The most challenging aspect of counseling is figuring out what individual students need--especially when that call comes in the middle of the night.

"Crisis time can be at three. You have to snap out of sleep and talk to somebody," one of the co-directors says.

Reindl says the late night availability is one of ECHO's greatest assets.

"People experience a great deal of distress in the middle of the night when they feel alone," she says. "It's a difficult time for people with eating disorders who are overwhelmed with emotions. ECHO gives them another choice in that moment."

The solitude possible in a college environment can be one of the most difficult factors for students struggling with eating disorders to overcome, she adds.

On One End

New counselors join the ECHO staff at the start of each semester. After an interview process that includes role-play situations, new staff members go through extensive training with nutritionists, psychiatrists and other experts.

People often have personal reasons for joining ECHO. Members acknowledge that several staff members have a history of eating disorders.

"For some they've had an experience. Often people want to share what they've learned. It can be a wonderful asset when talking to somebody or helping somebody," a co-director says.

Reindl agrees that ECHO staffers with a more intimate knowledge of the concerns can bring their expertise to the counseling process.

"A number of them have now recovered, and it's a way to take some additional steps in their own healing," she says. "That's powerful that they can make a real contribution."

But even though not all counselors have had eating disorders, they all have experiences from their daily lives that make them aware of the threat.

"People on staff have, people on staff haven't. We all have pretty strong reasons for attaching ourselves to this peer group over another one," a co-director says.

Resonating in the Community

In recent years, ECHO has reinvigorated the group's outreach program. Staff members say eating disorders need a higher profile on campus.