The Maudsley Method: Family-Based Treatment for Children and Adolescents

Family-Based Treatment (also called the Maudsley Method) for children and adolescents with eating disorders has proven to be the most effective intervention for sustained recovery from Anorexia Nervosa.  Increasingly studies are showing similar success in recovery from Bulimia Nervosa. At Columbus Park, we see remarkable success with our FBT families, and in almost all cases of childhood/adolescent anorexia or bulimia, we will recommend FBT as the intervention of choice. It’s worth noting that, in addition to being the most efficacious treatment, it’s also time-efficient (once weekly meetings) and cost-effective (a fraction of the cost as an alternative to hospitalization).  We see great benefit in avoiding a hospital or group program setting for our child/teen patients; unless there is immediate medical complication, we believe it’s in the child’s interest to recover in the least restrictive setting possible, surrounded by family support, protection and encouragement.

What is Family-Based Treatment?

Parental* empowerment is at the core of FBT. The treatment charges parents with the critical role of restoring their children back to optimal mental and physical health. Families participate in weekly sessions with a trained FBT therapist. For a malnourished person with anorexia, food is the only medicine available. Given the 35-42 (3 meals and 2-3 snacks per day) doses of nutrition your child will require weekly to successfully be re-fed and avoid hospitalization, he/she will require intensive “medication” management. In this process, every bite counts as a step back to the healthy child you once knew.

*FBT requires the commitment of at least one primary caregiver, but other close family members or friends may be central supports as well.

Want to learn about FBT? Check out this blog post about Family-Based Treatment Myths.

The Re-Feeding Process: Food is Medicine

In Phase One of treatment, you bring much needed relief to your child when you take back control of his/her food choices. Most often, there is resistance from the child/teen at the start — this is to be expected. We wholeheartedly support you through this challenging phase with concrete strategies and guidance directed to help you achieve the necessary compliance from your child. Parents often find that within a few weeks, they’re able to get into a groove and the feeding gets easier. The patient begins to show signs of returning health — physically, emotionally and behaviorally.

In Phase Two, you will carefully transfer feeding responsibilities back to your child after you’ve reestablished a solid foundation for him/her. So Phase Two is about maintaining weight with normalized eating and gradual return to more age appropriate independence.

In Phase Three, we will work together to restore a more normal lifestyle and relationships between family members, with particular focus on addressing gaps in development, which eating disorders often leave behind.

Additional “Family-Based Treatment Friendly” Support

There is nothing more powerful than your child’s family firmly planted on the frontline of the re-feeding effort. That said, many dedicated parents have very real limitations that prevent them from being available at each of the five daily feedings. If clinically indicated, we can offer FBT-friendly meal support, to step in when you can’t. Our goal here is to work creatively to ensure supervision for all of your child’s meals, while capturing the spirit of our family based work together, even in your absence. These meals might be administered by a Columbus Park-affiliated clinician or the nurse or counselor at your child’s school. Whomever you choose to allow help re-feed your child, your FBT therapist will work closely with them to ensure that continuity of care is upheld.

Support After Hospitalization

The changing landscape of managed care has caused length of hospital stay to become shorter and shorter. As a result, eating disorder inpatient units largely function to medically stabilize patients and restore them to 75 to 80 percent of Ideal Body Weight. We know you want 100 percent of your child back, and so you know this is just the first leg of the journey. Your active participation in continuing the re-feeding process as your child transition out of a hospital setting is critical. We are available to coordinate this transition and help you pick-up where the hospital left off.

Please reach out to our Clinical Director and Certified Family-Based Treatment Therapist, Melissa Gerson, LCSW, directly to discuss whether FBT is right for your family: