Family Based Therapy for Adolescent Eating Disorders

Family Based Therapy for Adolescent Eating Disorders

Parents often feel guilty, siblings may feel pushed aside, and the ill adolescent may worry that everyone is against her. Conflicts arise around food, eating, and ways to treat the adolescent. Parents often need support themselves so that they can better support their child’s recovery.

Family Based Therapy for ED is considered to be a research-based psychotherapy that assists the family to help the adolescent get better. The Trauma and Attachment Report had the opportunity to interview Researcher Karin Jasper, a mental health specialist who treats eating disorders at Southlake Regional Health Center in Newmarket, Canada. We spoke about the stress a family faces when an adolescent is diagnosed with an ED, and how Family Based Therapy can help them cope.

Q: How does having an adolescent with an eating disorder affect the family?

A: An eating disorder is a very serious illness that has life threatening and developmentally related consequences. It can throw the family into chaos. Having a child with an illness may take a lot of the parents’ time and there is much conflict during and after meal-time. For example, if a child is suffering from anorexia and finds it too difficult to eat, the worried parents try to get her to eat more, and that can result in arguments and fights, and disturb family relationships.

Q: In what ways is it stressful for families to learn that their child has an eating disorder?A: Anything that holds a family apart is stressful on the family, and ED certainly does that, especially before the parents have a more complete understanding of what the problem is and how it can be addressed.Q: Do families tend to grow apart or closer together through this experience?A: Often when we first begin to work with them, the families are drifting apart as they attempt to deal with the chaos that eating disorders cause. However, as the treatment begins parents together take responsibility for dealing with the eating disorder symptoms and siblings understands their supportive role, it becomes slightly easier for the child with anorexia to eat. Tthe family may start to feel like they are working together to help the ill child. It makes everyone feel better, more unified and connected. It is not unusual for parents to say at the end of the therapy that they feel like they’ve gotten closer through the process.Q: How does Family Based Therapy address eating disorders within the family?A: Until recently, parents have been in the position of having a child with an ED that is very ill but not understanding how they can contribute to helping their child. In Family Based Therapy, the parents are put front and centre with a key role in the recovery of their child.Q: How does the adolescent feel during therapy?A: At the beginning of the therapy they feel ambivalent about getting help. It’s like a person holding on to a leaky raft in the ocean. It might not work so well, but it’s the only thing keeping that person alive. They want to be rescued, but they are afraid to let go of the only thing they have. Similarly, the ED can make the adolescent feel safe and in-control in some ways, so she cannot easily let it go even if she wants to get better. She can’t simply snap out of it, she needs the support of her family, or peers that are also getting help for an ED. Because of the patient’s ambivalence, they are often resistant to change at some point of the therapy.

Once their weight is restored, and they are helped with underlying issues, they can go back to their social life and school, and their behaviour changes considerably. They are happier to be doing well, and they manage their meals better themselves. The conflicts they now have with their parents are more like normal teen conflicts.

Q: Can families find a way to manage this and move forward?

A: Yes. The majority of families can help their children get past this and go on with their lives. It takes between six months to a year, but parents still need to keep an eye on the child for warning signs. In more complex cases, treatment takes longer and other forms of therapy may be required, including hospitalization.

Q: What are the resources available for families in this situation?

A: There are a number of websites and books that provide information to parents and help them cope. One of the books, A Parent’s Guide to Defeating Eating Disorders: Spotting the Stealth Bomber and Other Symbolic Approaches, was published this past fall by Psychiatrist Ahmed Boachie and myself.

Q: What are some of the warning signs that parents should look out for in their children?

A: There are several warning signs, such as:

  • Losing weight or not gaining weight or height as part of normal development.
  • Wearing looser cloths to try to hide weight loss or due to profound dissatisfaction with their body.
  • Reporting that they are cold and wearing clothes that seem too heavy for the weather.
  • Drinking more caffeinated drinks, smoking, or chewing gums excessively -all things people do when they are not getting enough food.
  • Liking to cook for others but not eating what they prepared.
  • Becoming very anxious and defensive when issues related to body weight are brought up.
  • Finding holidays or family occasions that revolve around food to be highly stressful.
  • Developing certain rituals during meal times, such as cutting food into very small pieces, eating food in specific order, or taking an unusually long time to finish a meal.
  • Starting to be especially interested in physical activity, such as taking the dog out for a run even when the weather is really bad.

-Noga Lutzky Cohen, Contributing Writer