At Walden, intensive adolescent outpatient treatment is based on the principles of the Maudsley Method which temporarily puts parents in charge of nutritional stability. Doing this relieves the adolescent of the overwhelming anxiety regarding food, and requires simply that they come to the table and eat.
But, it’s not so easy. Providing calm and firm support amidst emotional deregulation and extreme resistance is a skill set that needs to be developed by the caregiver. Your clinicians will help you navigate this with support and guidance.
To help you get started developing these skills, a friend, who was a parent of a 12.5 year old boy with anorexia, compiled some sensible quick tips that she found helpful when her son came home from the hospital to continue his recovery. The list may seem overwhelming, but as my friend says, it was her job to feed her son and keep him safe. It was his job to eat.
- No scales in the house or any house where they might visit.
- Never discuss numbers: labels on food, clothing size, weight etc.
- No mirrors in the house.
- To keep your child out of the kitchen, put blue painters tape on the kitchen floor and tell them they can’t cross it. (this works perfectly)
- Do not allow your child to go in the refrigerator.
- Do not allow your child to go to the grocery store.
- Do not discuss/negotiate ingredients or contents of meals or snacks.
- Serve food in a cup/bowl/plate.
- Do not allow your child to go to the bathroom for one hour after meals.
- Put all knives and scissors in a lock box.
- Offer your child hot water bottles after meals.
- When your child goes to the bathroom, sit outside and listen in case they try to engage in unhealthy behaviors.
- Be prepared to cook three meals and snacks a day for your entire family. It can be helpful to prep food early in the morning before your child gets up.
- Do not let your child see you measure or count food.
- When serving food, use large plates and opaque cups.
- If you can, eat every snack and meal with your child.
- Serve meals and snacks at the same time every day. Take food in the cooler in your car if you need to.
- Set a timer; give your child 20 minutes to finish a snack and 30 minutes to finish a meal.
- Always have cartons of Boost in your fridge in case your child doesn’t finish their snack or meal. If they don’t finish a snack have them drink one Boost and if they don’t eat a meal have them drink two Boosts.
- Have lots and lots of distractions, games, trivia, riddles, during meals.
- Focus on distractions over mindfulness at meals.
- Never say “good job” or “you did great” for completing a meal, just say “I know that was hard”, thank them and moved on.
- Have an activity planned for after dinner – a movie, a craft, etc.”