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Healthcare providers and treatment centers are increasingly encountering clients with eating disorders who present with heightened medical and psychiatric acuity. These individuals often experience a significantly narrowed window of tolerance, resulting in rigid avoidance strategies, emotional dysregulation, and interpersonal disconnection that can impede progress in treatment. Treatment approaches that emphasize expanding the window of tolerance assist clients in building emotional tolerance and resilience, thus reducing their reliance on symptoms. However, traditional protocols, while evidence-based, may not fully account for the nuanced needs of this growing population, particularly when complex trauma histories are present. This interactive workshop offers an integrative clinical framework grounded in Trauma-Informed Care, Harm Reduction, Relational-Cultural Theory (RCT), and the Unified Protocol for Emotional Disorders (UP). It will explore how to adapt core transdiagnostic principles-including emotional awareness, distress tolerance, and cognitive flexibility-to better serve clients whose avoidance and dysregulation are rooted in relational wounds and psychological distress. Emphasis will be placed on the clinician's role in creating 'safe enough' therapeutic spaces that fosters mutual empathy, cultural humility, and connection. Participants will learn how to balance fidelity to evidence-based models with the responsiveness needed to attend to emotion dysregulation, shame, and disconnection-core drivers of emotional avoidance and eating disorder behaviors. Strategies such as harm reduction, emotion coaching, and co-regulation will highlight their practical application with vulnerable clients. The workshop will include case examples, experiential exercises, and group discussion that illustrate practical and flexible applications of these integrated models across disciplines and treatment spaces. Attendees will leave with concrete tools to enhance emotional regulation, reduce avoidance, and cultivate authentic, reparative relationships with clients-especially those navigating chronic dysregulation.
