One of the approaches that has the strongest research support for treating anorexia in adolescents is Family Based Treatment (FBT).
What is Family Based Treatment for Anorexia?
Anorexia nervosa is a very difficult disorder to treat. That’s why getting your adolescent into treatment just as the first signs and symptoms emerge is crucial. Through family based treatment, disrupting life because of inpatient treatment can be avoided. Treatment using FBT can be done on an outpatient basis.
The Treatment Protocol Overview
Through the Family Based Treatment approach, psychologists work to teach the parents to take charge of helping their adolescent child return to a healthy weight. Once this is done, then the control of meals and food slowly gets handed back to the adolescent and they can work directly with the therapist to continue to work on normal developmental issues and concerns. Treatment typically occurs over the course of 12 months.
Phases of Family Based Treatment
Phase I: Weight Restoration
In Phase I of FBT, the therapist helps to educate the family about the severe impact that being malnourished can have on their adolescent child. In this phase, the therapists asks the family about their typical interactions day-to-day along with the family eating patterns. The therapist also brings in siblings to help the adolescent patient get more support from them. The therapist will work with all family members to help them understand their role in helping the adolescent patient get back to a healthy weight. Essentially, the family unit will serve as a treatment team within the home. The parents will provide consistency in their expectations that the adolescent patient must complete meals and eat more than they may be comfortable eating. Parents will learn how to do this in an empathetic, compassionate, and caring way. The family will learn what therapists often do in treatment which is to understand that the adolescent is not being defiant and should not be criticized, but that the family is working together to eradicate the eating disorder.
Parents will be tasked with taking as many measures as needed to ensure that their child is eating adequately. Often that may mean meeting with the child for lunch at school or coordinating with guidance counselors or teachers at school to ensure that someone is eating meals with the patient. If parents are having trouble understanding how much to give their child to eat, they can meet with one of our nutritionists who specializes in Family Based Treatment for eating disorders to get guidance on this process.
Phase II: Giving back control over eating
As the patient’s weight is being restored and the patient is eating what is expected of him or her, then we gradually begin to give back control over eating to the adolescent patient. The parents and therapist will continue to monitor weight status and begin to tend to more routine family and adolescent concerns. As the parent becomes more and more confident that the patient is capable of feeding herself adequately, they can allow him or her to be back in control of making decisions around food and eating on his/her own.
Phase III: Focusing on adolescence & identity
In the last phase of treatment when the patient has demonstrated he or she can maintain a healthy weight on his or her own, the focus of treatment then becomes having the adolescent build a healthy identity and become more independent within parental limits. The therapist will continue to work with the family to focus on these particular issues.
There is strong evidence-based research supporting Family Based Treatment for Anorexia amongst adolescents.