Family-based therapy is a big buzzword when it comes to the treatment of adolescent eating disorders. Researchers and eating disorder professionals tout these benefits as being a key to long-term recovery to adolescents.
In these family-based treatments, “the overarching aim is to empower the young person’s parents to manage and take charge of the difficult situation caused by the eating disorder .” If you’re noticing the lack of autonomy-building for the teen, you are not alone.
As one study aptly notes, “In such a family-based framework, enhancing the young person’s intrinsic motivation, promoting the adolescent’s responsibility for change, and working with adolescent-related issues, both within and outside the family, is usually toned down or postponed to the end of treatment .”
The same study pointed out that, for this reason, many research trials find the success of family-based treatment to be “modest at best .” The study questioned how this treatment may improve if the adolescent’s view of what is important to their recovery were considered in the process.
I find myself happily surprised to find that the majority of the adolescents surveyed reported that, while the support of loved ones and healthcare professionals was valued, they emphasized their own motivation and self-determination as most important .
Exploring these results is key to taking the “moderate at best” efficacy of family-based treatment to the next level.
There is no denying that family involvement in treatment can be beneficial to recovery. After all, there are decades of research supporting this notion.
However, in this treatment, “the predominant role of parents is based upon the assumption that young individuals afflicted with the ED lack the ability to make rational and healthy treatment decisions due to inherent characteristics of the eating disorder .”
The intent of family-based treatment is to arm the “less afflicted and legally responsible” individuals with the tools necessary to take charge of the situation for their child’s recovery . While having these tools is undoubtedly valuable, it takes out a key requirement for recovery – individual autonomy.
Without bolstering the disordered adolescent’s belief that they can do what they need to help themselves in recovery, outcomes show that they are more likely to fall into remission at a later date.
Is family important to treatment? Absolutely. Should it be the focus of treatment? It seems the answer is no.
Supporting the Individual
Reconsider the role of the parent stated above, focused on the assumption that the afflicted individual cannot care for themselves or make appropriate decisions for their health and well-being.
If we view this from a larger perspective, one might say this is a parent’s role in general. However, a parent that maintains this status quo for the entirety of their child’s life is not doing their child any favors. The goal is to act as their training wheels, so-to-speak, until they can do it by themselves.
The same is true of eating disorder treatment and recovery. The individual undoubtedly needs the support of the family. However, they also need to learn how to engage in recovery-based thinking and behaviors by themselves.
For this reason, it is impressive that individuals in the above study had the self-awareness to notice that the most critical factor to their recovery was not their family’s participation or tools, but their own motivation, self-determination, and responsibility for their recovery .
Accordingly, the study “suggests the importance of endorsing an increased adolescent-focused approach within a family-based framework, rather than advocating for a separate adolescent-focused therapy for the adolescent .”
Resources: Nilsen, J. et al. (2020). External support and personal agency – young persons’ reports on recovery after family-based inpatient treatment for anorexia nervosa: a qualitative descriptive study. Journal of Eating Disorders, 8:18.
About the Author:
Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published May 12, 2020, on EatingDisorderHope.com
Reviewed & Approved on May 12, 2020, by Jacquelyn Ekern MS, LPC