May 2017

For parents of an adolescent with an eating disorder, determining the best treatment approach to meet the needs of both your child and yourself can be extremely difficult. It has to be effective. It has to include the family. Simply, it has to work.

For a growing number of families, the approach that fits all the above criteria is Family-Based Treatment (FBT), a philosophy giving families an active, transparent and supporting role not only at home, but inside clinical settings. Most families I work with discover FBT to be a very gratifying, fulfilling and pleasantly surprising experience. In fact, many have admitted it provides invaluable skills and confidence they couldn’t find anywhere else.

From our extensive use of FBT, here are seven surprises parents commonly discover:

1). It is okay to ask for and accept help. – Being the parent of a child with an eating disorder is hard, to say the least. Often the shame you feel for having “missed” something only compounds the fear you have of being blamed for the disorder. However, parents often talk about how helpful FBT is in decreasing shame and increasing their openness to support. FBT does not believe in blaming anyone for the eating disorder — blame is an unfortunate circumstance. The goal is to move forward through behavior disruption and recovery. With FBT, families are given permission to change the conversation from “what caused” the disorder to “I can help my child get well.”

2). I am not the only one going through this. – Eating disorders are isolative. They thrive in the secrecy and the mystery of no one knowing what is truly going on. FBT works to counteract this and empower you through the use of multi-family groups and parent support groups. Knowing you are not alone and that others struggle in similar ways is relieving and immensely helpful in re-energizing parents in their fight against their child’s eating disorder.

3). My child wants support and structure. – Many parents have stated this quote with disbelief during family sessions. If you think about it, few adolescents say, “I would love more boundaries and rules, thanks mom and dad!” Often, it feels like the complete opposite. But what parents learn through FBT is that their child tests their boundaries to ensure they are securely being held. They will challenge at meals to make sure that you are going to help them with their eating disorder and not back down. Your child is asking you to take away the constant stream of negative thoughts and allow them to focus on being a kid again.

4). I can have my child back.
– As parents struggle with eating disorders at home, they often feel as though they have lost their child. They question whether this is the new “norm” and whether life at home is changed forever. Yet, through FBT, parents often report seeing glimpses of their child, including the reemergence of a sense of humor and personality. Of course, this may also include a mix of good and bad, as adolescent development can involve its own challenges, such as having an attitude, challenging rules and making mistakes.

5). I can do it. – FBT is intuitive. At first, it may feel otherwise (counterintuitive). After all, it is hard to ask your child to do something that’s more challenging than anything else they’ve gone through. Remember though, you’ve been successfully feeding your child for years. The eating disorder might make you question yourself and lose confidence. But FBT allows you to regain both confidence and control around meals at home.

6). It works. – FBT works. Parents and their children are able to successfully move forward in their lives, achieving medical stability and ultimate recovery from their eating disorder. In fact, a 2010 study found that two thirds of adolescents participating in FBT in our Intensive Outpatient Program (IOP) were medically recovered one year after follow-up. In addition, 75-90% of adolescent clients remained fully weight-restored at the five-year follow-up.

7). Help is available. – The biggest surprise parents discover is that FBT can be successful, regardless of the severity of their child’s eating disorder.

Treating an eating disorder is incredibly challenging and overwhelming for all who are involved. But using FBT, you’ll find a trusted roadmap to gain the skills, resources and knowledge to help you and your child achieve a fulfilled life free of the eating disorder.

About Amanda Smith, LICSW
Amanda Smith, LICSW is the assistant program director at Walden Behavioral Care’s Peabody clinic. She can be reached at Walden offers a full system of specialized care for individuals and families impacted by all types of eating disorders.