Auburn Eating Disorders Clinic (AEDC), the newest clinic at the Psychological Services Center, is expanding access to mental health care by providing empirically based, low-cost treatment for a diverse range of clients.
Creation of the Clinic
Co-directors Dr. Tiffany Brown and Dr. April Smith, licensed clinical psychologists who work as assistant professors in the Department of Psychological Sciences, founded AEDC in 2022. Smith said opening an eating disorder clinic had been a dream of hers since the beginning of her career.
When Smith arrived at Auburn five years ago, Brown —her co-director and fellow eating disorder specialist— had just begun her tenure as well. The two realized they shared the same vision of opening an eating disorder clinic. Smith said their shared passion and energy helped bring the idea to life.
“We really wanted to do this because we have spent our lives researching eating disorders and understanding what contributes to their development and maintenance,” Smith said. “We wanted to transition to being able to take that knowledge base and apply it to people who are currently struggling with eating disorders.”
Smith said that part of the clinic’s mission is training the next generation of leaders in the field, particularly current graduate students.
An Empirical Approach
AEDC is dedicated to providing empirically-based treatment proven effective through randomized control trials. Smith said that randomized trials help identify the most effective treatments for specific eating disorders across different age groups.
Research serves as a foundation of the clinic’s work. Some studies are conducted directly within the clinic, where clients complete baseline assessments when they first arrive, followed by additional assessments at four weeks, 12 weeks and again at the time of discharge. These measures help clinicians track progress and evaluate the effectiveness of treatment approaches.
“We’re still relatively new and building that database up, but we do hope to be able to use that database to make sure we are seeing the types of positive outcomes that we expect,” Smith said.
However, early feedback has been encouraging.
“I can tell you from just looking at our acceptability and overall happiness with the clinic, people have reported really high ratings, which we’ve been delighted to see,” Smith said.
Meeting the Need
While AEDC is on campus, it serves diverse clientele, with about half being students and half being community members of varying ages with a wide variety of needs from different backgrounds.
The creation of AEDC has helped fill a significant gap in treatment options in the region. Previously, the closest clinics were several hours away in Atlanta or Birmingham, Alabama.
“There is not any other outpatient clinic that sees individuals across the lifespan within several hundred miles,” Smith said.
Smith also emphasized the clinic’s low cost, which improves accessibility for individuals seeking treatment.
“We’re probably the lowest-cost option you can find in the state,” Smith said. The clinic is a nonprofit organization that receives most of its funding through fundraising efforts and donations. It is currently preparing for Tiger Giving Day, the university’s annual fundraiser that supports programs and initiatives across campus. The clinic is also hoping to organize a drive or fundraiser for nutritional and liquid supplements that can be provided to clients who need them.
The clinic provides therapy for eating disorders, psychological evaluations, and specialized treatment programs. The demand for these services became clear almost immediately after the clinic opened. Within its first week, a waitlist had already formed — one that still exists today.
“We wish we could serve even more people than we can,” Smith said.
The clinic’s patient population has also been broader than the founders initially expected.
“We have been continuously surprised by the diversity of the clients that we’re seeing and the concerns: children, college students and adults who struggle with Avoidant Restrictive Food Intake Disorder (ARFID), anorexia, atypical anorexia, bulimia nervosa and binge eating,” Smith said.
Smith added that the distribution of these conditions among patients has been fairly even across diagnoses.
Context-Based Treatment
A specialty of the clinic is providing family-based treatment for anorexia for patients still living at home.
Typically, younger clients come in with ARFID. However, Smith said that the clinic has seen anorexia cases in children as young as 10. Despite the severity of these cases, Smith said early intervention has shown positive outcomes.
“We’re thrilled to say that the families we’ve worked with do well with those restrictive eating disorders with early intervention,” Smith said.
Family-based treatment for anorexia involves working with the entire family, utilizing parents and siblings to take charge in addressing the eating disorder and supporting refeeding. Coaching with parents takes a primary role at the beginning of treatment, and as treatment continues, the focus gradually shifts to the patient, providing the client with increasing control around eating in a developmentally appropriate way.
ARFID typically demonstrates food avoidance that is not related to shape or weight, Smith explained. “They’re typically avoiding foods because of sensory issues or because of a traumatic experience they had around eating, like choking or a lack of hunger signals.”
Treatment for ARFID in a family context often involves gradual exposure using all five senses. Smith explained that a vegetable intolerance may begin with foods such as veggie chips and gradually progress through purées and roasted vegetables before eventually reaching raw vegetables.
Smith said this process uses scaffolding —incorporating taste, touch and sight— to help introduce avoided foods while making the process more manageable and even enjoyable. Through this gradual buildup, clients can slowly increase their tolerance for foods they previously avoided.
A significant addendum to the work of the clinic is that students going through treatment, or those in the diagnostic process, have access to getting labs done at the medical clinic and working with dietitians and nutritionists at a very low cost.
Current Work
“We are constantly looking at the research to think about how to better serve our clients,” Smith said. She explained that one of those ways is through the incorporation of cognitive behavioral therapy for eating disorders.
This approach typically takes 20 to 40 weeks for treatment. However, a newer empirically-supported approach allows treatment for highly motivated individuals who are not underweight.
“We have been really pleased to get all of our graduate student clinicians trained on the 10 session cognitive behavioral therapy protocol,” Smith said.
Smith also highlighted the clinic’s innovative work in treating ARFID, noting that the clinic uses cognitive behavioral therapy for the disorder — a relatively new treatment that is not widely available at other facilities.
The clinic also offers four-week group programs aimed at improving body image. Smith said these groups have been shown to help not only with treating eating disorder symptoms but also with addressing broader body image concerns.
Get Involved
For individuals who may need help or are seeking involvement, Smith said they are not alone.
“Help is available, and early treatment is the single best predictor of recovery,” Smith said. "The sooner you can get in, the better your chances are of living a happy, well-nourished, fulfilling life - and you’re welcome to call the Auburn Eating Disorders Clinic.”
Additional resources and support can also be found through the National Eating Disorders Association website.
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