Maudsley Family Based Treatment (FBT)
Family-based treatment or FBT is the leading treatment for eating disorders in adolescents. Sometimes it is also called the Maudsley Method.
What makes FBT superior to other therapies is its strong evidence for a high rate of recovery indicated by research. FBT was developed to involve parents in the treatment to help their child get better in their home environment instead of being hospitalized or in an eating disorder program. Originally, FBT was developed to treat anorexia nervosa, however FBT has also shown to be effective to treat bulimia nervosa.
FBT focuses on empowering parents to take charge of the eating disorder and support their teen to make important changes in the eating behaviors.
There are three phases during a full treatment:
Phase 1: Main goal of treatment is on nutritional rehabilitation and weight restoration
Phase 2: The teenager is coached to become more independent eating
Phase 3: Normal adolescent developmental problems are addressed in therapy
If the child or teen is medically stable, FBT can be offered in outpatient level of care. Given that eating disorders have the highest mortality and morbidity rate of all mental illnesses FBT works best as a multidisciplinary approach where I work together with your pediatrician, a dietician (specialized in eating disorders), and a psychiatrist if needed.
In addition, I offer CBT-AR for children and teens who suffer from ARFID which is a psychiatric disorder requiring intense treatment to change the eating behaviors. Family-supported therapy is recommended for children and teenager ages 10-15 years, if the teenager still lives at home, and if there is a significant amount of weight to be gained. The parents or caregiver is attending all sessions with the child or teenager. Family-supported CBT-AR is delivered as a four-stage format treatment:
Stage 1: Psychoeducation of ARFID and formulation of maintenance factors of the illness. Increasing volume (if undernourished) and variety in foods (for all clients).
Stage 2: Assessment of maintaining factor to be addressed in treatment -treatment planning
Stage 3: Working on the different maintaining factors such as sensory sensitivity, fear of negative consequences, and/or lack of appetite and not feeling hungry (exposure to new food- and eating-related situations).
Stage 4: Relapse prevention
The treatment length can vary between 15 and 30 plus session depending on the severity of the illness and treatment progress.