Traditional treatment for eating disorders often excluded parents and families and even blamed them for creating the illness. In contrast to these, family based treatment for eating disorders (FBT) sees parents and families as a crucial part of the solution. In FBT, healing and recovery happen not just for the ill child, but for the family as a whole and for each family member. Critical to this process, however, is active and consistent participation in the treatment process on an ongoing basis.
FBT is a demanding treatment that brings stellar results when implemented properly. It is truly a treatment that only works if you work it!
What do I mean by this? First, let me describe some of the demands of FBT. FBT requires active and ongoing participation of parents in grocery shopping, meal planning and preparation, meal supervision, and post-meal supervision. It also requires parents to collaborate with each other on the parent level as well as to communicate effectively with all family members–including siblings, grandparents, and extended family. FBT requires parents to develop a system, implement it, and modify it as needed. FBT requires parents to be incredibly strong and committed, especially in the face of extreme resistance.
What are the payoffs of all this work?
FBT truly works, but only if you work it!
Occasionally, I see families starting to get “stuck” in the middle of treatment. The child’s weight may plateau at a lower weight than the target range or weight loss may even occur. When this happens, it is crucial to do some detective work.
Essential to being an effective detective is to make sure that throughout FBT you are keeping careful meal logs and doing very mindful meal observation. Ask yourself the following questions: Have portion sizes or types of food being eaten shifted? Has your child’s activity level changed? Has your child been been managing any of her own meals or snacks? Could any compensatory behaviors have developed?
Once you identify potential obstacles to further progress, develop a detailed game plan to address each and every obstacle. For FBT to continue to work, you must actively work the treatment as well. This means making modifications as needed. The same plan that works at the inception of treatment may not be the same one that is needed at later stages.
Ask yourself the difficult questions. Refocus your lens. Recommit to the process. Above all else, stay strong. If you take these steps, you can and will get your child on the path to full recovery.