Q: Can you explain FBT to me? I’m not sure if it’s right for my family.
Family Based Treatment (FBT) is an evidence based treatment for eating disorder recovery for those aged under 18 years. Also called Family-Led refeeding, the focus is on providing the family with the education and support they need to help their young person to recovery.
FBT can be provided through a trained private or public family therapist or through the public mental health system such as CYMHS/CAMHS. Whilst a CYMHS/CAMHS clinician can provide mental health support to the young person with an eating disorder, whenever possible they will engage the whole family in FBT to treat the eating disorder. For further information about FBT or accessing treatment, please see the below resources, or contact the EDV Hub to speak to someone about your family’s situation.
Q: How long will it take before my child is recovered?
A: Recovery from an eating disorder can be a difficult and a long process. Putting time frames on things is difficult, because every journey is different. The best evidence indicates that recovery for a young person is most likely achieved through the FBT approach, which is why it is recommended as a first line treatment option.
Q: What age can I send my child to a private inpatient facility?
A: For some parents there is a hope that the child can go away to an inpatient facility (private hospitals will take children aged 16 years) and get better there.
Sometimes this is true but it is not generally the reality for a child to go and do the work at a hospital then return home fully recovered…..this is not the reality of ED recovery. It takes both time and a team, and the team is the family, supported by a FBT trained clinician/psychologist, perhaps a dietitian, and a GP (or pediatrician).
Q: How do I know if FBT is working?
A: Sometimes I wondered if FBT was ever going to work. My child would often say “I don’t know why you are bothering with this treatment I am never going to get better, I am never going to get over this”. These comments both terrified and motivated me.
On reflection, part of FBT is to have moments of “we can’t do this, there must be another way”. As a parent of a child who has fully recovered from an ED through FBT, I can say it is hard, but it can work.
Often as parents we think, well, if FBT is the right treatment it will be positive and we will feel relief and that we are moving in the right direction. In FBT especially at the start the opposite is true - you feel overwhelmed, unsure, the child is resisting and feels like hating you even more. Take this as signs the treatment is working, you are making life very uncomfortable for the ED and it is making life uncomfortable for you! Don’t back down! It’s a battle of the wills you must win.
Some parents see this as infringing on their child’s rights or feel uncomfortable insisting a child eats when they are protesting. Do not become concerned that you are harming your child, you are not. You are saving their life.
Q: My child needs psychiatric help.
A: I often said this and I also pushed for my child to have medication, but we ended up needing neither of these things, our child needed re-nourishment and I now know that this drove some of her frightening behaviour.
When I felt like this I would call or email the therapist and tell them what was happening. They would ask me the behaviours my child was displaying and were able to reinforce that these behaviours were a normal part of recovery.
When I had moments of doubt, affected by the ED temper, anxiety, tantrums, hatred, pleading and begging to avoid food, I needed to remember that MY CHILD WAS HUNGRY… starving, but that their fear of food was overwhelming.
Yes, there are of course other things that your child may need to talk about, have therapy for, talk to someone about but you need to refeed their brain first, this is the first step. The other stuff can come later when they can focus and communicate their voice, not the ED voice.
You need a therapist or team that understands eating disorders and can support you in in the re-nourishing of the person you care for. Here at EDV we can help you navigate the system and find the support your family needs as you help your child recover.