The term body image refers to our thoughts, perceptions, feelings, attitudes, and behaviors about our physical appearance. Our body image begins to take shape at a young age and is influenced by our environment, culture, caregivers, and peers. A negative body image can cause anxiety or discomfort regarding our body, including physical appearance, skin color, muscularity, physical capabilities, and physical features. In some cases, these concerns are mild and manageable without professional support.
For those who struggle with moderate to severe body image concerns, comprehensive care may be impactful. This can take place in an inpatient or outpatient care setting, depending on their current symptoms, underlying factors, and overall level of functioning. Several risk factors can contribute to the development of body image concerns, such as:
- Gender: Studies have indicated that women are more likely to experience body dissatisfaction, though 10 to 30% of males experience struggle as well.
- Sexual orientation: Research has shown that body dissatisfaction is higher among gay and bisexual men.
- Home environment: Those who are exposed to negative comments about their body, over-exercising habits, or restrictive eating may be more likely to develop poor body image at a younger age.
- Societal norms: Those who feel as though their body does not align with social norms or expectations can experience higher rates of body dissatisfaction.
- History of trauma or abuse: These experiences, especially at a young age, can lead to body dissatisfaction or feeling as though their body is betraying them.
- Social Media: This is a relatively newer risk factor that can lead to misperceptions that cause body dissatisfaction among those who feel as though they look different than others. The use of filters and other technological techniques can modify others’ appearances from their normal state.
Some individuals who struggle with their body image may develop an eating disorder. This can include conditions like Binge-Eating Disorder (BED) and Avoidant/Restrictive Food Intake Disorder (ARFID). For some, eating disorder treatment requires medical intervention and monitoring to promote physical health in addition to psychological wellness.
Cognitive Behavioral Therapy (CBT) is one of the most commonly used therapies with those who are struggling with body image concerns. This approach can help clients identify and modify unhealthy thought patterns and beliefs that affect their feelings and behaviors related to their body image concerns. Treatment can include approaches like self-monitoring, exposure exercises, and cognitive restructuring.
View all of our body image worksheets
Setting Goals and Objectives With Clients in Your Body Image Treatment Plan
Before you begin developing your treatment plan’s goals and objectives, it is important to get an understanding of your client’s presenting symptoms and other mental health concerns. You can begin by reviewing the documentation you have received so far. This can include self-assessments, questionnaires, and completed intake assessments in some cases.
Treatment plans should be tailored to each client. While you may incorporate similar interventions and approaches, there will be variations for each client. Clinicians often find benefit from incorporating worksheets into their sessions and body image treatment plans. TherapyByPro is a leading resource for mental health professionals working with a variety of mental health concerns, including body image and self-esteem issues. Popular worksheets for these concerns include:
What to Include in an Effective Body Image Treatment Plan
For the remainder of our time, we will focus on developing a negative body image treatment plan. We will incorporate a hypothetical case example for a 13-year-old female named Jane. The remainder of this article will be guided by the customizable treatment plan template available with TherapyByPro. Continue reading to begin!
Jane’s Story:
Jane is a 13-year-old female whose parents suggested she try speaking with a counselor. Her parents completed some of Jane’s intake paperwork and indicated that they have noticed a shift in Jane’s mood, behaviors, and clothing choices since returning to school in the Fall. It was noted that she has experienced bullying for her weight, though she is within a healthy weight range for her height and age.
During her initial session, Jane shared that she has started dieting as a result of being uncomfortable in her body. She reported tracking calories and exercising daily. She does not see a concern with these behavioral changes, though her parents have a different opinion. Jane shared that she does spend a significant amount of time focusing on her appearance, especially on school days. She engages in frequent mirror-checking behaviors and experiences negative self-talk about her appearance and body throughout the day. She verbalized a concern about gaining weight, and noted that she has a preoccupation with her stomach and arms. Jane reported mild disengagement from her friends, with a decreased amount of time spent with them outside of school. Anxiety symptoms occur before meal times and before arriving at school and other social events. Jane sees that her behaviors are a concern, but notes that her discomfort in her body is a bigger concern for her. Jane denied all suicidal concerns and has no history of mental health concerns. She denied experiencing severe distress from her symptoms and has been able to maintain her excellent academic standing.
