Evidence-based Family Therapy for Children and Adolescents with Eating Disorders
Family based therapy (FBT) is the only evidence-based treatment for children and adolescents with eating disorders. Treatment providers of FBT recognize that by the time families reach out for treatment, the eating disorder has likely disrupted the entire family system and families are either in distress or denial. Unlike other therapies that might have an underlying belief of the family as the cause of the disorder, FBT views parents as a child’s greatest asset in recovery. This treatment modality utilizes the family system to facilitate their child’s healing. By involving the whole family in the treatment process, the parents are empowered and become an integral part of their child’s recovery. As a result of their level of participation and learning, the entire family system experiences growth and is strengthened by the process of recovery. At The Smith Counseling Group, we believe that family based therapy (FBT) is not only science-based, but essential for the treatment of eating disorders in children and adolescents.
Why Family Based Therapy Is Key for Treating Eating Disorders in Children and Adolescents
Family based therapy, or FBT, teaches parents to become experts on their child’s eating disorder and the therapist will often function as a recovery “coach” to the family. While helping to empower and inform the family, FBT therapists also act as liaison to other involved health professionals, such as nutritionists, pediatricians and psychiatrists. Through weekly meetings, FBT will help to correct the family hierarchy that may have become disrupted by the eating disorder. Parents are empowered to re-establish their roles as competent and confident leaders of the family.
FBT also improves overall family communication. Parents and siblings grow more confident in their communication, and with newly developed skills it becomes easier to tackle complex family issues and topics.
Key Techniques Used in Family-Based Treatment
1. Meal Support and learning how to do food-based exposures
Families are guided on how to provide supportive and structured meal times while dealing with behaviors triggered by the child’s anxiety around eating. For a child with an eating disorder, meal times are often the most disruptive part of family life. FBT provides parents with education around what is happening with their child during meal times, as well as tools for how best to support their child through the meal.
2. Externalizing the illness
During the acute phase of an eating disorder, parents often don’t recognize their child. Suddenly, an enthusiastic and cheerful child can become angry, aggressive or sullen. Externalizing the illness means that you will not assume the behaviors you are seeing are your child being “difficult”. Rather, FBT will teach you to recognize when the eating disorder is driving your child’s behavior and they are not currently in control. Externalizing the illness (for example, “That’s not my child, that’s the eating disorder talking right now,”) allows parents to tolerate current disturbing behaviors knowing through the process of recovery your child will be returned to you.
3. Emotion Coaching
Families learn how to tolerate and diffuse emotional situations that in the past might have led to conflict. FBT borrows from the discipline of Dialectical Behavioral Therapy (DBT) to teach parents critical skills around emotion regulation and distress tolerance.
4. Problem-Solving Skills
Prior to FBT, parents may freeze or negotiate in the moment when eating disorder symptoms arise. FBT therapists equip families with skills to resolve conflicts and issues on the spot, particularly during the first phase of FBT.
5. Setting Behavioral Expectations
FBT meetings focus on establishing behavioral expectations around meals and daily routines. With expectations clearly laid out, the child has the structure necessary for nutritional rehabilitation and parents have an easier time staying on-track with recovery.
These are only some of the myriad skills that will be addressed during FBT. Each session focuses on what is happening with their child’s recovery in the moment to help or hinder weekly progress. Parents will leave each session with a greater understanding of the illness, skills and tools to deal with symptomatic behaviors and a plan for how to proceed that week. This holistic approach ensures that all family members actively participate in healing.
The Smith Counseling Group believes in the evidence-based power of FBT. Our dedicated professionals are here to guide families through this journey. By working together, we can help your child achieve recovery, while also healing the family system.
If you're ready to take the first step towards evidence-based family based therapy, contact The Smith Counseling Group today. Let’s work together to support your child's path to recovery.
