Parents often report feeling guilt or blame when discussing their child’s eating disorder. Though research has shed light on the underlying mechanisms of the disease, myths regarding a parent’s responsibility for their child’s eating disorder have been perpetuated. There was a time when parents were purposefully excluded from their child’s recovery. Today, studies demonstrate that parent involvement in their child’s treatment is not only important but profoundly impactful and central to an ultimate recovery.
So why does this myth persist?
Perhaps because there is no one specific factor or cause for an eating disorder, parents have a tendency to look inward to evaluate their role in the development of an eating disorder. What we do know is that multiple factors, including a biological and brain-based sensitivity, along with social, emotional and environmental factors play a role in the development of eating disorders. We also know that a variety of personality traits (one’s nature) present in childhood and adolescence make an individual more sensitive or susceptible to an eating disorder. There is no evidence to suggest that a parent may be responsible for the development of a biologically-based illness but there is evidence to suggest that parental involvement is essential to a child’s recovery.
Family-Based Treatment (FBT), also known as the Maudsley Method, is the gold standard intervention for childhood and adolescent anorexia and bulimia. FBT is utilized widely at the Columbus Park Eating Disorder Center in New York City and our results are both consistent and remarkable. In FBT, parents are not “the problem”; rather they are the solution. They are guided in taking charge of their child’s nourishment with the therapist playing a supportive role in this process. We liken the parent “take-over” to the idea of taking over the wheel for an ill-equipped driver; for the individual’s safety, taking charge is 100% necessary. The goal, of course, is to return full control to the child/teen as soon as they are able to manage the tasks of self-care and feeding responsibly.
Among the many advantages of FBT is that the child remains in the home environment – as opposed to a hospital or institutional program – and is able to go on with most daily activities like school, extracurricular activities, and social events.
While FBT has a very specific and thoughtful structure and approach, it does not have to be a rigid, “one size fits all” treatment. There are many ways to be true to the spirit of FBT while also making the treatment work for different family structures (i.e. single parents) and with accommodation for various realities and challenges of life (i.e. working parents, other children to manage etc).