And they're clear and well-supported: For teenagers with anorexia nervosa, the first-line treatment should be family-based treatment (FBT), also known as the Maudsley approach.
I think the days of FBT being labeled as a marginal, alternative, or "very special" treatment for "very special families" are officially over. For a high percentage of teens with anorexia, FBT works--they recover, and they stay recovered.
Does it work for every single family? Nope. But then neither does chemotherapy, or penicillin, or other mainstream treatments we don't question. (For an inside look at how it worked for our family, see my new book, Brave Girl Eating.)
Now, the hard part: Training enough FBT therapists so that more families have access to them. Luckily, someone's already on the case.
We still need more research. We still need better techniques. But there's no question that this is big news, and important news, for families and clinicians.
Big congratulations to Dr. Daniel le Grange and Dr. James Lock, who co-authored the study.
7 comments:
Thank you Harriet for getting the word out about this treatment option! Such a good point that even such an effective thing as penicillin doesn't work for everyone.
Becky Henry
Hope Network, Inc.
Today is a great day for parents, families and children suffering from ED. Finally the research is backing up what we have known in our hearts. Hopefully this will mean better and more effective treatment for all those families who are just starting their battle against ED.
I have struggled with and am recovering from Orthorexia. My mom has been, always, my biggest proponent and believer, even when I lose hope.
I heard this story on NPR this morning.
http://www.npr.org/templates/story/story.php?storyId=130342901
I think it's right on!
Thank you for your wonderful blog!
Erin
http://mysteriesinternal.blogspot.com/
We also owe gratitude to the many families who participated in this study. They will remain anonymous, but their legacy will live on.
This seems very encouraging. However, I think it will be interesting to see how these kids do further down the road. Does the fact that they haven't relapsed within a year mean that they will stay well once they are no longer living with their parents and knowing that they are going to be "forced" to eat.
As a 23-year old who struggled with anorexia as a preteen and teen i am skeptical. Throughout middle school and high school, my parents tried to make me eat and in many ways that is what kept me from fully recovering. It was when i moved away from home for college that i finally took responsibility for eating into my own hands and recovered fully.
I know a lot of these kids--or kids like them, anyway. And they do just fine down the road.
The parental control of eating is a temporary part of the process. In Phase 2 of FBT, the teenager takes control of her eating once more. By the time she's leaving home, she's been independently eating for some time, and doing it well. And when you're well-nourished, the urge to restrict typically doesn't come back.
But in my experience the slightest restricting during recovery can lead to a relapse. Which is why it's so important for someone in recovery to eat all her fear foods and learn to do that without fear.
I am glad you're fully recovered. I really think it doesn't matter how anyone gets there, so long as they do.
Thanks for your response. It is good to hear that kids treated with Maudsley still do well later on. I find the FBT treatment really interesting. I first heard of it after one of my students parents (I teach 6th grade) asked if her daughter could eat lunch in my classroom and if i could watch her eat. This was a very interesting and challenging experience for me. I felt as though i wanted to educate this (I assumed) misinformed parent on eating disorders , without revealing my past. I wanted to tell her that her daughter wouldn't get better by being watched eat. Since then, i've been really interested in finding more out about FBT.
On one hand, i wonder if maybe i would have gotten well sooner had my parents been more on top of me to eat. On the other, i really couldn't IMAGINE that it would have worked for me (even though i come from a great, loving family) .
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