Family-based eating disorder treatment is proven to be beneficial and research continues to explore how it can be used to support anorexia nervosa treatment and recovery.
For teens struggling with anorexia nervosa, it is common practice to involve the family in treatment.
Family dynamics play an important role in the beliefs and behaviors developed by children in teens and this can include attitudes toward food, exercise, body weight, size, and appearance, and worth.
This is not to say that the family is to blame for the development of disordered eating behaviors, however, it does show that the family system is powerful.
This power can be used for good whether in preventing, or supporting in recovery from, anorexia nervosa.
The degree to which the family is involved in treatment can vary from center-to-center.
Some treatment centers may focus on a family therapy approach, including weekly family therapy sessions with the identified patient and their familial support system.
This involves processing of relationships, family dynamics, and communication skills to inform the family how they can best support the individual in their recovery.
The degree to which this becomes a discussion of family influence, relationships, and beliefs as they relate to eating disorder development, enabling of behaviors, and/or triggering actions/speech depends on the unique dynamics of each family.
The most common method of Family-Based Treatment (FBT) is known as the “Maudsley Method.”
This method is viewed as an “intensive outpatient” treatment method wherein parents become instrumental to their child’s eating disorder treatment and recovery.
The Maudsley Method involves parents engaging actively in efforts to “help restore their child’s weight to normal levels expected given their adolescent’s age and height; hand the control over eating back to the adolescent, and; encourage normal adolescent development through an in-depth discussion of these crucial developmental issues as they pertain to their child .”
Parents essentially become a part of the treatment team in this method, as they “fully take charge of their ill child’s eating, assuming the functions typical of an inpatient staff. The therapist helps parents develop and refine their techniques in an in-session family meal, a goal of which is for parents to convince their child to consume at least one more bite than s/he was originally willing .”
There are many critiques of this method due to the intensive involvement of the parents as treatment members, with many reporting concern over lack of education/training of parents as well as the complications brought in by their personal/emotional involvement with their child.
However, other studies point out the “zero tolerance” attitude of parents as well as the openness and coordination of the family dynamic as being helpful in making family-based treatment more effective.
Supporting a child struggling with anorexia can be overwhelming and parents often do not know where to begin.
Critics of the Maudsley Method maintain that the responsibility placed on parents is too great.
A recent study took an in-depth look at parental viewpoints of the Maudsley Method as it would pertain to inpatient treatment settings. Interestingly, the study involved 8 families and admitted the entire family, not only the identified patient.
“Findings suggest that different levels of readiness for change, knowledge of the ED as well as preparedness for the admission, in addition to varied expectations and needs are important to explore in-depth prior to an admission .”
The study also learned that interaction with other families throughout admission could be beneficial but were problematic if not moderated by treatment team members .
It was determined that most families viewed family-based treatment as strengthening relationships within the family . However, none of the 8 families stayed throughout the entire duration of treatment, making this data questionable.
Ultimately, it seems that family-based treatments continue to be viewed as useful and effective as components to treatment, however, more research needs to be considered as to whether this effectiveness also includes inpatient treatment settings.
Resources Le Grange, D. (Unknown). Family-based treatment of adolescent anorexia nervosa: the Maudsley approach. Maudsley Parents, retrieved from http://www.maudsleyparents.org/whatismaudsley.html.  Loeb, K. L., Le Grange, D. (2009). Family-based treatment or adolescent eating disorders: current status, new applications, and future directions. International Journal of Child and Adolescent Health, 2:2.
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 April 29, 2021, on EatingDisorderHope.com
Reviewed & Approved on April 29, 2021, by Jacquelyn Ekern MS, LPC