When to Add an Individual Therapist in FBT-Phase 1

Individual therapy in FBT

When I am working as the Family-Based Treatment (FBT) therapist for a teen in recovery, their parents will often ask whether the teen should also see a therapist individually. Unlike other therapy situations, in FBT there is no expectation that there is both an individual therapist and a family therapist. It’s there in the name: …

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What Parents of Teens with Eating Disorders Need to Understand About Diet Culture

What Parents Need to Know About Diet Culture

  Many parents experience guilt when their teen is diagnosed with an eating disorder. Nearly every parent can point to a time they themselves dieted, opted not to have a dessert they really wanted, expressed a preference toward thinness, or discouraged their child from keeping eating. You may have done things to try to keep …

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Externalizing an Eating Disorder: When, Why, and How Do You Do That and Who is “Ed” Anyway?

Externalizing an Eating Disorder [image description: drawing of a child reigning in a monster]

Externalizing an eating disorder is a therapeutic strategy that became more widely known through Jenni Schaefer’s book Life Without Ed, cowritten with her therapist Thom Rutledge. The book summarizes Jenni’s recovery from an eating disorder. Jenni describes how in her treatment she learned to personify the eating disorder as “Ed,” an abusive boyfriend. As explained in …

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How do I Parent My Teen During Family-Based Treatment? When to Set Limits

Parents doing FBT often struggle with “normal parenting concerns” and setting limits while doing FBT. They’re refeeding their teens at home, doing the hard work often done by professional staff at treatment centers, but they still have to parent. It’s exhausting. Their teens who have eating disorders are often experiencing the psychological and physical consequences …

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How We Set Recovery Weights

Recovery Weight [Image description: doctor scale]

If you have an eating disorder, or your child has one, there is a good chance that weight gain will be an essential part of the recovery process. This is true not just for people in objectively small bodies, but also for people in larger bodies who are diagnosed with Atypical Anorexia, a weight-biased diagnostic …

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Structuring Your Eating Disorder Recovery Environment

Structuring Your Eating Disorder Recovery Environment [Image description: hand visible writing in planner]

  Recovery is challenging! I am repeatedly moved and impressed by the courage of my patients as they work through recovery from an eating disorder. One strategy that can help support recovery is a careful ​structuring of one’s recovery environment. This applies to adults working individually in treatment as well as to families helping adolescents to recover. Most evidence-based …

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College, COVID, and Eating Disorders: What You Need to Know

College, COVID, and Eating Disorders [Image description: woman with mask in front of computer]

  As I’ve talked about in depth here, the transition to college away from home is challenging for most young adults. It is especially fraught for young adults with eating disorders. In that article I provided a College Readiness Checklist for students who are either considering their first move away from home after a history …

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Adjunctive Therapies to FBT: What are the Additional Therapies That May be Added to FBT? And When Should They Be Added?

Image Description: Paper in window that reads "Mindfulness" Adjunctive therapies that go alongside FBT for Eating Disorders

In a previous post, I have discussed who is typically on an FBT team. In its traditional manualized form, the core team is a therapist, a medical doctor, and the parents. The team can also include a registered dietitian nutritionist (to guide the parents) and may include a psychiatrist. It is not uncommon for medical …

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Online FBT in the Face of the COVID-19 Pandemic

FBT Telehealth Covid

As of March 2020, the advent of the COVID-19 pandemic is bringing dramatic changes to all aspects of our lives. One of the most significant impacts of social distancing is a change in the mode of delivery of psychological treatment. It appears that most outpatient therapists, dietitians, and medical doctors are moving entirely to telehealth sessions …

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With a Little Help From My Family: Who is FBT For?

Who Is FBT For?

  Family-Based Treatment (FBT) is the leading evidence-based treatment for adolescents with anorexia nervosa and bulimia nervosa. One of the common misbeliefs I hear is that it’s “only for kids or younger teens.” However, I think it has a much wider applicability. In fact, I would say that my FBT training has significantly improved my …

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