Family Based Treatment

Maudsley Approach

What is it?

Family Based Treatment (FBT) is the gold standard, evidence-based therapy for children, adolescents, and young adults suffering from eating disorders. This approach puts parents at the forefront of establishing safety and stability for their child who is trapped by the illness, utilizing strategies that promote weight restoration and/or eliminating eating disordered behaviors. FBT is a structured, practical, behavioral approach to restoring health in an appropriately urgent manner. When a child is not getting enough nutrients, every organ in their body is impaired, including their brain.  This impairment makes it nearly impossible for a child to recover without parental involvement.

 

Who can benefit?

Families seeking an effective, targeted, outpatient approach to treating their child’s eating disorder may benefit from FBT. Overall, FBT is an appropriate intervention when a child is medically stable but needing weight restoration or interruption of eating disordered behaviors, such as binge eating, purging or compulsive exercise.  FBT can serve as an initial treatment implemented early on to prevent the eating disorder from progressing, as an alternative option to inpatient or residential levels of care, or as a stepdown treatment for families wishing to reduce risk of relapse after residential or inpatient levels of care.


What can I expect?

FBT therapists first and foremost honor and establish that parents are responsible for the care and health of their children. In Phase I, the FBT therapist works with the parents in a weekly coaching role to provide education about eating disorders, to teach new skills to interrupt the eating disorder’s hold on their child, and to offer ongoing support to unite families against the illness.  In Phase II, the FBT therapist, parents, and child work together as a team to reestablish the child’s independence, allowing them to relearn how to take care of their own health and well-being. Sessions may be weekly or every other week in this phase.  Phase III identifies and addresses any of the underlying factors that made the child vulnerable to the eating disorder, helps the child get back on track developmentally with peer relationships/school/other areas of life, and works to repair any relationships damaged by the eating disorder. This phase may be brief or involve starting an additional therapy, depending on need. FBT is typically 20-30 sessions over 9-12 months but can vary based duration and severity of illness, presence of comorbid conditions, and family dynamics. 

To learn more see our Caregiver Workshop for Eating Disorders page. 

Image by Dim Hou