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TBTS - Temperament Overview

CE Hours 1.5

About this course

Temperament-Based Therapy with Support (TBT-S) is a treatment approach for eating disorders that focuses on how biologically based temperament traits interact with eating disorder behaviors. Rather than viewing symptoms as simply a matter of choice or willpower, TBT-S recognizes that traits such as harm avoidance, persistence, novelty seeking, and reward sensitivity influence how individuals respond to stress, food, and emotional experiences. For example, individuals with high harm avoidance may experience intense anxiety and avoid uncertainty, which can contribute to restrictive eating patterns. Those with high persistence may struggle to stop behaviors once they begin, reinforcing rigid food rules or perfectionistic habits. Others with high novelty seeking may be more vulnerable to impulsive eating or binge behaviors. A key principle of TBT-S is that temperament is biologically based and not something that can simply be changed. Instead, treatment focuses on helping individuals and caregivers understand these traits and learn practical skills to work with them more effectively. Caregivers play an important role in the model by supporting behavioral change, reducing blame, and helping create environments that promote recovery. By understanding the relationship between temperament and symptoms, families can respond with empathy while still encouraging healthier behaviors. Ultimately, TBT-S aims to help individuals manage temperament traits, build coping skills, and support long-term recovery from eating disorders.

Learning Objectives

  • Learners will be able to describe at least three temperament traits commonly associated with eating disorders, including harm avoidance, persistence, and novelty seeking.
  • Learners will be able to explain how temperament traits interact with eating disorder behaviors and influence patterns such as restriction, perfectionism, or impulsive eating.
  • Learners will be able to identify at least two ways caregivers or clinicians can support recovery using principles from Temperament-Based Therapy with Support (TBT-S).

Learning Levels

  • Beginner

Target Audience

This educational program is designed for mental health professionals, dietitians, social workers, and health care providers.

Course Instructor(s)

  • Krista Crotty, LMFT, PsyD

    Dr. Krista Crotty earned her Master of Science from Fuller Theological Seminary, School of Psychology, and her Doctorate in Clinical Psychology with an emphasis in family and pediatrics from Azusa Pacific University. She trained at Harbor UCLA Medical Center in the Dept. of Early Intervention Neuropsychology and Loma Linda Children's Hospital in Neuropsychology. Krista serves in the role of clinical education specialist for Accanto Health on a part-time basis. Additionally, Krista is a Certified Temperament Therapy with Supports (TBT-S) Treatment Provider and trainer offering TBT-S in module format in outpatient care and a 5-day intensive TBT-S program in WA state. She is currently the owner of Brain-Based Therapy NW, offering the first privately owned TBT-S intensive program in the world. Dr. Crotty has been blessed by the opportunity to train with Dr. Laura Hill in TBT-S starting in 2018 and is thrilled to be the first certified US trainer. Beyond TBT-S Krista is trained in and clinically draws from cognitive behavioral therapy, dialectical behavioral therapy, family-based treatment, and acceptance and commitment therapy. She is a firm believer in the incorporation of Support and family members in the treatment process and enjoys bringing activity and creativity into the clinical arena. Away from work, Krista loves being a mom to her three boys, being outside, exploring the world, and always finding ways to learn new things.

References

  • Hill, L. L., Knatz Peck, S., & Wierenga, C. E. (2022). Temperament-based therapy with support for anorexia nervosa: A novel treatment. Cambridge University Press.
  • Knatz Peck, S., Towne, T., Wierenga, C. E., Hill, L., Eisler, I., Brown, T., Han, E., Miller, M., Perry, T., & Kaye, W. H. (2021). Temperament-based treatment for young adults with eating disorders: Acceptability and initial efficacy of an intensive multifamily parent-involved treatment. Journal of Eating Disorders, 9(1), 110. https://doi.org/10.1186/s40337-021-00465-x
  • Stedal, K., Funderud, I., Wierenga, C. E., Knatz-Peck, S., & Hill, L. (2023). Acceptability, feasibility and short-term outcomes of temperament-based therapy with support (TBT-S): A novel 5-day treatment for eating disorders. Journal of Eating Disorders, 11, 156. https://doi.org/10.1186/s40337-023-00878-w
  • Stedal, K., Funderud, I., & Lindstedt, K. (2024). How do patients and their supports experience temperament-based therapy with support (TBT-S)? A qualitative study. International Journal of Eating Disorders.
  • Hill, L. L. (2024). Temperament impact on eating disorder symptoms and habit formation: A novel model to inform treatment. Journal of Eating Disorders, 12, 40.
  • Peck, S. K., Towne, T., Wierenga, C. E., Perry, T., Miller, M., Kim, J., & Kaye, W. H. (2024). Parental perceptions of participation in young-adult-focused eating disorder treatment. European Eating Disorders Review.

CE Process Info

Content

  • Materials
    1 parts
    • TBTS - Temperament Overview Deck
  • Recordings
    1 parts
    • Recording
TBTS - Temperament Overview
You Have Completed This course
Free
You are enrolled
  • CE Hours
    1.5
  • Type
    Self-Paced
  • Publication Date
    Jul 8th, 2026

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