How is family therapy for eating disorders going?

When psychological treatment is carried out on an eating disorder in girls and adolescents, it is essential to carry out therapeutic sessions with the family, since it is essential to obtain the support of their family to facilitate the recovery of the patients.

Family therapy for eating disorders (ED) can be a good solution treat these psychopathologies in adolescents due to the fact that the effects of this class of disorders are not limited to the person who suffers from them, but also tend to affect their family nucleus, so the TCA can lead to certain difficulties of coexistence.

Therefore, although the intervention is mainly focused on patients suffering from a certain type of ED, the support of their parents is important for a faster and stronger recovery, so there will also be greater likelihood of avoiding future relapses.

Then we will see What is this model of family psychotherapy applied to eating disorders?as well as its structure and objectives.

What is Family Therapy for Eating Disorders?

In younger patients with eating disorders, the most recent psychological treatment guidelines recommend the use of family therapy, the most popular being that known as “Family-Based Treatment” or FBT (Family-Based Therapy). which began to be developed by a team of professionals at Maudsley Hospital in London in the 1990s, being a therapy that requires the work of a multidisciplinary health team, which includes a psychologist and/or psychiatrist, medical and nursing staff and a nutrition specialist.

This model of therapy is based on that parental involvement and support during treatment is essential for the therapy to work and the patient can successfully overcome the eating disorder. In addition, another of the objectives during the sessions is to strengthen the resources of the patient’s parents in order to support their daughter in the change towards a healthy lifestyle and a relationship to healthy eating, in order to avoid having to resort to ‘hospitalization.

It should be noted that it is very important that parents learn to separate the eating disorder from their daughter’s identity, so that said disorder is externalized and they do not blame their daughter for the way she behaves towards her. -to diet and physical appearance.

FBT is a therapy model that has shown good results with two-thirds of parents and adolescents accepting this treatment, achieve complete remission of the eating disorder in 40% of caseshaving relapsed in the rest, which does not mean that all is lost, since there is always the possibility of trying again or resorting to another model of psychotherapy, such as cognitive-behavioral therapy applied to eating disorders

Among the reasons for the failure of this modality of therapy are the following: the lack of support in the treatment from the parents and their lack of availability to accompany their daughter to the therapy sessions.

Objectives and techniques used in this psychotherapy

For family therapy for eating disorders to work, it is important to keep the treatment goals in mind at all times and for the psychotherapist to use a series of techniques that facilitate their achievement.

1. Goals of Family Therapy for Eating Disorders

The fundamental objective of this therapy is, in addition to achieving healthy eating habits and a healthy weight, to foster positive communication models between parents and their daughter, so that they help their daughter achieve the goals of therapy, feeling supported and understood by his Parents.

In turn, they must be worked skill strategies that allow emotional regulation in the face of situations that generate frustration and distress in the patient To do this, they must be taught to express their emotions appropriately and this is done by expressing their feelings and ideas more clearly. So her parents will be able to better understand what is happening to their daughter and, at the same time, she will feel better understood.

Clear interpersonal boundaries must be established between family members, supporting the parents and also promoting the autonomy of their daughter in cases where it is necessary for her to have a little more freedom.

In addition, together with the parents and their daughter, they must look for the advantages and disadvantages that could have solutions to the problems that could be in the family. For this it is important analyze how problems are perceived by each member of the family and thus be able to work on an individual style of constructive adaptation to these problems.

It is important to set realistic goals for family therapy and to establish step by step how to approach the problems and find the corresponding solutions.

As in any form of psychological therapy, it is very important to establish a good alliance with all the members who participate in it, in order to develop a therapeutic environment that facilitates the process of improvement. In this environment, the family must strengthen a structure of mutual support among its members to face the treatment together in order to carry out the therapy, as well as any type of problem that may arise in the future.

It is essential that family therapy for eating disorders be performed by a psychotherapist specialized in systemic or family therapies so that the treatment can be developed properly.

2. Intervention techniques most used by psychologists in this type of therapy

One of the techniques most used in this family therapy is active listening by the therapist, in order to facilitate understanding and to take an interest in the patient and her parents, so that they feel understood by the psychologist.

The psychologist must encourage the patient to recognize her personality traits and the factors that hinder the recovery process.

It is important to work on learning the expressions of support between parents and their daughter through behavioral tests which must be explained in detail by the psychologist beforehand, using techniques of modelling, repeated practice, feedback and of generalization.

Family therapy for eating disorders is a structured treatment whose sessions have already been planned in advance and therefore the sessions and steps planned in advance must be completed, so there is no room for improvisation.

Phases of Family Therapy for Eating Disorders

This therapy has an approximate duration between 6 and 12 months, depending on the severity of the symptoms, as well as the response to treatment, among other factors and; on the other hand, it is structured in 3 phases, which are divided between 10 to 20 sessions, according to the needs of each particular case. Pudiendo alargarse in some cases where it was necessary.

1. Full Parental Controls

This is the first phase of family therapy for eating disorders it consists of the first 10 sessions, which take place at the frequency of 1 session per week.

The main objective of this phase is to provide the necessary support to the parents of the young woman with an eating disorder so that they promote the re-establishment of correct and healthy eating habits in their daughter, as well as a healthy weight, especially when he has anorexia nervosa and his weight is much lower than it should be for his height.

Throughout the psychotherapy process, you must also work with any emotional aspects that may be causing the patient discomfort (eg symptoms of anxiety, depression, addictive behaviors, etc.).

2. Gradual return of control to the adolescent

This phase covers the following 6 sessions, which take place with a frequency of 1 session every 15 days, after completing the first phase, from the moment when eating habits and weight are practically normalized within margins that could be considered healthy.

Throughout this phase you should try to reduce the need for parental supervision, and it is the daughter who should gradually take responsibility for maintaining a correct feeding style.

3. Establish healthy independence

This third phase generally lasts 3 or 4 sessions, at the rate of 1 session per month or every 3 weeks, and begins when eating habits and weight have normalized, without risk to the patient’s health.

In recent sessions the therapy will focus on the psychological aspects related to the construction of the patient’s identity.

Likewise, during this phase, the family must also be supported in their process of adapting to the life cycle crisis which could mean having to adapt to the demands of your adolescent daughter to have greater independence, always within limits. reasonable.

Family Therapy Modules for Eating Disorders at Maudsley Hospital

This family therapy model is made up of four modules, each of which is prepared to achieve different goals.

1. Proper power supply relearn module

In this module, the restoration of a healthy eating style is soughtfocused on a varied and balanced diet, understanding the pleasant and social aspects of food for people.

2. Rehabilitation module

Here we mainly work with the erroneous cognitive biases that patients usually have regarding food, body image, self-image, etc.

3. Module for the emotional reward system

In this module, the main objective is to search for the patient the balance of the avoidance approach emotional system.

4. Psychoeducation module

Psychoeducation and teaching of communication skills are carried out, the patient being accompanied by her parents, with the aim of avoiding confrontation of the patient and thus helping to alleviate the psychological discomfort from which she suffers.

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