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 – it is an unfortunate circumstance and the goal is to now 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 eating disorder
    3. “My child wants the support and structure” – Many parents have stated this quote with disbelief during family session. If you think about it, few adolescents say “I would love more boundaries and rules, thanks mom and dad!” Often times it feels like the complete opposite. But what one learns 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 disorders and not back down. Your child is asking you to take away the constant stream of negative thoughts which will 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 feel as though they have lost their child. They question if 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 might 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, in a study done at in 2010, outcomes reported that 2/3 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. Here at Walden, we have four levels of care which integrate the philosophy of FBT and its principles into the treatment of adolescents with eating disorders improving ease of access to effective treatment.

Treating an eating disorder is incredibly challenging and overwhelming for all those 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.


Amanda Smith, LICSW, is the Assistant Program Director at Walden Behavioral Care’s Peabody clinic. In this role she oversees the day-to-day care of adolescents in the partial hospitalization and intensive outpatient programs. She works closely with staff, providers, families and clients to help foster a recovery-focused environment. Her career at Walden began in 2010 when she served as a clinical case manager on the inpatient unit for eating disorders. Prior to her current role, she spent time as a clinical case manager in residential and the partial hospitalization and intensive outpatient programs in Waltham. She received her masters of social science administration from Case Western Reserve University.