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Family-Based Treatment for Anorexia Nervosa
Family-based treatment is an outpatient, evidence-based therapy designed to address the symptoms of anorexia nervosa in three phases.
What is family-based treatment for anorexia nervosa (FBT-AN)?
Individuals suffering from anorexia nervosa often experience emotional and interpersonal dysfunction as the illness tends to impact every aspect of one’s life. Anorexia nervosa is also ego-syntonic in nature, meaning it is difficult for those suffering to recognize the severity and to find motivation to recover, which in turn directly impacts the entire family system. As a parent or caregiver, knowing how to respond and best support a child with anorexia nervosa can feel intimidating and overwhelming, and this is further complicated by the serious medical risks associated with the disorder. The need for quality care in the treatment of anorexia nervosa is apparent, and family-based treatment (FBT) does this by taking a structured and supportive family-centered approach that is backed by research.
FBT-AN is an outpatient treatment for children, adolescents, and young adults that is designed to address the symptoms of anorexia nervosa in three phases, and allows the recovery process to be done at home with the family. FBT views families as the most important resource in the treatment of an eating disorder, so the approach is centered on empowering parents and caregivers to take the lead in helping their child return to a healthy weight and normalized eating behaviors. The therapist then serves in a consultation role that guides treatment decisions and expectations in a warm and empathic way. Similar to other treatment approaches, a multidisciplinary team is an essential part of FBT-AN. A Nashville Child and Family Wellness Center treatment plan includes therapy, nutrition, and medical monitoring by a pediatrician or primary care physician. Psychiatry is included when indicated.
Understanding FBT-AN
FBT-AN Treatment Phases & Goals
Phase One
In phase one, parents and caregivers are empowered to take control of the treatment process by making weight- and health-promoting decisions on behalf of the patient. The entire family is invited to learn about anorexia nervosa and how to best support the patient through this challenging process. During this phase, we often say that food is the best medicine, and it is not uncommon for the patient to abstain from strenuous physical activity. Here, the therapist also assesses the family's strengths and challenges, helps parents and caregivers work together, supports the family at a therapeutic meal, and tracks weight restoration.
Phase Two
The adolescent or young adult patient plays a larger role in phases two and three as they experience increased motivation and resist eating disorder behaviors. Phase two slowly reintroduces food control back to the patient with support and supervision from parents and caregivers. During this phase, the patient might return to age-appropriate activities like playing a school sport or going to dinner with friends. The therapist works with the family to help them manage any challenges that arise throughout this process.
Phase Three
The third phase shifts focus to promoting autonomy and reducing the need for ongoing therapy by promoting normal adolescent or young adult development and addressing other co-occurring mental health needs. Goals center on giving the patient healthy coping strategies, strengthening the family system, and discussing ways to maintain recovery over the long term.
Meet the family-based therapists for anorexia nervosa at NCFWC.
Meet the Nashville Child and Family Wellness Center therapists and dietitian.
What do FBT-AN treatment plans include?
- Family-style Therapy: Once weekly sessions with the patient and at least two parents/caregivers. These sessions provide education and consultation. The therapist guides the family in problem-solving and working together to achieve treatment goals.
- Collaborative Weighing: Once weekly weigh-in with your FBT-AN therapist prior to starting the family therapy session. The dietitian works with the assigned FBT-AN therapist to identify age-appropriate weight expectations using pediatric growth charts.
- Family Meal: A one-time, 90-minute therapeutic meal led by your FBT-AN therapist.
- Nutrition Coaching: Once weekly for at least the first five weeks. Sessions use a balanced nutrition philosophy that will help parents feel confident in taking charge of meals and snacks in order to reestablish normalized eating for the patient.
- Psychiatry: If indicated, this may include: - An assessment of psychiatric comorbidities - Medication Management: Medications may be used to treat psychiatric comorbidities or other symptoms related to the eating disorder
- Medical Monitoring: Conducted by your external pediatrician or primary care physician. This is required in order to participate in our FBT-AN services, and follow-up appointments will be scheduled at the discretion of your provider.
- Care Collaboration: Conducted between your treatment team to ensure your family is provided with a high standard of care. Your assigned FBT-AN therapist is the team lead and will spend time between appointments communicating with and updating your dietitian, psychiatrist, and medical provider.
What are the benefits of family-based treatment for anorexia nervosa?
Promotes Family Involvement
FBT recognizes the importance of full family involvement in the treatment of eating disorders. It encourages parents and caregivers to take an active role in their loved one's recovery, which can help to strengthen family relationships, increase family communication, enhance co-parenting skills, and reduce stress at family meals.
Focused on Recovery
FBT is focused on helping the individual with the eating disorder to achieve and maintain recovery. It is an evidence-based treatment that has been shown to be effective in promoting weight restoration, decreasing the need for hospitalization, and reducing the risk of relapse. It recognizes that recovery is a long-term process as highlighted by the three phases.
Tailored to Individual Needs
FBT recognizes that each person and family is unique. The treatment is tailored to meet the individual needs of each person struggling with an eating disorder while working with the parents or caregivers to both prioritize the patient’s health and determine what is best for the family environment.
If you have noticed these signs or symptoms in a child or loved one, consider calling 615-238-9100 to discuss scheduling a comprehensive assessment at Nashville Child and Family Wellness Center.
Family Based Treatment-Anorexia in Tennesseee
If you feel your child could benefit from FBT-AN treatment, give us a call at 615-238-9100 or complete a Request For Services (RFS) form using the link on our website. We are proud to offer therapy, nutrition, and psychiatry services at our Nashville and Franklin locations, as well as via telehealth for the entire state of Tennessee.
info@nashvillefamilywellness.com