Some More of God’s Greatest Mistakes

Enjoy your holidays!! Will miss your posts!
xxx

from Dr. Joy Jacobs web site:

http://www.eatingdisordersblogs.com/one_more_bite/2008/12/the-gift-of-fbt.html

December 24, 2008
The Gift of FBT

Thanks to “runforjoy” for taking a turn at bat:

I am now 21 and have spoken with several other young adults who wish our parents could have used FBT. I was wondering if you have any experience using FBT with older patients. I’m also curious how families that used FBT help their children maintain recovery. What level of vigilance/control do they maintain when a child goes to/comes home from college?
Great questions! I have used FBT with young adults who agreed to move home to live with their families in order to recover. In fact, some of these cases have been among the most successful recoveries I have witnessed.

Once undertaken, FBT requires similar levels of parental involvement, regardless of the age of the “child.” FBT can be slightly more complicated with older children since both legally and in terms of life experience, young adults can (for the most part) come and go freely and cut off the treatment at any time (especially when the eating gets hard or feels overwhelming). Younger children typically do not have the legal, financial, and other means to escape treatment in the same way that young adults do.

I personally like to address these and similar potential barriers at the very start of treatment by having the family collaboratively develop “ground rules” about how these issues will be handled if they do arise. Doing this from the very start of treatment not only allows everyone to start getting prepared for the challenge ahead, but also contributes toward addressing ambivalence about pursuing this path and developing concrete plans about how to incorporate the treatment into the young adult’s and family’s life—a life that is going to look radically different from the current day-to-day of all involved and will maximize the chances of successful recovery.

In my experience, FBT with young adults tends to be most effective when the young adult is clear that recovery no matter what is the primary goal. At this point, the costs of the eating disorder have become so high (in terms of health, social life, education, career) that treatment compliance tends to be higher.

Runforjoy, I too wish for you that FBT would have been available to your family at the time you needed it. I work with many teens who—without the benefit of experience– resent the treatment; it will be so helpful for them to hear from someone only slightly older, who has been there, that this treatment can be a gift, not a punishment.

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Thank you so much for responding to my questions! It is great that FBT can be so successful with older patients as well. Though I’m sure I wouldn’t have appreciated it at the time, to see that my family was willing to change their entire day-to-day life (and it would have been drastic!) would have reinforced how much they cared for me, at a time when I was feeling incredibly unlovable and lonely. I also feel like the ability to get mad at them and even resent treatment might have been better than holding all my emotions inside out of fear of hurting or scaring them. Though my parents never did FBT, they were involved in a family group during my last treatment, and seeing their willingness to come and try to make changes showed me that they cared much more than I had ever thought. I hope teens whose parents use FBT will eventually be able to thank their parents. This week, In a group session with other college students, we all spoke about whether we had a harder time staying in recovery at school or at home, and each of our answers seemed to depend on our level of accountability at each place. For me, it is much easier to stay in recovery at school, where I eat regular meals everyday with a certain group of friends. If I don’t show up to a meal, friends (some who know I’ve struggled with an ED) will ask me what is going on. At home, this accountability and expectation does not exist and it is harder to justify preparing and eating a meal when no one else is. For others in the group who have little support at school, it is much easier to be in recovery at home, where parents prepare regular meals and will ensure they are eating. We talked about how we all desired to feel cared for in the way that someone was “watching out” for us. I agree that FBT can be a wonderful gift of life, even if unappreciated at the time.

Posted by: runforjoy | December 25, 2008 at 06:51 PM