Family-Based Treatment
Family-based treatment (FBT), also known as the Maudsley Approach, is a prominent and effective treatment for eating disorders, particularly for adolescents. It involves the whole family in the recovery process, emphasizing the role of family support in overcoming the disorder.
Core Principles
Family Involvement: FBT places the family at the center of the treatment process. It involves parents as active participants in the recovery, particularly in the early stages.
Restoration of Weight and Health: The initial focus is often on helping the individual restore a healthy weight and normalize eating patterns. Parents are given guidance on how to support their child in achieving these goals.
Parental Control: At the beginning of treatment, parents are tasked with taking control over their child’s eating behaviors, including meal planning and supervision. This is intended to remove the disorder's control and encourage healthier behaviors.
Gradual Return of Autonomy: As the individual starts to recover, responsibility for eating and health gradually shifts back to them. The therapy addresses any ongoing issues and supports the adolescent’s development of self-management skills.
Addressing Family Dynamics: The therapy also explores and addresses family dynamics and relationships that may impact the eating disorder. It aims to improve communication and problem-solving within the family.
Phases of Treatment
FBT typically involves three phases:
Phase 1: Weight Restoration: Parents manage the eating disorder behaviors, including meal supervision and encouragement. The goal is to help the individual regain a healthy weight and stabilize their physical health.
Phase 2: Returning Control to the Adolescent: Once weight is restored and the eating disorder’s immediate impact is managed, focus shifts to allowing the adolescent to take more control over their eating and addressing any psychological issues related to the disorder.
Phase 3: Establishing Healthy Adolescent Identity: The final phase deals with helping the adolescent develop a healthy identity and coping strategies. The family’s role is to support the adolescent’s autonomy and address any lingering issues related to the eating disorder.
Evidence and Effectiveness
Research has shown that FBT can be highly effective for adolescents with anorexia nervosa and bulimia nervosa. It has been associated with significant improvements in eating disorder symptoms, weight restoration, and overall functioning. Outcomes are generally positive when treatment is delivered effectively and families are engaged.