder Inventory","volume":"110","author":"Jenkinson","year":"2018","journal-title":"Journal of Psychosomatic Research"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/eat.22670","article-title":"Addressing critical gaps in the treatment of eating disorders","volume":"50","author":"Kazdin","year":"2017","journal-title":"International Journal of Eating Disorders"},{"key":"ref_17","first-page":"3","article-title":"Addressing anti-fat bias: A crash course for counselors and counselors-in-training","volume":"15","author":"McMurray","year":"2022","journal-title":"Journal of Counselor Preparation and Supervision"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1002\/eat.23238","article-title":"Body appreciation and intuitive eating in eating disorder recovery","volume":"53","author":"Koller","year":"2020","journal-title":"International Journal of Eating Disorders"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40337-023-00758-3","article-title":"Prevention and early intervention in eating disorders: Findings from a rapid review","volume":"11","author":"Koreshe","year":"2023","journal-title":"Journal of Eating Disorders"},{"key":"ref_20","first-page":"2","article-title":"Exploring clinician attitudes towards treating eating disorders: Bridging counselor training gaps","volume":"17","author":"Labarta","year":"2023","journal-title":"Journal of Counselor Preparation and Supervision"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"101678","DOI":"10.1016\/j.bodyim.2023.101678","article-title":"A systematic review of weight stigma and disordered eating cognitions and behaviors","volume":"48","author":"Levinson","year":"2024","journal-title":"Body Image"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1002\/j.2161-1939.2006.tb00008.x","article-title":"Eating disorders training and counselor preparation: A survey of graduate programs","volume":"45","author":"Levitt","year":"2006","journal-title":"The Journal of Humanistic Counseling, Education and Development"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.bodyim.2019.08.009","article-title":"Cognitive-behavioral roots of body image therapy and prevention","volume":"31","author":"Diedrichs","year":"2019","journal-title":"Body Image"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s40337-020-00323-2","article-title":"Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type: A systematic review","volume":"8","author":"Mancine","year":"2020","journal-title":"Journal of Eating Disorders"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.neubiorev.2019.08.020","article-title":"Interoception and disordered eating: A systematic review","volume":"107","author":"Martin","year":"2019","journal-title":"Neuroscience & Biobehavioral Reviews"},{"key":"ref_26","unstructured":"Mehler, P. S., and Andersen, A. E. (2022). Eating disorders: A comprehensive guide to medical care and complications, Johns Hopkins University Press. [4th ed.]."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1186\/s13643-021-01823-1","article-title":"Treatment of eating disorders in older people: A systematic review","volume":"10","author":"Mulchandani","year":"2021","journal-title":"Systematic Reviews"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1097\/MOP.0000000000000911","article-title":"Eating disorders in adolescent boys and young men: An update","volume":"32","author":"Nagata","year":"2020","journal-title":"Current Opinion in Pediatrics"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Philip, S. R., Standen, E. C., Schueler, J., Fields, S. A., and Phelan, S. M. (2025). Weight bias in mental health settings: A scoping review. Frontiers in Psychiatry, 16.","DOI":"10.3389\/fpsyt.2025.1596625"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.bodyim.2022.12.005","article-title":"The developmental theory of embodiment: Quantitative measurement of facilitative and adverse experiences in the social environment","volume":"44","author":"Piran","year":"2023","journal-title":"Body Image"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/jmcd.12035","article-title":"Multicultural and social justice counseling competencies: Guidelines for the counseling profession","volume":"44","author":"Ratts","year":"2016","journal-title":"Journal of Multicultural Counseling and Development"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/ceas.70017","article-title":"Teaching the body-as-lived: Integrating embodied self-awareness into counselor education through phenomenology and practice","volume":"65","author":"Wilkinson","year":"2026","journal-title":"Counselor Education and Supervision"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.annepidem.2022.04.007","article-title":"Variability in eating disorder risk and diagnosis in transgender and gender diverse college students","volume":"70","author":"Simone","year":"2022","journal-title":"Annals of Epidemiology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1002\/eat.22846","article-title":"Disparities in eating disorder diagnosis and treatment according to weight status, race\/ethnicity, socioeconomic background, and sex among college students","volume":"51","author":"Sonneville","year":"2018","journal-title":"International Journal of Eating Disorders"},{"key":"ref_35","unstructured":"Taylor, R. E. (CSL-634 eating disorders: Course development map [Unpublished course development document], 2024). CSL-634 eating disorders: Course development map [Unpublished course development document]."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.bodyim.2015.04.001","article-title":"What is and what is not positive body image? Conceptual foundations and construct definition","volume":"14","author":"Tylka","year":"2015","journal-title":"Body Image"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.bodyim.2010.01.001","article-title":"\u201cBut I like my body\u201d: Positive body image characteristics and a holistic model for young-adult women","volume":"7","author":"Tylka","year":"2010","journal-title":"Body Image"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/9\/1618\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:49:42Z","timestamp":1789040982000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/9\/1618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":37,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["bs16091618"],"URL":"https:\/\/doi.org\/10.3390\/bs16091618","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]}}}