Family-Based Treatment (FBT)

What is Family-Based Treatment (FBT)?


Around the world, Family Based Treatment is considered to be First-Line-of-Treatment for Child and Adolescent Eating Disorders, particularly for early onset Anorexia, Atypical Anorexia, Bulimia, and ARFID (Avoidant Restrictive Food Intake Disorder). FBT, or the Maudsley approach, is a Gold Standard treatment. FBT is a culturally-sensitive method that keeps a child in their family environment. In the FBT method, the parents play a major role in the re-nourishment of their starving child, under the guidance of the trained and certified Family Based Treatment practitioner and in medical collaboration with an outpatient Pediatrician or Adolescent Medicine Specialist. The child, adolescent, or young adult, and his or her parents, are carefully screened to be appropriate candidates for this protocol, conducted in the Least-Restrictive-Environment – your home!

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FBT is a Culturally-Sensitive Treatment

At Resilience, Barbara Reese and her team practice the formal FBT protocol, including caregivers and siblings, with certification from the Training Institute of Child and Adolescent Eating Disorders. The FBT protocol, developed at the UK’s Maudsley Clinic, consists of around 20 sessions and differs from traditional eating disorder treatments that rely on insight and motivation. FBT acknowledges anosognosia, a condition where individuals don’t recognize their illness severity.

Parents don’t cause eating disorders but are crucial allies in recovery. FBT leverages parents’ knowledge and awareness to counteract the effects of anosognosia. Anorexia, a brain disorder, responds better to initial nourishment to restore brain function than to insight-driven treatments.

Hope-Full Nutrition

FBT is a a well-researched protocol. It is best when practiced adherently and adherent does not mean rigid. It means using interventions with the highest probability of success and not wasting precious time with interventions that are known to delay or interfere with recovery. Your FBT provider is an experienced therapist and family therapist who will follow your childs individual progression thru the 3 stages of FBT:

PHASE 1:

Refeeding/Weight Restoration

  • The family partners with an FBT Practitioner
  • Parents take full charge of “plating” meals/snacks, suspending calorie-burning exercise, and interrupting ED behaviors
  • Parental Teamwork, and role of other Caregivers/Siblings is established
  • A physician monitors for Outpatient Safety during Refeeding Process

PHASE 2:

Transitioning the Control of Eating Back to Child/Adolescent

  • Eating flexibility and eating independence emerges
  • Parental Supervision lessens when Adolescent achieves full weight restoration.
  • Exposure work is conducted to tackle “Fear Foods” and feared eating situations.
  • Physical activity may be gradually introduced here

PHASE 3:

Focus on Normal Adolescent Issues and Terminate Treatment

  • “State not Weight”, achieving full mental health recovery weight
  • Eating disorder thinking and behaviors begin to resolve
  • Flexibility and normalization in eating is established
  • Normal adolescent life becomes possible the with nourished brain/body

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