Family-Based Treatment (FBT) for Anorexia Nervosa
FBT for Anorexia Nervosa is a treatment modality based upon research and controlled trials completed at the Maudsley Hospital in London, Stanford University's Department of Psychiatry and Behavioral Sciences, Lucile Salter Packard Children's Hospital, and the University of Chicago Eating Disorders Program in the Department of Psychiatry and Behavioral Neuroscience. FBT is an intensive form of treatment, often used in higher levels of care such a partial hospitalization programs (PHP) or intensive outpatient programs (IOP).
In my practice, I treat adolescents age 12-17 using this treatment modality.
The Five Tenants of FBT
01.
The therapist holds an agnostic view of the cause of the illness
02.
The therapist takes a non-authoritarian stance in treatment
03.
Parents are empowered to bring about the recovery of their child
04.
The eating disorder is separated from the patient and externalized
05.
FBT utilizes a pragmatic approach to treatment, with the focus on the here and now
Treatment within this model sees parental/family involvement as vital, and unlike other forms of treatment, does not seek to place blame on an underlying cause for the eating disorder.
FBT is evidence-based and follows a structured manual. Families that participate in FBT can expect to be guided through three phases of treatment, outlined below.
Phases of FBT
FBT is completed in three phases. The therapist and family will meet on a weekly basis in beginning of treatment, decrease frequency as treatment progresses, with a goal of termination by the end of phase three.
Phase 1
Weight restoration. Parents are in full control of meals during this phase.
Phase 2
Returning control of eating to the adolescent
Phase 3
Addressing adolescent issues and treatment completion
References
Lock, J., & Le Grange, D. (2012). Treatment manual for anorexia nervosa: A family-based approach (2nd ed.). Guilford Press.
Rienecke, R.D., Le Grange, D. The five tenets of family-based treatment for adolescent eating disorders. J Eat Disord 10, 60 (2022). https://doi.org/10.1186/s40337-022-00585-y