Family-Based Treatment (FBT) for Eating Disorders: 5 Things You Didn’t Know
There are few words that can describe the feeling a parent gets when they discover their adolescent has been diagnosed with an eating disorder. As a complex illness that can dramatically and rapidly affect both the physical and psychological well-being of an individual, families might feel hopeless or not know how to specifically help with the recovery process. Most probably don’t realize how Family-Based Treatment (FBT) can actually empower them.
FBT focuses on expanding treatment outside of the clinical setting and into the individual’s home. Under this philosophy, families are provided with skills, resources and an active role in their child’s treatment. It is a manualized approach that can be implemented in a variety of family systems, including both single caretaker and multiple caretaker homes, allowing it to work across numerous populations. Through my work at Walden, I continually see the power of FBT in uniting families during what is otherwise an incredibly challenging time.
Some facts you may not know about Family-Based Treatment:
1) FBT is currently considered the best treatment for adolescents under 19 years old diagnosed with Anorexia Nervosa. As an evidence-based approach, research has shown that approximately two-thirds of adolescents with anorexia nervosa are recovered at the end of FBT treatment and 75-90% maintained full weight recovery at five years following treatment. In addition to maintaining physical recovery, these adolescents also demonstrate similar progress in terms of psychological factors.
2) FBT can be used to treat several types of eating disorders. Although typically considered a treatment for adolescents with anorexia nervosa, the three stages found in FBT can be modified to treat individuals impacted by bulimia nervosa, avoidant/restrictive food intake disorder (ARFID), binge eating disorder and other unspecified eating disorders. These stages include 1). Weight restoration (or cessation of eating disorder behaviors), 2). Returning control to the adolescent and 3). Establishing healthy adolescent identity.
3) FBT doesn’t play the blame game. FBT is a strength-based approach that redirects all treatment focus on figuring out what we can do to help a child recover. It’s not about who or what caused the eating disorder, but helping the child and family to move forward into healthy adolescent development. FBT views parents as invaluable resources in their child’s recovery.
4) FBT has origins in the Maudsley Approach. Established in the 1980’s by a team of child and adolescent psychologists and psychiatrists at the Maudsley Hospital in London, the Maudsley Approach was developed to help reduce inpatient hospitalizations of adolescents with anorexia nervosa. The team believed treatment would be more effective if parents were equipped with the skills and knowledge necessary to help their child recover and return to normal adolescent life and development. Utilizing this concept, FBT was developed as a more behaviorally focused family-based treatment intervention.
5) FBT is not force feeding. FBT works to empower parents throughout their child’s recovery process. An integral part of the FBT model includes engaging in coached meals. During a coached meal session, parents receive in-the-moment training around how to support their child firmly and compassionately through meal expectations geared towards reversing the effects of starvation.
Helping a loved one through their eating disorder recovery process can often be a daunting experience. However, with the help of professionals trained in the FBT model, individuals and families alike are provided with the skills, direction, and framework to not only reach eating disorder recovery – but sustain it.
Cailin Mateleska, LMHC, ATR, is an adolescent clinician providing individual, family, and group counseling within Walden’s partial hospitalization and intensive outpatient levels of care at the Peabody clinic. Receiving her master’s degree in mental health counseling and expressive therapies from Lesley University, Cailin has been with Walden Behavioral Care since September 2016. Prior to her time at Walden, Cailin was serving individuals in DYS, foster care, as well as international conflict region settings. Cailin’s current interests include utilizing a combination of Family-Based Treatment (FBT), Cognitive Behavioral Therapy (CBT), and the expressive therapies to work with individuals suffering from eating disorders.