What is Family Therapy for Eating Disorder Treatment?

By Allison Chase

Family therapy isn't easy, but when a family is committed to doing the work of therapy and when family members can start to solve problems together in a collaborative and compassionate way patients are able to move more effectively towards recovery.

Family involvement is key to helping a loved one recover from an eating disorder. 
When an individual is suffering from anorexia, bulimia, binge eating disorder or another related mental health issue, family therapy is often a hallmark of treatment.

Why is family therapy so important?

Family therapy serves as a mechanism to engage, educate, empower and encourage family members. When an individual is willing to support their loved one’s recovery with true understanding and a commitment to work alongside them, a great deal of healing and transformation can occur. 
Family therapy is not easy, but when a family is committed to doing the work of therapy — and when family members can start to solve problems together in a collaborative and compassionate way — patients are able to move more effectively towards recovery.

How does family therapy work?

Family therapy is not just for children and teenagers with eating disorders; people of all ages benefit from family involvement in eating disorder treatment. 
Parents are typically involved in family therapy sessions when patients are young. But, adult patients may also choose to incorporate their close relationships into family therapy sessions. These chosen caregivers may include a spouse, partner, adult child or even a close friend. 
Family therapy offers a number of benefits to all individuals of the family:

  • Education regarding how complex eating disorders are to treat
  • Practice in talking openly and honestly with each other and identifying each family member’s struggles
  • Identification of ways to apply the skills learned in therapy in the “real world” including tolerating difficult emotions
  • Gaining clarity on family goals and creating a structure to achieve them
  • Understanding how parents and caregivers can support mealtimes

At Eating Recovery Center, we incorporate several different family therapy approaches into our work with patients.

Types of family therapy

Currently, at ERC, we are using two primary therapies: Maudsley Family Based Treatment and Emotion Focused Family Therapy. I describe the basic principles of each orientation below.

Maudsley Family Based Treatment

In Maudsley Family Based Treatment (or FBT for short), parents are an essential and active part of their child’s treatment plan. Note: this therapy is used for children and adolescents, not adult patients. 
When an individual has an eating disorder, they are often unable to make healthy choices for themselves. The Maudsley approach puts parents in charge of managing certain aspects of the patient’s life with the goal being to eventually eliminate the eating disordered behaviors. The therapist serves as the parents’ coach and guides them through the process. 
Since Maudsley Family Based Treatment is set up for those in outpatient care, we modify it for our higher levels of care. We do this by using the primary underlying principles of FBT, which include:

  • Treating the symptoms and behaviors
  • Not focusing on the cause
  • Not blaming parents
  • Encouraging parents to lead the way
  • Encouraging parents to take care of their children

In essence, FBT focuses specifically on addressing eating disorder behaviors, utilizing a behavioral approach to do this.

Emotion Focused Family Therapy

Emotion Focused Family Therapy (EFFT) serves as a comprehensive treatment modality to help manage both behaviors and emotions. This therapy is helpful for child/adolescent and adult patients. 

  1. EFFT integrates the behavioral components of Maudsley FBT, by having caregivers implement behavioral strategies, also know as “behavior coaching” in order to help reduce eating disordered behavior. 
  2. EFFT also provides support and guidance to caregivers to teach them how to “emotion coach” their loved ones. Caregivers learn strategies to help themselves and the patient. 

The beauty of EFFT is that it creates an opportunity to address emotions in family therapy, which FBT doesn’t discuss. Some have hypothesized that FBT can increase caregiver emotionality. EFFT helps teach caregivers how to manage these emotions with the goal being to work towards repairing and strengthening the relationship between a caregiver and their loved one.

Full and lasting recovery is possible

At Eating Recovery Center, we believe that it is critical to work with both caregivers and patients in eating disorder treatment. Caregivers/families are instrumental in helping patients make progress towards recovery. Equipping caregivers with the necessary tools and guiding them to provide both behavioral and emotional support is essential. Recovery is possible, and involving family and loved ones is a key ingredient in the process — regardless of the age of the patient suffering with the eating disorder. 
Learn more about family therapy and helping a loved one with an eating disorder at Eating Recovery Center’s Family Support Center.

Written by

Allison Chase

Dr. Chase is Senior Clinical Advisor for Eating Recovery Center and Pathlight Mood & Anxiety Center. Her areas of specialization include child and adolescent mental health, the treatment of eating…

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