Preparing for your child’s return from residential eating disorder treatment

The return from residential eating disorder treatment can be a hard thing for parents. When you enrolled your child in treatment, they were probably physically and emotionally at a low point. You probably spent significant time making the decision to send them to treatment and agonized over the details. And the weeks or even months apart have probably been intensely stressful for you and your child as well. So while there is relief and hope when they come home, there’s also trepidation and worry that treatment won’t stick.

This guide is designed to help you prepare for the reality of your child’s return from residential eating disorder treatment. For most families, this stage of recovery requires a tremendous amount of effort. But the payoff can also be tremendous. 

You can approach eating disorder recovery much as you would any other serious health rehabilitation and recovery. Don’t underestimate what is involved, but also don’t be afraid. I am 100% confident that you have what it taks to support your child’s recovery from an eating disorder. Here are some ways you can prepare for your child’s return from eating disorder residential treatment.

Education

Become educated about eating disorders, their causes, symptoms, and recovery. Imagine if your child had cancer. You would learn about their cancer, become informed about symptoms and treatment, and be engaged in recovery tasks. 

Your education about eating disorders is even more important than if your child had cancer because of two things. First, there is tremendous stigma and misunderstanding about eating disorders. You need to uncover your own biases and misunderstandings to support your child’s recovery. Second, treatment for cancer is based on vast evidence and clinical trials. Unfortunately, eating disorders suffer from a deep lack of funding and knowledge. This makes your education more important than for almost any other type of illness. 

Parents need a lot of knowledge and new skills to support eating disorder recovery. If your child returns to the exact same home and family dynamics in which their eating disorder developed, they are very likely to relapse right back into their eating disorder when they come home. 

Reasonable expectations

The hard truth is that your child will still need a lot of ongoing support and treatment when they return from a treatment program.

You should be prepared for a minimum recovery time of 6-12 months. Under the best circumstances, that’s how long it takes for a person to fully recover psychologically and physically from an eating disorder. This recovery period will be challenging, and your child will need your family’s support. During early recovery, it is easier to return to eating disorder behaviors than to abstain from using them. They will need your constant, confident support. 

Imagine your child had a stroke and is now living with you. They’ve returned home from hospitalization or rehab, but they still need daily support to get to and from physical therapy appointments. They need mobility aids, and you may need to learn new ways of communicating with them while they regain skills, mobility, language, and more post-stroke. 

You can’t anticipate everything about what recovery will entail, but you know that your life will continue to be disrupted. Eating disorders require a long recovery with ongoing care and new skills to support the reality that early recovery is harder than relapse. Luckily, full recovery is completely possible and gets easier over time and with the right support.

Structure

Residential treatment is highly structured. From sleeping to eating and activities, everything is planned out in advance. Even free time is scheduled. This is because any stress and chaos increase eating disorder urges and behaviors. And the return home after residential eating disorder treatment will be a major stressor. Therefore, you want to minimize stress and chaos by having a good schedule in place. 

While you may be relieved to have your child home and they may want to have freedom and little oversight, a lack of scheduled eating and activities will likely make recovery harder. It’s best if you have a firm schedule at least for the first 30 days after they return home and then taper off as long as recovery stays on track. Most people are doing some form of ongoing outpatient treatment, so this may take up several hours of their day. But avoid being too flexible with the remainder of the day.

Remember: they will not come home wholly recovered and will need your ongoing support. Structure is a big part of that. 

At a minimum, they should have structured meal times for three meals and three snacks daily. These should be planned times that your child can eat with at least one other person who will uphold the expectation that they eat. It’s best if you replicate treatment by planning, preparing, and serving all meals at a structured time and – importantly – expecting your child to eat every 2-4 hours without fail.

Empathy

Eating disorder recovery is hard on everyone. It’s hard on the person going through it, and it’s hard on every family member. So it’s essential to have an intentional empathy practice. This means understanding that everyone is trying their best and is not intentionally being difficult. 

Practicing empathy is not easy in the best of times. Most of us subconsciously assume that when people frustrate or hurt us that they are doing it on purpose or have ill intentions. But most of the time when people frustrate or hurt us, it’s because they are having a hard time. And this is almost always the case with our kids.

Kids are biologically driven to seek care and attention from their parents. One of the key ways they do this is with behavior. They act out so we know they’re having a hard time within. When your child does something “bad,” they are showing you they feel really, really bad. 

Empathy means you realize this and try to respond from a place of calm curiosity rather than defensiveness and criticism. One way to do this is to remember, no matter what your child is doing at the moment, that they are “good inside” and worthy of your love and affection.

Importantly, self-criticism (a lack of empathy) is a significant cause and symptom of an eating disorder. Your ability to practice empathy with your child will model for them how to have empathy for themselves.

Relationships

Eating disorders are complex because they are “biopsychosocial” disorders. This means they combine biological, psychological, and social influences. Most eating disorder treatment focuses primarily on the biological and psychological drivers. But social factors, especially your child’s relationship with you and others in your family, are critical. 

An eating disorder is not your fault. It’s not your child’s fault. But it’s also true that you have tremendous influence over your child’s psychology and environment. Parents matter a lot. Don’t lose sight of the fact that while your child has an eating disorder, everyone needs to “recover” by increasing mental health and learning new ways of communicating and relating to each other. 

Focus on building your relational skills and deepening your relationship with your child. Learn active listening skills and emotion coaching. How well you learn and grow as a parent in the next 6-12 months will impact how well your family functions far into the future. 

See Our Eating Disorder Treatment Guide For Parents