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June 7, 2019

The Maudsley Method and Anorexia Nervosa Treatment

Stronger Family Smiling After family-based therapy

Maudsley Method Therapy, also known as Family-Based Treatment (FBT), is an intervention created to treat individuals struggling with Anorexia Nervosa (AN).

The treatment itself was devised in the Maudsley Hospital in London after a study of 80 patients diagnosed with Anorexia found that family-based interventions were more effective in treating those under the age of 18 [SOURCE].

The method involves 3 phases that generally take one year for a patient and their family to complete.

According to MaudsleyParents.org, the treatment involves parents playing “an active and positive role in order to:

(1) Help restore their child’s weight to normal levels expected given their adolescent’s age and height

(2) Hand the control over eating back to the adolescent, and

(3) Encourage normal development through an in-depth discussion of these crucial developmental issues as they pertain to their child [2].”

Maudsley Method 3 Phases

Phase 1 – Weight Restoration

In this phase, the most immediate danger to the individual is addressed – physical malnutrition.

The “therapist focuses on the dangers of severe malnutrition associated with AN, such as hypothermia, growth hormone changes, cardiac dysfunction, and cognitive and emotional changes” that could have arisen from a lack of proper nutrition [2].”

In this phase, the treatment team also assesses the family’s relationship patterns with one another as well as the family belief system related to food.

Parents and siblings play a role in this first phase, and it typically includes a family meal, during which time the therapist can observe interactions as well as provide feedback and support to all family members [2].

Phase 2 – Return Control Over Eating to the Adolescent

During this phase, the treatment team emphasizes that the goal is to encourage autonomy and independence by giving the adolescence back control over their eating habits [2].

Both the teen and parent(s) have the support of the treatment team as they navigate this return of control, which often involves addressing day-to-day issues that occur for the teen related to their eating habits, such as wanting to go over to a friend’s house for dinner.

Phase 3 – Establishing Healthy Adolescent Identity

As MaudsleyParent.org specifies, Phase 3 “is initiated when the adolescent is able to maintain weight above 95% of the ideal weight on her/his own, and self-starvation has abated [2].”

Dad talking to Teenage daughter with Anorexia during Maudsley Method therapy

This final phase of the Maudsley Method focuses on coping with how the Anorexia has impacted the teen’s healthy identity.

The teen will learn how to work with their autonomy, and the family also discusses appropriate parental boundaries [2].

Effectiveness

The Maudsley Method has been accepted as an evidence-based and effective treatment for Anorexia Nervosa, and it has met criteria for the American Psychological Association’s “well-established treatment” criteria [3].

Studies indicate that two-thirds of adolescents with Anorexia are recovered at the end of family-based therapy interventions [2]. This does not mean, however, that it is full-proof.

Some studies show that approximately 40% of teens experience ongoing psychological distress or Anorexia Symptoms [3].

One study, in particular, found that this may relate to Phase 3 of the Maudsley Method and that success with this method hinges on the adolescent and family gaining support in continuing treatment, adjusting to their shifting roles, and being able to rebuild their identities [3].

Studies also find that this method is most effective in teens who have experienced Anorexia Nervosa symptoms for “a relatively short period of time (i.e., less than 3 years) [2].”


Resources:

[1] Russell et al. (1987). An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives of General Psychiatry, 44:12, 1047-1056.

[2] LeGrance, D., Lock, J. (Unknown). Family-based treatment of adolescent anorexia nervosa: the Maudsley approach. Maudsley Parents. Retrieved from http://www.maudsleyparents.org/whatismaudsley.html.

[3] Wufong, E. Rhodes, P., Conti, J. (2019). “We don’t really know what else we can do”: parent experience when adolescent distress persists after the Maudsley and family-based therapies for anorexia nervosa. Journal of Eating Disorders, 7:5.


Image of Margot Rittenhouse.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 June 7, 2019, on EatingDisorderHope.com
Reviewed & Approved on June 7, 2019, by Jacquelyn Ekern MS, LPC

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