Agencies Involved and Plans for Care Coordination
In this section of your treatment plan, you would note other professionals that can be contacted to ensure whole-person care. In Jane’s case, it would be appropriate to consult with her pediatrician because of her body image concerns and restrictive eating behaviors.
Example for Jane:
Care Coordination: Pediatrician, Dr. Smith (123)456-7890
Clinical Diagnoses
Here, you will make a note of the diagnosis that aligns with your client’s symptoms. Jane appears to be struggling with Other Specified Feeding or Eating Disorder- Atypical Anorexia Nervosa. This diagnosis aligns with her symptoms, including food restriction, fear of gaining weight, and body image distortion. With a healthy weight, she would not meet diagnostic criteria for anorexia nervosa.
Example for Jane:
Clinical Diagnosis: Other Specified Feeding or Eating Disorder-Atypical Anorexia Nervosa ICD-10: F50.89
Current Medications and Responses
Depending on a client’s presenting characteristics, psychiatric medications can be used to promote emotional wellness and healing. Medications may be used in conjunction with therapeutic services. At this time, Jane is not taking medications for psychological or medical concerns. If this changes during her treatment, you’re able to modify this section of your treatment plan.
Example for Jane:
Current Medications: None at this time
Presenting Problem and Related Symptoms
This section of your treatment plan allows you to develop a case conceptualization that supports your coming body image treatment plan goals and objectives. Here, you should be highlighting your client’s current symptoms, their severity, and how they impact her daily functioning.
Example for Jane:
Jane is a 13-year-old female who was referred to treatment by her parents. She has no previous mental health treatment experiences, including counseling and the use of psychiatric medications. Jane’s parents have observed behavioral changes since school began in the fall, including changes in her clothing choices, a decline in social activities, and a preoccupation with her appearance. Her parents noted that Jane has been experiencing bullying about her weight, though her pediatrician indicated that she has a healthy weight for her current height.
Upon speaking with Jane, you learn about restrictive eating patterns, calorie tracking, and excessive mirror checking that began around the time she began to experience bullying. Jane identified her stomach and arms as her “problem areas” and shared her concern for gaining weight in those areas. Jane experiences negative self-talk throughout the day, more so before going into social and public settings. It appears that her body image dissatisfaction appears to be the main source of distress for Jane. She endorsed mild anxiety symptoms and denied suicidal ideation and depressive concerns. She noted that while she does feel overwhelmed at times during the day, she is still able to complete her school work and maintain her academic performance. Jane’s mild symptoms are at risk of worsening without proper support, especially if bullying and other negative social experiences continue.
Goals and Objectives
The goals and objectives section of your treatment plan should identify the framework for your sessions with Jane. Goals and objectives should be tailored to her specific needs, ensuring that she receives personalized and comprehensive care. Your treatment plan objectives should align with the therapeutic framework that you’ll be working from.
Example for Jane:
GOAL: Improve Body Image and Reduce Preoccupation with Appearance
Objective 1: Use thought records to identify negative body image thoughts. Challenge three of these automatic thoughts per week, making note of how they affect her feelings and behaviors to review in session.
Objective 2: Engage in exposure exercises using a mirror while using self-compassion prompts or phrases. Complete this activity a minimum of twice per day before the following session, make a note of thoughts before and after this exercise to bring attention to how self-compassion affects her self-esteem.
Objective 3: Incorporate one mindfulness activity into her daily routine. This can include mindful breathing, body scans, meditations, etc.
GOAL: Incorporate Balanced and Healthy Attitudes Regarding Eating Behaviors and Exercise
Objective 1: Reduce calorie tracking behaviors by deleting apps on the phone and other methods being used. Begin using mindfulness eating logs that track how eating makes her body feel.
Objective 2: Engage in behavioral experiments to test beliefs and thoughts about food and weight that contribute to psychological distress. This can include seeing if certain foods, like carbs, lead to weight gain. Track experiments so they can be reviewed in session.
