Family Based Treatment (FBT) is an evidence-based modality used to treat adolescents and teens with eating disorders, like anorexia, bulimia or other specified feeding or eating disorder. During FBT, parents are highly involved in sessions and their child’s care. It mimics the kind of treatment you would find at a residential or partial hospitalization program level of care, but done at home.
It is common to hear that parents are “at fault” for their child’s eating disorder, but in FBT, blame is not placed on the parents for their child’s eating disorder. Rather, family members are viewed as a crucial and useful tool in recovery! The job of the treatment team is to empower parents to believe they are the expert when it comes to nourishing their child.
The FBT model has 3 phases. In phase 1, there is full parental control. Parents are planning, preparing, serving and supervising all meals and snacks. If weight restoration is needed, the goal is often gaining 1 pound per week. Studies show that FBT has a much higher success rate when the child can restore 4 pounds in the first 4 weeks of treatment. Furthermore, parents help encourage their child to reincorporate those foods that they may have been avoiding.
In phase 2, there is a gradual return of control to the child. This starts once weight has been restored, behaviors are manageable, and meals/snacks are going more smoothly. This may start with allowing the child to prepare their own snacks, portioning out their meals or eating a meal/snack independently.
In phase 3, the child is returning to the level of independence they had prior to the eating disorder. The child is no longer engaging in eating disorder behaviors and treatment starts to focus more on helping the client live a healthy and balanced life. Appointments with the treatment team may become less frequent, or as needed, as the teen has acquired the skills and tools to maintain healthy eating habits on their own.
Interested in learning how FBT can help your child? Our food peace clinicians can help provide you with more information to decide if FBT is a good fit for you and your family. Schedule your initial appointment here.
References:
Le Grange D, Accurso EC, Lock J, Agras S, Bryson SW. Early weight gain predicts outcome in two treatments for adolescent anorexia nervosa. Int J Eat Disord. 2014 Mar;47(2):124-9. doi: 10.1002/eat.22221. Epub 2013 Nov 4. PMID: 24190844; PMCID: PMC4341963.
Loeb KL, le Grange D. Family-Based Treatment for Adolescent Eating Disorders: Current Status, New Applications and Future Directions. International Journal of Child and Adolescent Health. 2009 Jan;2(2):243-254. PMID: 20191109; PMCID: PMC2828763.
Rienecke RD. Family-based treatment of eating disorders in adolescents: current insights. Adolesc Health Med Ther. 2017 Jun 1;8:69-79. doi: 10.2147/AHMT.S115775. PMID: 28615982; PMCID: PMC5459462.
