What is Family Based Treatment?
Eating disorders are complex mental health conditions that don’t have a singular cause. When a child or adolescent develops an eating disorder, many parents blame themselves, but no one causes an eating disorder in someone else. Parents are, however, an instrumental part in recovery from an eating disorder. Beyond finding clinicians to help their child and taking them to appointments, another option exists that empowers parents to facilitate their child’s recovery. Family-Based Treatment, also known as FBT or the Maudsley method/approach, is an evidence-based treatment for eating disorders. It’s most often used in outpatient settings, and utilizes the patient’s family members. FBT recognizes that families are not to blame for an eating disorder, and it equips families with specific tools to help their loved one recover.
At Namaste Nourished, we utilize FBT when appropriate or requested. This requires our families and caretakers to understand we need them as an integral part of the treatment team. Our dietitians can help guide you in how to implement FBT at home, provide coaching, and be a support system for both family members and their loved one. Read on for the 5 core tenets to FBT and the 3 phases of treatment to see if FBT might be right for your family.
5 Core Principles of Family-Based Treatment
FBT has a few specific principles that differ from other approaches to treating eating disorders.
FBT takes an agnostic view of the illness, and makes no assumptions about the potential cause(s). This removes any blame on the child, family, and parents.
Separation of the disorder from the child. It emphasizes that the child and the eating disorder are distinct, and treats the eating disorder as something that the child is not in control of. It also removes parental criticism from treatment.
The provider takes a nonauthoritarian point of view, and guides the family, but does not tell them what to do. It recognizes that there is no one-size fits all approach to treating eating disorders, and allows the treatment team to provide guidance, but empower the parents to make the decision that is best for their family and child.
Empowering the parents is another core principle. FBT views parents as the best resource for a child in eating disorder recovery, and the people who will best be able to enact behavioral change. Providers work closely with therapists to empower and educate them, so that the parents have the resources and confidence to best help their child.
Focusing on current symptoms and reducing their impact. FBT recognizes that there are co-occurring conditions along with other complications that occur from the eating disorder, but these are not addressed in the course of FBT. Rather, weight restoration is prioritized, with the complications either resolving themselves when weight is restored, or the complications are addressed after FBT is complete.
3 Phases of Family-Based Treatment
FBT can take 6-9 months and is separated into three phases. Each individual and family are different, and we want to emphasize that 6-9 months is an average. Early intervention coupled with a motivated client and family can result in a shorter recovery overall. A dietitian who specializes in FBT can help you determine when it is appropriate to move to the next phase, and assist in implementing each phase, so that you feel supported and in charge.
Phase 1: Parents or caregivers have 100% responsibility for their child’s eating-related decisions. They decide what the child will eat, plate the food, and the child must finish all the food provided by the parent/caregiver.
Phase 2: Eating-related decisions are gradually handed back to the child. This depends on the age of the child, where they are in their recovery and behaviors, and can be very slow and gradual, as everyone adjusts to this new phase.
Phase 3: The FBT provider assesses where the child is in their recovery, what symptoms currently look like, and creates a plan for the family moving forward.
Family Based Treatment is incredibly effective in the treatment of eating disorders. If you have questions about FBT, or how a dietitian could help you and your family explore FBT, please reach out to us today.