When parents find out their child has an eating disorder, many describe feelings of devastation and helplessness. Through education and experience however, they are often able to discover how invaluable they can truly be in their child’s treatment and recovery.
One area this frequently plays out is meal coaching. For parents, meal coaching is a balance of compassionate limits and encouragement – and often where they realize that they, too, are an active participant in their child’s treatment team. Parents become a partner in recovery through skills coaching and education, alongside what their child is learning in treatment.
Meal coaching isn’t easy. There are regular ups and downs, better moments and worse moments. What works for one family isn’t guaranteed to do the same for the next. But based on our work with hundreds of families, here are six tips to keep in mind:
Validate the efforts
For a child with an eating disorder like anorexia, sitting through a meal is emotionally and physically exhausting. There’s a lot of fear to overcome – and your child is likely fighting an internal battle in their own head. Research shows that it is more effective to praise a child’s efforts rather than what they accomplished. Statements such as “I’m proud of you – You worked hard” are more validating than “You finished! Good job,” which may inadvertently increase fear and guilt after a meal.
Remain cool, calm, and consistent
Sounds pretty easy, right?! No. We are all human with rich emotional lives. Expect to feel frustrated, worried and guilty for feeding your own child, among other things. It happens. Your child is not only anxious about their thoughts and feelings; they’re also very much affected by your overall demeanor. There’s a strong link between a parent’s involvement in learning skills to remain composed and how a child responds to treatment.
Plan – and Stick to It
Without a plan to anchor the approach, parents are more apt to respond ‘off the cuff’ or from a more emotional place. It’s helpful to always think through the following prior to a meal: What is in place for coping (for parent and adolescent)? What will I provide for food? How can I remain consistent with this meal? What rewards are in place for my child for getting through? How can I handle it if my child is stuck? No plan is perfect. The key is to be as prepared as possible and stick to the plan. Everyone is learning.
Effective meal-coaching is about remaining focused and on-task. It is easy to get caught up in discussing what and why things are difficult, but these are important conversations to have away from the table. Doing so in front of your child can increase their emotions and decrease your focus. Establish rules about when negotiations and feedback happens. Try using food-focused prompting language, such as “Take a bite,” “Slow down” and “Sip your milk” – while remaining calm and consistent.
No, this isn’t a mixed message. While a parent needs to remain focused on the meal, an adolescent often needs help distracting from their own thoughts. Innocuous conversations, games, trivia, etc. can be supportive diversions from the battle within – and produce a strong balance to move forward.
Modify Where Needed.
There is no perfect science behind meal coaching; it differs for every single family. Embrace the practice and learning. Take note of what worked and what didn’t. Try different things, like changing where the child sits at the table, rewards or what activities occur before or after a meal. In the end, you know your child best. Use that knowledge.
Again, meal coaching isn’t easy. What happens at the table one night isn’t guaranteed to happen the next. But using these steps – combined with plenty of patience and awareness – one small step at a time will turn into a big difference for both you and your child.
Renee Bazinet Nelson, Psy.D, is Walden’s director of adolescent services. She has comprehensive responsibility for adolescent intensive outpatient programs including oversight of all ambulatory clinics, new program development, program staffing, selection and supervision of staff, budgeting and compliance with all organizational and regulatory agency standards. Formerly, she served as assistant director of Walden’s Worcester clinic. She earned her doctorate in clinical psychology with a concentration in health psychology from the Massachusetts School of Professional Psychology and completed her post-doctoral training at the Cambridge Eating Disorder Center in Massachusetts.