We held a Q&A webinar with eating disorder therapist John Levitt, Ph.D. on May 5, 2019. Here are some important questions he answered for us.
1. Do you have any advice about FBT for eating disorders?
Answer recap: FBT (family therapy) is one of the evidence-based therapies available for eating disorders. It’s effective for a certain group of patients. Its primary outcome is to cause weight gain.
2. Should I send my child to residential treatment for an eating disorder?
Answer recap: The purpose of a program is to stabilize and refeed to manage the critical side effects of an eating disorder. I’m concerned about sending a child away from their family and recommend asking: how is the family involved, and how does the family sustain recovery when they return home? Often a local treatment program can achieve the same goals.
3. What should I do if my child is in treatment for an eating disorder and the behaviors aren’t stopping?
Answer recap: If your child is in a treatment center and their behaviors aren’t stopping, it’s important to understand why that is. Ask questions, and understand the goals and treatment plan.
4. Parents are doing their best, why isn’t child recovering from their eating disorder?
Answer recap: Your child not recovering doesn’t mean you’re doing anything wrong. Most people recover from an eating disorder, but it can take time. Recovery depends on many factors, including how long they have had the eating disorder. It’s OK to sit down with the therapist and ask how treatment is going. You should have some sort of treatment plan to guide the process.
5. What is evidence based treatment for an eating disorder?
Answer recap: Evidence-based treatments have been tested with group studies in which there have been random assignments to different treatment types. Certain therapies have been statistically proven to be more effective. It’s important to ask the therapist or treatment center what it means to use “evidence-based” treatment and how do they use it?
6. Why, if the eating disorder behaviors are under control, does my child still need therapy?
Answer recap: When someone recovers from an eating disorder, they may still have trauma symptoms, anxiety, depression, self-harm, and other residual symptoms that existed in addition to the eating disorder. These conditions and symptoms can be a good reason to continue therapy beyond eating disorder treatment.
7. If my child has trauma and an eating disorder, will an eating disorder treatment center treat both?
Answer recap: If possible, find an integrated treatment approach that addresses eating disorders and other challenges like trauma, self-harm, etc. Be sure to ask your treatment team or therapist whether they are using an integrated approach.
8. How do I find a good therapist for my child who has an eating disorder?
Answer recap: Ask a lot of questions! The therapist is a guide, and it’s their job to facilitate recovery with the child and the parents. We should be available to answer parents’ questions. If your child is not responding to treatment, it’s not always because the therapist isn’t “good,” but it is important to talk to the therapist about the treatment plan and that they can communicate with you and your child.
9. Our therapist told me to be patient with my child who has an eating disorder – what does that mean?
Answer recap: I’d ask “what does ‘patient’ mean?” and try to find out what the therapist is asking for. Yes, treatment takes time, but you should see some results. If your child is medically compromised, you don’t have time to be patient. But if you’re talking about therapy, it’s a process. It does take time. Ask what you should be doing while you’re “being patient.”
10. My child’s in treatment for an eating disorder, what should I be doing?
Answer recap: Ask your child’s therapist! You should receive suggestions from the program or therapist regarding what they think will be helpful. Your outpatient therapist should regularly give you recommendations about what to do. I suggest parents provide support, love the child, supervise the food, weight, eating, and be mindful of purging. If the child is at a more acute stage of eating disorder behavior, parents may need to be more active in preventing the behaviors.