Family Based treatment for eating disorders

What is Family Based Treatment?

Family Based Treatment for Anorexia Nervosa (FT-AN) and Family Based Treatment for Bulimia Nervosa (FT-BN) are the NICE guideline recommended approaches for children and adolescents struggling with eating disorders.  In family based treatment, parents are viewed as the expert on their child. The family unit is viewed as essential for supporting the young person in their recovery. Within family based treatment, the eating disorder is viewed as separate from the child, and the parents and child are encouraged to form an alliance to fight off the eating disorder that may be taking over the child's life.

What does Family Based Treatment involve?

Family based treatment typically has three phases:

  • Phase 1: Empowering parents to take control. Parents are usually encouraged to take complete charge of meals as they help their child to reestablish regular patterns of eating and interrupt problematic eating disorder behaviors such as restricting, bingeing, purging, and overexercise. If weight gain is indicated, the aim is to increase by approximately 0.5kg per week. The therapist works to empower the parents to take on these tasks and helps the parents learn tools to support their child at mealtimes. 

  • Phase 2: Supporting a gradual return of control to the adolescent. This phase typically begins once weight is mostly restored, when meal times are going more smoothly, and when the young person is showing fewer eating disorder behaviors. Control is gradually handed back to the adolescent in an age-appropriate manner. For example, the young person may start to have some meals or snacks away from the parent. Parents may have to reassert control on occasion if there is some relapses occuring, which is part of the process.

  • Phase 3: Encouraging the young person to establish a healthy independence. When the adolescent is able to eat with an age-appropriate level of independence and does not exhibit eating disorder behaviors, the focus of treatment shifts to helping them develop a healthy identity away from their eating disorder and to address any other difficulties that may be present. The family is supported to adjust their roles now that the young person is healthier.

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