Objective 3: Find three value-driven reasons for exercising before engaging in physical activity. This can include enjoyment, improve flexibility, and increase energy levels.
GOAL: Improve Self-Esteem
Objective 1: Create a collage that highlights a minimum of five strengths that Jane sees in herself. Bring the collage into a therapy session to explore and process.
Objective 2: Engage in a mindfulness-based self-compassion exercise, like a loving-kindness meditation, twice per week. Have Jane keep track of changes that occur regarding her negative self-talk after using these practices.
Objective 3: Develop a thought replacement card that highlights positive affirmations that can be used to replace or challenge cognitive distortions and other automatic thoughts.
Specific Interventions to Be Used
Here you can list the specific interventions that can be used to work towards your treatment goals. This section of your treatment plan can be updated as you use the different interventions.
Example for Jane:
Intervention: Cognitive restructuring focused on distorted thoughts
Responsible Person: Counselor and Jane
Intervention: Behavioral experiments
Responsible Person: Jane
Intervention: Mirror exposure
Responsible Person: Jane
Intervention: Cognitive rehearsal and role-playing
Responsible Person: Counselor and Jane
Intervention: Thought replacement card
Responsible Person: Jane, with support from Counselor
Additional Services and Interventions
There are a variety of treatment services that can be used to complement other treatment services. In Jane’s case, family therapy sessions can be used to promote communication, provide psychoeducation, and ensure that everyone in the family unit feels heard and supported.
Example for Jane:
Additional Services: Family Therapy once per week
Estimation for Completion
The duration of treatment is dependent and can vary from client to client. It’s important to note that this date is an estimation, which means that the actual duration of treatment can be sooner or later than expected. In Jane’s case, she may benefit from a longer duration of treatment to ensure she receives the support needed to keep her symptoms from progressing. Treatment can include psychoeducation, family therapy, active therapeutic work, and maintenance once she begins to show signs of improvement.
Example for Jane:
Estimated Time of Completion: Six months, to be adjusted as needed
Aftercare Plans
There are a number of reasons why a client would terminate treatment. In a perfect world, it would be that their treatment plan would have been completed, and they would have made significant clinical progress. In some cases, life happens, and treatment is shorter than expected. Preparing the aftercare section of your treatment plan can help you feel prepared for an unexpected termination from treatment. This section should be written as if your client discloses today, which can be adjusted as time progresses.
Example for Jane:
Aftercare Plans: Consult with the Pediatrician and request a referral for outpatient treatment in the local community.
Final Thoughts On Creating an Effective Body Image Treatment Plan
Thank you for taking the time to read about creating a negative body image treatment plan. Working with clients who are beginning to struggle with their body image or self-esteem can prevent the escalation of their symptoms into eating disorders like bulimia or anorexia. Clients can also experience a decrease in anxiety and depressive symptoms that are related to their body dissatisfaction. With a healthy identity and self-esteem, clients can improve their emotional regulation and self-acceptance.
To learn more about how you can support clients struggling with their body image or self-esteem, we encourage you to explore available training and continuing education opportunities within your niche. These are common sources of distress within the United States and may affect a number of clients within your clinical setting.
TherapyByPro is a trusted resource for mental health professionals worldwide. Our therapy tools are designed with one mission in mind: to save you time and help you focus on what truly matters-your clients. Every worksheet, role-play script, and therapy poster in our shop is professionally crafted to simplify your workflow, enhance your sessions, reduce stress, and most of all, help your clients. TherapyByPro is also a worldwide therapist directory. Learn how we can help you connect with new clients, showcase your expertise, and change lives.
View all of our body image worksheets
Resources:
- Alleva JM, Sheeran P, Webb TL, Martijn C, Miles E. A Meta-Analytic Review of Stand-Alone Interventions to Improve Body Image. PLoS One. 2015 Sep 29;10(9):e0139177. doi: 10.1371/journal.pone.0139177. PMID: 26418470; PMCID: PMC4587797.
- Body image and eating disorders. National Eating Disorders Association. (2025, March 21).