Family Therapy in Eating Disorder Treatment

As a Licensed Marriage and Family Therapist, I have seen the benefit of family therapy in the treatment of teens and adults struggling with eating disorders. As with other addictions, it is vital to have a support system in eating disorder recovery, and families usually make up a huge portion of that support system. That support will often be parents, especially for children and teens. Sometimes my older clients will have a spouse or sibling as their support person. Thus, the need for family therapy becomes paramount in recovery. In fact, a a recent study found that Family-Based Treatment for adolescents struggling with eating disorders is more effective than individual treatment 6-12 months AFTER treatment has ended.* This is likely due to the fact that family systems last longer in a person's life than treatment providers. Some parents hesitate to engage in family therapy. They may wonder, "Why should I have to change what I'm doing?" Or, "If I go to family therapy will I be blamed for my child's eating disorder?" When I see families in session, I address these concerns by working on three main issues.

Three Treatment Areas in Family Therapy

1. Establish Supportive Structure for Eating Disorder Recovery

I like to set up a supportive structural system at home so that the loved one has the best chance at defeating the eating disorder. It is especially important for teens that their parents are involved in the recovery process. This system includes ways for the family to support their loved one with adequate food intake, supervision, and regular check-ins. Even though the parents or family members are not the ones with the identified problematic behavior, it is important for them to identify ways to change that will be supportive to their loved one. Sometimes this includes not dieting, eliminating fat talk, and/or getting rid of scales in the house.

2. Boundaries

Often times when there is a serious diagnosis in the family, the boundaries tend to get off. It’s important to establish healthy boundaries for the best chance at recovery. I make it clear to parents that they are not to blame for their child’s eating disorder. A person’s behavior and choices are their own. I also want to make sure that boundaries aren’t too rigid, but also that the parents have authority to provide the structure needed for recovery. Finding the right balance of healthy boundaries is a process, and most families find that therapy is helpful to establish these new boundaries.

3. Connection

A person struggling with an eating disorder (or any addiction for that matter) tend to feel more dedicated and loyal to the eating disorder than they do to friends and family. Facilitating connections to loved ones is an important piece in the recovery process so that the client feels like there is someone to turn to when they are struggling. I work on helping families re-establish connection that has often been lost through the eating disorder. This includes finding way to enjoy each other's company outside of dealing with the eating disorder.

If you’re interested in reading more about how families can improve their relationships, check out my blog post here.

*Courturier, J., & Kimber, M., et al. (2013). Efficacy of Family-Based Treatment for Adolescents with Eating Disorders: A Systematic Review and Meta-analysis. International Journal of Eating Disorders 46(1), 3-11.

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